White glove clad hands insert a needle in a person lying in a black chair. Only the blood donor's arm is visible.
Blood drive. Photo: Nguyễn Hiệp/Unsplash

Health Canada has given Canadian Blood Services the green light to end the three-month donor deferral period in place for sexually active men who have sex with men.

Instead of a blanket ban, the policy change means Canadian Blood Services will focus on sexual behaviour associated with a higher risk of infection. When implemented later this year, the new criteria means all blood donors will be screened for high-risk sexual behaviours, regardless of their gender or sexuality.

The new screening approach will include a questionnaire about sexual behaviours applicable to all blood and plasma donors.

“Today’s approval from Health Canada is the result of over a decade of work to make participation in Canada’s Lifeline as inclusive as possible, without compromising the safety of biological products or the security of supply,” Dr. Graham Sher, CEO of Canadian Blood Services, said in a news release.

“Numerous 2SLGBTQIA+ and other stakeholder groups, researchers and Canadian Blood Services employees have contributed countless hours to this effort over the years. This could not have happened without their hard work.”

Canadian Blood Services said the change will bring an end to men being asked if they’ve had sex with another man during the pre-screening process.

Under the new criteria, all donors will be asked if they’ve had new or multiple sexual partners in the last three months. If they answer yes to either question, they’ll be asked if they’ve had anal sex with any of those partners. If so, they’ll be required to wait three months from when they last had anal sex with any of those partners.

Canadian Blood Services expects to introduce the new sexual behaviour-based screening criteria by September 30 of this year.

The national blood donor organization is now working on implementing the new criteria, including system and process updates and what it described as “robust” employee training.

“While this eligibility change represents a significant step on our continual journey to build a more diverse, equitable and inclusive national transfusion and transplantation system, we still have considerable work to do to build trust and repair relationships with 2SLGBTQIA+ communities,” Sher said.

In response to a Canadian Blood Services tweet sharing the news of Health Canada’s approval, one person tweeted “Finally!!! So many of my friends could have helped save lives but this embarrassing, archaic rule was sticking around. Thank you Canadian Blood Services for pushing this to Health Canada.”

Twitter

In a media release issued Thursday, Health Canada said its authorization was based on a “thorough assessment of evidence supporting the safety of the revised donor screening.” It convened a group of medical and scientific experts on blood safety to seek input.

“Today’s authorization is a significant milestone toward a more inclusive blood donation system nationwide, and builds on progress in scientific evidence made in recent years,” Health Canada’s news release said.

“Over the past decade, Health Canada has authorized several changes to the donor deferral period for men who have sex with men, from a lifetime restriction to five years in 2013, to one year in 2016 and to three months in 2019.”

UPDATE:

In a media release Thurday afternoon, the AIDS Coalition of Nova Scotia said while the announcement is “cause for joy,” more work needs to be done federally and provincially.

“The blood ban was never based on science, and that decades-old decision pandered to a misinformed public perception – and reinforced that misinformed public perception,” Chris Aucoin, the coalition’s executive director said in the release.

“Instead of celebrating this moment in Canadian history, I’m simply left saying ‘it’s about time.’”

The coalition wrote that when Canadian Blood Services requested the policy change last December, it was made clear that sexual behaviour, not orientation, has more to do with passing on sexually transmitted and blood-borne Infections (STBBIs) and HIV.

Aucoin said the decision not to act sooner on the blood ban contributed to a fear of HIV testing and likely to rising HIV rates in Canada.

“The blood ban was based on unfounded fear and stigma–and has reinforced unfounded fear and stigma – which has doubtless fueled new infections, not prevented them,” Aucoin said.

“That fear and stigma has discouraged HIV testing, and we have decades of international evidence showing that catching and treating HIV early is the surest way to prevent future infections.”

The coalition reiterated that diagnosed HIV positive people who are on effective treatment and maintain a very low undetectable viral load are 100% medically unable to be the source of infection to others through sexual transmission.

“There’s still a long way to go. We need national pharmacare, for many reasons – but also so people have access to PrEP – the medication to prevent HIV – without a cost barrier,” Aucoin said.

“We need much better STI testing infrastructure in Nova Scotia for everyone, and more funding for grassroots organizations to educate the public about the current realities of HIV and other STBBIs. The governments – at both the provincial and federal levels – still have a lot of work to do.”


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Yvette d'Entremont

Yvette d’Entremont is a bilingual (English/French) journalist and editor, covering the COVID-19 pandemic and health issues. Twitter @ydentremont

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