Australian Blood Donation: Review the Sexual Deferral Period #AllOurBlood

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Many people are unaware that as a man in a same-sex relationship in Australia in 2019 I cannot donate my blood. My partner of many years cannot donate his blood either. He is a nurse and I am a medical student. We satisfy all other donor criteria, except for the gender of our partner.

Our colleagues regularly donate blood and are often surprised to learn that we cannot. A blanket 12 month ban exists for all men who have sex with men (MSM) irrespective of circumstance. This is defined, by the Red Cross Blood Service as men who engage in oral or anal sex with or without a condom.

The principle behind a deferral period is to account for a window where a disease can potentially remain undetectable in the body. With advances in scientific testing the window period has fallen dramatically. The central problem with the current policy is the discrepancy between the actual window for testing for HIV and the deferral period for blood donation. This disparity in time only serves to unnecessarily exclude a proportion of healthy potential donors; it does not add to the safety of the blood supply. Given the increased demand for blood products in Australia and reported shortages, it seems pertinent to consider ways to increase the blood donor pool without compromising safety.

The most important consideration for blood donor eligibility is to maintain a secure and safe blood supply. This is achieved through screening questionaires which identify high risk behaviour and by testing blood donations for infections. Screening questionaires aim to remove individuals who engage in behaviour that places them at higher risk of bloodborne diseases leaving a pool of low risk donors. Donations are then rigorously screened for bloodborne diseases. The current exclusion of all men who have sex with men (MSM) assumes all MSM carry equally high risk of disease. While the HIV burden disproportionately affects the MSM population, the contact risk is not the same for every individual in this subgroup. The MSM population reflect a diverse spectrum of people. Blanket bans do little to accurately stratify actual risk.

Currently a heterosexual person can engage in unprotected sex with as many partners as they like, in whatever way they like and are eligible to donate. They're trusted to decide if their exposure risk compromises the safety of their donation; this is a privilege not extended to queer men.

Through sharing our story, which is a common experience for many LGBTQI people, we hoped to simply raise awareness about the current policy and question its effectiveness. We would like to acknowledge that the sexual deferral also precludes trans and non binary folk from donating if they engage in activity with “MSM” as defined by the TGA. This ban also extends to females who have relations with MSM as well as sex workers of either gender.

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