December 6, 2021 – The end of Canada’s ban on gay and bisexual men donating blood for sexual orientation alone could soon be a thing of the past.

Canadian Blood Services (CBS) plans to require Health Canada to screen potential blood donors based on higher risk sexual behaviors, rather than gender or sexuality. The approach is similar to that already being used in many other countries and is also suggested by proponents in the US.

The request for change is’ ‘imminent, “says CBS spokeswoman Catherine Lewis, who expects the request to be completed before the end of the year. Health Canada, the federal department responsible for Canadians’ national public health, must agree” If it does If it were approved, we would try to make it fit for purpose, “says Lewis.” It would probably take us several months to make system changes and train the staff. “

The Canadian proposal follows a similar change in approach in the UK. On World Blood Donation Day, June 14th, the National Health Service Blood and Transplant introduced a new policy whereby eligibility to donate is based on a more personal assessment rather than a risk associated with a population or group. Today, shifts are based on behaviors known to put a higher risk of sexual infection.

After British policy changed, a perspective published this year in the New England Journal of Medicine suggested that the US should follow suit.

“We believe that this updated guideline should serve as a call to the Food and Drug Administration (FDA) to re-evaluate and revise its own guidelines for the postponement of potential blood donors,” the authors wrote.

According to current guidelines, men are given a 3-month grace period after the last sexual encounter with another man. While men who have sex with men have a higher prevalence of HIV than others in the population, guidelines in the US do not take into account individual behaviors, the authors wrote, including those of other groups that can be just as risky.

US guidelines even exclude gay and bisexual men who are at low risk of developing sexually transmitted infections – such as monogamous married gay men – while not deferring others who engage in high-risk practices.

British politics are following the example of France, Argentina and Brazil, wrote the authors of the perspective. These countries have individual ratings or no restrictions, they said.

Details on the new approach

Change in Canada is welcomed by many, including Nathan Lachowsky, PhD, Associate Professor of Public Health and Social Policy at the University of Victoria. He and others have campaigned for the removal of the MSM-specific ban (men who have sex with men) for over a decade, ”he says.

Currently in Canada, men who have sex with men can donate if it has been more than 3 months since they last had sexual contact with a man.

If the move to behavioral screening is approved, Lachowsky said, “they will be asked new questions during the screening process.”

While Lewis says these questions will be released shortly, Lachowsky will be expected to ask about details such as relationship status, number of partners, new partners, and types of sexual practices.

Aside from ending what Lachowsky and others view as discrimination, “we expect this change to result in a number of new donors donating blood.”

This expected increase in the donor pool would include not only gay and bisexual men, “but also others who have stayed away from donating because of existing discrimination.”

In his research, Lachowsky found that gay and bisexual men are willing to donate blood if they are deemed eligible. When he interviewed 39 men, most said they were low-risk, willing donors, and that they would “gain satisfaction and civic pride from donation.”

Some cited feelings of discrimination by the current Politics.

US policy change effort

In the US, the latest FDA guideline calls for three months of sexual abstinence before donating blood for all men who have sex with men. The policy applies to men who are married to other men as well as to two men in a mutually monogamous relationship. A woman who has had sex with a man in the past 3 months who has had sex with another man in the past 3 months is also not eligible to donate.

But an FDA study is underway to see if assessing personal risk, rather than mandating a blanket deferral, will keep the country’s blood supply just as secure. The ADVANCE study (Assessing Donor Variability and New Concepts in Eligibility) aims to enroll 2,000 men in eight study locations.

However, enrollment has been slower than expected, in part due to COVID-19 restrictions that are limiting ways to reach volunteers at community events, says Brian Custer, PhD, the study’s lead researcher and vice president of research and science programs at Vitalant. Research institute. With events like PRIDE and other social events being canceled, it was more difficult to find people for the study, he says.

However, the study is expected to be completed by mid-2022, says Custer. No early analyzes have been completed yet.

Andrew Goldstein, PhD, Associate Professor of Molecular, Cellular and Developmental Biology and Urology at UCLA who is participating in the ADVANCE study, says, “ The current guidelines are discriminatory and hurtful. “So it’s frustrating that healthy donors are turned away because of an outdated rule.”

Meet a need

Lifting the restrictions would mean more blood donors at a time when blood supplies are extremely scarce. On November 26th, Blood Services Canada called for donors and said it needed 38,000 appointments by Jan 4th to maintain the inventory.

According to the American Red Cross, there is still a severe lack of blood in the USA. In late October, the Red Cross announced that donor turnout had reached its lowest level for the year, and that September and October had the lowest national blood inventory levels in more than a decade.

Lewis will update once they send the request … with information on questions, etc.


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