Blood donor deferral for men who have sex with men: still
room to move
Bridget Haire , Kate Whitford, and John M. Kaldor
Like a number of other countries,
Australia mandates that a man who has had sex with
men is deferred from donation until 12 months has
elapsed since the sexual activity. This review examined
whether this deferral period is justified by current
STUDY DESIGN AND METHODS:
(Medline, EMBASE, Scopus) were searched using terms
“blood donation” and “gay” or “MSM” and “HIV risk” from
the mid-1980s to the present to investigate the history of
donor deferral policy and its rationale in Australia.
Gay and bisexual men in Australia face a
higher risk of human immunodeficiency virus and other
blood-borne viruses (BBVs) than other populations. All
blood donations, however, are tested for BBVs, and with
current testing technologies the window period during
which infection may be present but not detected is now
less than 1 week. While there is a moral imperative to
maintain blood safety, there is also a moral imperative to
ensure that differential treatment of population groups
with regard to donation eligibility is scientifically justified.
Potential social harms that may flow from a dissonance
between deferral policy and its evidence base include
loss of trust and increased nonadherence to policy.
A 12-month deferral for gay and
bisexual men exceeds what is required to maintain blood
safety. This disparity potentially causes social harm
without any additional benefit to public health. Reducing
the deferral period to 3 months will not increase health
risk to recipients and may have the social benefit of
n the days after a man with an assault rifle attacked
patrons of a night club popular with the gay commu-
nity in Orlando in June 2016, many concerned com-
munity members who volunteered to donate blood
found that they were ineligible because they had had
male-to-male sex within the past 12 months.
prompted renewed calls to overturn the so-called “ban”
that has limited the ability of men who have sex with men
(MSM) to contribute to the blood supply. The US Food
and Drug Administration (FDA) had recently overhauled
its policy, replacing the decades-old permanent exclusion
of any man who had had sex with another man since
1977, with a deferral of 12 months since last sex.
icy change followed a number of other high-income coun-
tries that made similar shifts over the past 15 years. It can
be portrayed as a major victory for those who have argued
the case for change, but is it a real change, and does it go
as far as it could in responding to the multiple imperatives
that determine decisions about eligibility for blood
In the United Kingdom a technical committee has rec-
ommended far more sweeping changes, including a reduc-
tion in the deferral period to 3 months since the last male-
to-male sex (implemented from 28 November 2017).
recent call for comment on the new US policy suggests
ABBREVIATIONS: BBV(s) 5 blood-borne virus(-es); MSM 5
men who have sex with men; TGA 5 Therapeutic Goods
From the Kirby Institute, University of New South Wales,
Sydney, NSW, Australia.
Address reprint requests to: Bridget Haire, Kirby Institute,
Level 6, Wallace Wurth Building, University of NSW, Kensing-
ton, NSW 2052, Australia; e-mail: email@example.com.
Both BH and JMK are supported by research grants from Austral-
ia’s National Health and Medical Research Council (NHMRC).
Received for publication March 28, 2017; revision received
November 4, 2017; and accepted November 11, 2017.
816 TRANSFUSION Volume 58, March 2018