Canada Aims to End Ban on Blood Donations from Gay, Bisexual Men

Dec. 6, 2021 — The finish of Canada’s ban on homosexual and bisexual males from donating blood primarily based on sexual orientation alone could quickly be historical past.

Canadian Blood Services (CBS) plans to ask Health Canada to display potential blood donors primarily based on higher-risk sexual behaviors fairly than on gender or sexuality. The strategy is just like what’s already adopted in lots of different nations, and it’s one which advocates within the U.S. are additionally proposing.

The submission to request the change ”is imminent,” says CBS spokesperson Catherine Lewis, who expects the request to be finalized earlier than the tip of the yr. Health Canada, the federal division chargeable for the nationwide public well being of Canadians, must approve it. “If authorised, we might search to implement expediently,” Lewis says. “We’d seemingly want a number of months to make system modifications and practice workers.”

The Canadian proposal follows an identical change in strategy within the United Kingdom. On World Blood Donor Day, June 14, National Health Service Blood and Transplant launched a brand new coverage, with eligibility to donate primarily based on a extra private evaluation fairly than on a threat assigned to a inhabitants or group. Now, deferrals are primarily based on behaviors identified to hold the next threat of sexual an infection.

After the U.Okay. coverage change, a perspective printed this yr in The New England Journal of Medicine steered the united statesshould observe swimsuit.

“We imagine this up to date coverage ought to function a name to motion for the Food and Drug Administration (FDA) to reevaluate and rewrite its personal deferral insurance policies for potential blood donors,” the authors wrote.

Under present tips, a 3-month deferral interval is imposed on males after their final sexual encounter with one other man. While males who’ve intercourse with males do have the next prevalence of HIV than others within the inhabitants, the rules within the U.S. fail to think about particular person behaviors, the authors wrote, together with these of different teams that may be simply as dangerous.

The U.S. tips even exclude homosexual and bisexual males who keep a low threat of contracting sexually transmitted infections — akin to monogamous married homosexual males — whereas not deferring others who interact in high-risk practices.

The U.Okay. coverage follows the lead of France, Argentina, and Brazil, the attitude authors wrote. Those nations have particular person assessments or no restrictions, they stated.

New Approach Details

The shift in Canada is welcomed by many, together with Nathan Lachowsky, PhD, an affiliate professor of public well being and social coverage on the University of Victoria. He and others have been advocating for the ”elimination of the MSM (males who’ve intercourse with males) particular ban for over a decade,” he says.

Currently, in Canada, males who’ve intercourse with males are eligible to donate if it has been greater than 3 months since their final sexual contact with a person.

If the change to behavior-based screening is authorised, Lachowsky says, ”there will likely be new questions they’re requested throughout the screening course of.”

While Lewis says these questions will likely be launched quickly, Lachowsky says they’re anticipated to ask about particulars akin to relationship standing, the variety of companions, new companions, and forms of sexual practices.

Besides an finish to what Lachowsky and others view as discrimination, “we anticipate that this transformation will imply that there are a variety of recent donors to contribute blood.”

This anticipated improve within the donor pool, he says, would come with not solely homosexual and bisexual males, ”but in addition others who stayed away from donation due to the discrimination that was in place.”

In his analysis, Lachowsky has discovered that homosexual and bisexual males are prepared to donate blood if they’re deemed eligible. When he surveyed 39 males, most stated they had been low-risk, had been prepared donors, and would ”achieve satisfaction and civic delight from donation.”

Some cited emotions of discrimination from the present coverage.

U.S. Efforts to Change Policy

In the U.S., the newest FDA steering requires a 3-month sexual abstinence interval earlier than donating blood for all males who’ve intercourse with males. The coverage applies to males married to different males in addition to two males in a mutually monogamous relationship. A lady who has had intercourse throughout the previous 3 months with a person who has had intercourse with one other man previously 3 months can be not eligible to donate.

But an FDA research is underway to search out out if assessing private threat as a substitute of mandating a blanket deferral will hold the nation’s blood provide simply as secure. Called the ADVANCE Study (Assessing Donor Variability and New Concepts in Eligibility), its aim is to enroll 2,000 males at eight research areas.

But enrollment has been slower than anticipated, due partly to COVID-19 restrictions that restrict alternatives to achieve out at group occasions for volunteers, says Brian Custer, PhD, the principal investigator for the research and vp of analysis and scientific packages on the Vitalant Research Institute. With occasions akin to PRIDE and different social occasions canceled, it has been more durable to search out individuals to participate within the research, he says.

Yet the research continues to be as a consequence of be completed by mid-2022, Custer says. No early analyses have been accomplished but.

Andrew Goldstein, PhD, an affiliate professor of molecular, cell, and developmental biology and urology at UCLA, who’s participating within the ADVANCE Study, says: ”The present tips are discriminatory and hurtful.” There are important blood shortages, ”so it’s irritating that wholesome donors are turned away primarily based on an outdated rule.”

Filling a Need

Lifting the restrictions would imply extra blood donors at a time when blood provides are working extraordinarily low. On Nov. 26, Blood Services Canada issued a name for donors, saying it must fill 38,000 appointments by Jan. 4 to take care of stock.

In the U.S., a extreme blood scarcity continues, in keeping with the American Red Cross. In late October, the Red Cross stated that donor turnout had reached the bottom stage of the yr, and that September and October had the bottom nationwide blood stock ranges in additional than a decade.

Lewis will replace as quickly as they submit the request…with information on questions, and many others.