Canadian Blood Services mulling shorter wait time for gay donors

Canadian Blood Services (CBS) is considering another change to its donation policy that would allow gay men who have abstained from sex for three months to give blood, down from the current one-year waiting period. 

The organization — which manages the national supply of blood products — says it has been reviewing research that suggests the abstinence period can be reduced and still keep the blood supply safe.

CBS is "currently discussing the results of the analysis with stakeholders and partners," including patient and LGBT groups, and its provincial counterpart Héma-Québec, said spokesperson Ross FitzGerald in an email. 

Health Canada would have to approve the change. CBS did not provide a date or timeline for the potential change.

Gay and bisexual men have faced restrictions since the tainted blood scandal of the 1980s, when thousands of Canadians were infected with HIV or hepatitis C from donated blood. 

A lifetime ban was lifted in 2013, when Canada moved to a policy that allowed donations from men who said they had abstained from sex with other men for five years. In 2016, that deferral period was dropped to one year. 

"Any reduction in the deferral is a good thing," said Dr. Dustin Costescu, a family planning specialist, and assistant professor at McMaster University in Hamilton, who is gay.

"I would imagine they've landed on three months because it's the standard accepted window," for accurate testing, he said. 

The window exists because an early HIV infection might not appear during a blood test. Tests also can't identify if someone has been in contact with an HIV-positive person. 

Someone becomes HIV positive when their body begins resisting the virus, Costescu said.  

CBS considers men who have sex with men a high-risk group, as they account for the largest proportion of new HIV infections reported in Canada.

In 2016, this group represented 44.1 per cent of reported HIV cases in Canada.

Attainable targets

Many have pushed for CBS and Health Canada to drop the deferral period altogether, calling it discriminatory.

"It's still having the same effect as the policy that came before it and it still makes us feel 'less than,'" said Christopher Karas, a human rights advocate who has filed a complaint about it at the Canadian Human Rights Commission.

"It needs to apply across the board to everyone. If that's not the case, then the policy shouldn't exist."

Dropping to a three-month deferral could lead to more blood donations from LGBT people, specifically men who have relationships with men and women, said Costescu. But he thinks the policy needs to continue evolving, toward behaviour-based screening. 

"By making deferral targets more attainable people can make a more informed choice about whether they want to participate in the blood donation process," he said. 

"Asking people to defer specific behaviours rather than deferring their entire orientation would be more realistic."

'Unfair' label

Canada's one-year deferral is in line with the policies of the U.S., Australia and Japan, while other countries, including Italy and Spain, use a behaviour-based approach.

That approach screens out gay men who have unprotected sex with multiple partners, as opposed to those who are in monogamous relationships. 

That would be more effective than a blanket waiting period, said Kat Lanteigne, executive director of Blood Watch, a not-for-profit that advocates for a safe, voluntary blood supply.

"The safest way to manage a donor base, in our view, is to ensure that you are screening every single individual donor and that it's behaviour based,"she said.

"We have a whole generation, you know, coming up behind us where there's a lot of gender fluidity," she said, adding it's "unfair to label" gay men as the only part of the population who are at risk.

In the meantime, Blood Watch supports reducing the deferral period to three months, she said.

CBS said it might change its screening process. 

"[We're] focused on moving away from a time-based deferral … to an alternative screening approach, which may evolve the current deferral policy," FitzGerald said. 

Haran Vijayanathan, executive director for the Alliance for South Asian AIDS Prevention, called on CBS, which routinely faces donor shortages, to quicken the process. 

"We're going into the holiday season, into the winter months and we know accidents go up," he said. "They're desperately short on blood… You're going to test that blood before you transfuse it anyways, so why even three months?"

Despite the LGBT community and CBS being at "somewhat oppositional ends right now," Costescu encourages those who can eventually donate under a three-month policy to do so — to "show the world we want to donate."

"At some point, we as a community… will have to decide what we're comfortable with in terms of what a deferral period looks like," he said.