Sexual activity

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  • Australia has one of the safest blood supplies in the world – and the safety of our blood and plasma products for patients will always be our number one priority.
  • We acknowledge that gender-based sexual activity rules, whilst necessary to ensure a safe blood supply in the past, have contributed to the stigma faced by gay and bisexual men in Australia. We hear their pain and frustration at being excluded from something so many take for granted – being able to help their fellow human being with the simple yet life-giving act of donating blood or plasma.
  • Lifeblood wants change too and we want to propose donation options that allow as many people as possible to donate, including those with new or multiple partners and the tens of thousands taking PrEP1, an antiretroviral mediation to prevent HIV.
  • To this end, we have been working towards two approaches:
    • A ‘plasma pathway’ that will allow everyone, regardless of their sexual activity, including gay and bisexual men, and anyone taking PrEP, to donate plasma without any wait period at all.
    • A gender-neutral approach or ‘Individual risk assessment’ for blood donation.
  • The plasma pathway has been approved by the Therapeutic Goods Administration (TGA) and we’re now working with CSL Behring, which processes plasma into medications for patients, and the National Blood Authority on a timeline to start these plasma collections in 2024.
  • At the same time, the work being done by the research advisory group set up to look at an option for blood donation will shape a submission for blood donation to the TGA in 2024.
  • This dual approach to blood and plasma donation offers the greatest access for people to save lives and is a world-first opportunity to change donation options for gay men without compromising the safety and quality of Australia’s blood supply.

Register so we can keep you up to date. Just click the link below, then fill out the form to be added to the notification list. You’ll then be the first to know of any potential changes.

If you’re already registered as a donor, you’ll still find out about any rule changes.

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1 PrEP is an acronym that stands for pre-exposure prophylaxis. It involves HIV negative people taking antiretroviral medication to protect them and prevent HIV infection. Currently, people cannot donate whole blood for 12 months after they last took PrEP, or 3 months for plasma.

Ensuring safety

Keeping Australia's blood supply one of the safest in the world.

The safety of our blood and plasma products is our top priority
  • Australia currently has one of the lowest risks in the world of being infected with HIV through a blood transfusion, and we don’t want to change this.
  • Unfortunately, even the very best blood screening tests cannot detect an early HIV infection – usually in the first week after infection. That’s why we need to do our best to make sure that people don’t donate blood if they might have an early ‘window period’ HIV infection.
  • Australia has such a low HIV blood-transfusion risk because:
    • The number of new HIV infections is reducing in the community
    • We use the best blood screening tests
    • Sexually active people in groups with a statistically higher risk of HIV infection cannot donate
  • All countries, including those with gender-neutral or individual risk assessments in place, have a period where people with higher-risk sexual behaviours may not donate - even though there are some differences in how those people are assessed.
  • It is important for Lifeblood to propose safe donation options that are available to as many people as possible.
  • To have the ‘plasma pathway’ and an individual risk assessment or a gender-neutral approach working safely side by side means Australia would be the first country in the world to remove wait times for plasma donations for gay and bisexual men taking PrEP or having anal sex with new or multiple partners, and if approved, have an option for blood donation, under which gay and bisexual men having sex with only one partner in the three months prior would become eligible to donate blood.
  • Because safety of the blood supply is the highest priority, any change to blood safety rules takes time, research, and detailed analysis, and we need to know that any change is safe and feasible for patients as well as donors.
  • Final decisions about blood safety rules are made by the TGA and Australian governments following careful consideration of the information, data, and evidence submitted by Lifeblood.

Increasing inclusion

Plasma Pathway
  • The need for plasma – the lifesaving “golden” part of blood – is at a record high. Plasma has now overtaken whole blood donations as the type of donation most needed by Australian patients and hospitals.
  • There are a growing number of patients relying on plasma donations for the treatment of cancer, immune disorders, haemophilia, trauma, and kidney disease. We need donations of all types. All donations save lives and plasma donations are equally as lifesaving as blood donations.
  • Lifeblood collects more plasma donations than other blood donations each year.
  • Lifeblood’s plasma pathway was approved by the TGA in May 2023 and collection under the pathway will begin in 2024.
  • The plasma pathway will:
    • Allow anyone to donate plasma regardless of their sexual activity if they meet all other eligibility rules. This means someone with a new partner or multiple partners could donate plasma without any wait period at all.
    • Enable someone on PrEP to donate plasma while maintaining the safety of the blood supply.
  • The plasma donation experience will be the same for everyone and there will be no need to quarantine plasma or require donors to return for testing.
    • Because plasma for plasma medicines undergoes a different type of processing called pathogen inactivation that reduces the risk of an infection being passed to a patient, our submission focused on this vital blood product. Unfortunately, the same steps used to process plasma donations are not available for other blood donations.
A new assessment approach for blood donations
  • Some countries have adopted a gender-neutral approach for sexual activity in blood donations. This approach varies, but generally involves asking donors if they’ve had anal sex with multiple sexual partners in the last 3 months, or if they've had anal sex with a new sexual partner in the last 3 months. People who answer yes, cannot donate.
  • Under this approach, many people who can’t donate under current rules in Australia would remain ineligible to donate blood and plasma. That’s why we are seeking to have both the plasma pathway for plasma donations, as well as an option for blood donation.
  • A research advisory group was set up in early 2023 to look at how individual risk assessments or gender neutral assessments for blood donation could work in Australia.
  • The research program includes issues such as:
    • Calculating the likely impact on the size of the donor panel – from newly eligible donors, and from losing currently eligible donors – and how to reduce those losses.
    • Assessing the community’s attitudes towards the risk of a HIV transmission through a blood transfusion.
    • Assessing the acceptability of asking all blood donors more detailed questions about their sexual activity.
  • This work will help shape a submission to the TGA in 2024 seeking approval to commence an option for blood donation.
Lifeblood’s next steps
  • Following regulatory approval for the plasma pathway, we are now working with stakeholders including CSL Behring, to begin collections under the plasma pathway as soon as possible in 2024.
  • Lifeblood is currently undertaking a research program to inform a submission to the TGA for an option for blood donation.
  • The table below compares the approaches:
 Current approachIndividual risk assessmentPlasma pathway
Questions about sexual activity as part of the donor questionnaireYesYesNo
Anal sex with one sexual partner for > 3 monthsMSM2 not eligibleEligibleEligible
Anal sex with a new sexual partner for < 3 monthsMSM not eligibleNot eligibleEligible
More than one sexual partner in the last 3 months and anal sex with at least one of these partnersMSM not eligibleNot eligibleEligible
PrEP within last 3-4 monthsNot eligibleNot eligibleEligible

2 MSM = men who have sex with men

Research Advisory Panel

Individual risk assessment or gender-neutral assessments are ways of assessing blood donors that’s being used in some other countries.  Our panel of independent and Lifeblood experts advises on a research program helping Lifeblood decide if this kind of approach could work in Australia. The panel will review current research in the field, make recommendations on further research, interpret any research outcomes, and advise on how to structure and implement an assessment approach for blood in Australia.

Panel members 

Rodney Croome AMLGBTIQA+ community advocate, board member of Just Equal Australia, member of the Let Us Give campaign
A/Prof Joseph DoyleDeputy Program Director, Burnet Institute; Infectious Diseases and Public Health Physician, Alfred Health and Monash University; President-elect, Australasian Society for Infectious Diseases
Dr Skye McGregorEpidemiologist, Kirby Institute
Suzanne O’CallaghanResearch and Education Manager, Haemophilia Foundation Australia
Adj. Prof Darryl O’DonnellCEO, Australian Federation of AIDS Organisations (AFAO), Adjunct Professor, Kirby Institute, UNSW
Mish PonyCEO, Australian Sex Workers Association, Scarlet Alliance
Prof Iain GosbellDirector Donor and Product Safety, Lifeblood Infectious Diseases Specialist
Dr Veronica HoadPublic Health Physician, Lifeblood
Prof David IrvingDirector Research and Development, Lifeblood
Peter McDonaldExecutive Director Governance, Quality and Assurance, Lifeblood
Dr Joanne PinkChief Medical Officer / Executive Director Pathology and Clinical Governance, Lifeblood Haematologist
Cath StoneExecutive Director, Donor Engagement and Experience, Lifeblood
Jeremy WeissDirector Marketing, Lifeblood

Frequently asked questions

Check out our responses to frequently asked questions related to sexual activity.

What are the current rules around sexual activity and blood donation?

The postponement for donating blood, plasma, and platelets for those with a sexual activity-based risk factor was reduced in 2021 from 12 months to three months since the last sexual contact.

If you answer ‘yes’ to any of the following questions, you’ll need to wait 3 months since last contact before you can donate.

In the last 3 months, have you:

  • had oral or anal sex with another man, even ‘safer sex’ using a condom (if you’re a man)
  • had sex (with or without a condom) with a male who you think may have had oral or anal sex (with or without a condom) with another man?
  • been a male or female sex worker (i.e. received payment for sex in money, gifts or drugs?)
  • had sex with a male or female sex worker?
  • engaged in sexual activity with someone who ever injected drugs not prescribed by a doctor or dentist?
  • engaged in sexual activity with someone who was found to have HIV, hepatitis B, hepatitis C or human T-lymphotropic virus (HTLV) infection?

In the last 12 months, have you had sexual activity with a new partner who currently lives or has previously lived overseas? If ‘yes’, you may need to wait to donate depending on the level of HIV risk in your partner’s country of residence.

Can someone on PrEP currently donate blood?

Since October 2021, you’ll need to wait three months since your last dose before you can donate plasma. If you choose to donate blood, you’ll still need to wait 12 months since your last dose. This is because PrEP impacts the ability of testing to pick up early HIV infection.

The ‘plasma pathway’ that has been approved by the Therapeutic Goods Administration will enable people on PrEP to donate plasma without any wait period at all. We expect to begin collecting donations under the plasma pathway later in 2024.

Why do you ask about my health history?

Our donation criteria, and questions on the donor questionnaire form, are designed to ensure that the blood collection process is as safe as possible for blood donors and patients alike.

Our pre-donation screening includes a questionnaire made up of three sections. The first looks at the health history of first-time donors and the second is a medical questionnaire for all donors. These two sections are designed to identify possible medical issues in potential donors, as well as general risks of infection.

The third section is a legal declaration for you to fill out, pertaining to specific infection risks such as sexual activity and blood exposures. Some of these questions ask about ‘sexual contact’ and ‘sex’. We use these terms to refer to any sexual activities including vaginal, oral or anal.

I’m in an exclusive relationship, why can’t I donate blood?

We understand that there are different levels of risk among men who have sex with men. Right now, we are working on a solution that will allow all gay and bisexual men to donate plasma. We are also undertaking a research program to help shape a submission for an approach for blood donation in Australia.