Male to male sex and blood donation
Here at the Australian Red Cross Blood Service we wish everyone could donate blood. But, for the safety and wellbeing of blood donors and the patients who receive donations, around a third of all Australians aren’t eligible.
One thing we’re often asked about is why men who have sex with men must wait 12 months before donating.
We realise that this restriction can be frustrating – it is for us too. I assure you that the Blood Service doesn’t discriminate based on sexual orientation, and that this rule is strictly for the medical reasons explained below.
In the future, advances in medicine may let us change this. For now, I hope this information gives you some insight into why this restriction is necessary and what we’re doing about it.
Thank you for your understanding,
What is the Blood Service policy regarding blood donation for men who have sex with men?
Men who have sex with men are not eligible to donate blood for 12 months since their last sexual contact with a man.
Is the Blood Service being discriminatory in not allowing gay men to donate?
Our policy considers an assessment of risk, and does not discriminate against anyone based on their sexuality. Deferrals are in place for any number of potential donors who may be more likely to be exposed to infection or present other risks to patients.
The Australian Human Rights and Equal Opportunity Commission has visited this issue, and agrees that the Blood Service is not being discriminatory with our deferral policy for men who have sex with men.
I’m in an exclusive relationship, why can’t I donate blood?
We recognise that there are different levels of risk among men who have sex with men. The latest information from the Kirby Institute (University of NSW) states that HIV continues to be transmitted primarily through sexual contact between men. Even within declared monogamous relationships the risk is on average 50 times higher than in heterosexual couples.
Don’t you test blood for HIV?
Yes, the Blood Service tests every donation. However, even this sophisticated testing is unable to detect the early presence of infectious diseases such as HIV, hepatitis B, and hepatitis C. You might hear this referred to as a ‘window period’ – it’s a time when the infection is just starting and is not yet detectable. This is why we don’t rely on testing alone.
I disagree with you. Can’t I skip the question about men who have sex with men?
The donor questionnaire is a legal document that people must answer honestly. The rules around who can and can’t donate blood help to ensure that the blood supply in Australia is as safe as possible for patients.
Why can’t you ask more questions about behaviour to identify suitable donors?
Unfortunately more detailed questions about sexual practices are not practicable and will not change the scientific knowledge around the risk associated with men who have sex with men.
It’s been years since anyone was infected with HIV because of a blood donation. Surely it’s time to relax the rules?
Evidence shows that it is the deferral system, alongside improved testing for HIV and other blood-borne diseases, that has kept transfusion-transmitted infection rates as low as they are.
In the general population, men who have sex with men accounted for 90% of newly acquired HIV cases in Australia in 2014.
The rate of blood-borne infections amongst our donors is lower than the general population and this is because of our deferral systems.
How do you come to these decisions?
The deferral is based on research and international policy decisions. The Blood Service reviewed our policy on this recently and recommended to our regulator, the TGA, that men who have sex with men should be able to donate blood after a six month wait. Unfortunately the TGA, did not approve a reduction in the deferral period to six months.
What do they do in the rest of the world?
Australia is usually given as an example of one of the more liberal deferral policies although many countries are intending to, or have already moved from indefinite to time-limited deferrals. The US reduced their indefinite deferral policy to 12 months, in-line with ours, in 2015. Canada has a five year deferral period but also intends to implement a 12 month deferral. New Zealand recently reduced its five year deferral period to 12 months, and France has announced it will trial a phased approach which will see their whole blood deferral policy brought in-line with ours, followed by a 4 month deferral for plasma donation for those who engage in male to male sex with only one partner in the last 4 months. We will continue to monitor these developments closely.
Countries with no specific male to male sex deferral period include Chile, Italy, Mexico, Poland, Spain and Uruguay.
Shouldn’t I have the right to donate?
This is a common belief, however no one has the right to donate. Everyone has a right to receive (safe) blood, and our greatest concern is ensuring the safety of the blood supply. We defer people for many reasons, including ensuring the preservation of their own health.
Tell us what you think
Please share your thoughts on this policy here.