Current Issues
Deferral of Men who have Sex with Men from Blood Donation
The permanent exclusion of men who have sex with men (MSM) from donating blood has changed to a 12 month fixed period deferral from the latest relevant sexual contact in November 2011 following an evidence based review by the Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO).
SaBTO is responsible for regularly reviewing the major criteria for accepting blood donors and for recommendations to the four UK Health Ministers on blood donation policy.
SaBTO completed a review of blood donor selection criteria related to sexual behaviour in May 2011. Following this review, and based on recommendations from SaBTO, Health Ministers in England, Scotland and Wales announced in September 2011 that the blood donor selection criteria for men who have sex with men in those would change.
Previously, men who had ever had oral or anal sex with another man, even if a condom was used, were permanently excluded from blood donation in the UK. The change means that in future only men who have had anal or oral sex with another man in the past 12 months, with or without a condom, are asked not to donate blood. Men whose last sexual contact with another man was more than 12 months ago are eligible to donate, subject to meeting the other donor selection criteria.
NHS Blood and Transplant (NHSBT) implemented the change at blood donation sessions across England and North Wales on 7 November 2011. The Scottish and Welsh Blood Services also implemented the change on this date.
At blood donation sessions, all donors are asked to complete a questionnaire called the donor health check, to assess whether they meet the donor selection criteria. This is to ensure that the supply of blood to hospitals is as safe as possible.
NHSBT welcomes the review and the resulting change as it is supported by the most up to date scientific evidence. SaBTO's review concluded that the safety of the blood supply would not be affected by the change and we would like to reassure patients receiving transfusions that the blood supply is as safe as it reasonably can be and amongst the safest in the world.
NHSBT has a clear responsibility to minimise the risk of any blood transfusion transmitting an infection. Blood donor selection criteria and a wide range of other blood safety measures, including stringent testing, mean there has been no documented transmission of a blood-borne virus in the UK since 2005, with no HIV transmission since 2002.
Clearly any transmission would be one too many and the purpose of blood donor selection criteria, alongside other safety measures, is to minimise any potential harm to recipients of blood donations. All groups that are excluded or deferred from blood donation have been assessed as being at a statistically increased risk of carrying blood-borne viruses. For more information on all blood donor selection criteria and other blood safety measures click here.
The change brings the criteria for men who have sex with men in line with those for the majority of other groups that are deferred from blood donation for 12 months due to the risks of infection associated with sexual behaviours. We appreciate that it can be disappointing for anyone who wishes to donate blood but is not able to meet the donor selection criteria. The criteria are based on complex assessments of risk and must by their nature be based on evidence and statistics that are recorded at a population level. Such an approach results in assessments of certain groups as being at a higher risk than others of carrying blood borne infections, and can make individuals that are deferred from donation feel they are being placed into a 'category' even if they believe their own sexual behaviour and risk-taking would not be a risk to the blood supply.
Although some would prefer a system that assesses every individual's behaviour and level of risk rather than applying deferrals to groups, SaBTO's review concluded that there is insufficient evidence available to be able to determine the impact on blood safety of such a system. It is also not certain that all people could objectively assess their own level of risk. Based on published data, the review also concluded that the introduction of extensive donor questions regarding sexual behaviour could lead to a loss of existing donors who may find the process intrusive. The Blood Services are therefore required to follow deferral rules that estimate the statistical risk of certain groups based on behaviour. We are sorry for any inadvertent offence this may cause.
Blood donation works on the principles of kindness and mutual trust and we ask all potential and existing donors to adhere to the blood donor selection criteria by providing completely honest answers to all the questions asked, both for the protection of their own health and that of others. Donor selection criteria that are proportionate and based purely on evidence are necessary to help ensure that donors comply with the health check process. Compliance with all donor selection criteria is crucial in order to ensure the continued safety of the blood supply. Anyone may require a blood transfusion in the future and it is in the best interests of us all to ensure that we strive to maintain blood safety.
November 2011