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Banning gay men from donating blood unfair: CMAJ authors

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Date: Tuesday May. 25, 2010 5:21 PM ET

Canada's ban on blood donations from homosexual men is outdated and unfair, contends a new article in the Canadian Medical Association Journal.

Canadian Blood Services and Hema-Quebec have banned blood donations from men who have sex with men since 1983, when the AIDS crisis was in its infancy. Back then, there was no effective way to test blood for HIV.

But while the ban made sense back then, it no longer does in 2010, write pioneering AIDS researchers Dr. Mark Wainberg and Dr. Norbert Gilmore.

"The 1983 ban has hung on so long, unfortunately, because many people became infected by HIV in the early 80s through blood transfusions, and they have mounted continuing pressure on the blood agencies to maintain the ban," Wainberg said in a news release.

"While we can sympathize with them, this no longer makes sense in 2010, and with each passing year it makes less sense."

In the article, Wainberg, the head of the McGill University AIDS Centre, and Gilmore, of the McGill Centre for Medicine, Ethics and Law, argue that rather than barring all gay men from donating blood, a better policy would be to allow donations from gay men in long-term, monogamous relationships.

Those with multiple sex partners should still be barred, just as heterosexuals with multiple partners currently face one-year deferrals, they argue.

Prospective blood donors in Canada are required by Canada's blood agencies to complete questionnaires about their medical history and potentially harmful behaviour.

Intravenous drug users, people who may have been exposed to Creutzfeld-Jakob disease (mad cow disease), people who have exchanged money for sex or drugs are all permanently banned. Currently, men who had sex with men from 1977 onwards (the year estimated as the start of the AIDS epidemic) also face "indefinite deferrals" from donations.

When Canada brought in its policy against donations from gay men in 1983, many other countries followed. But in recent years, a number of industrialized countries have altered their policies.

Argentina, Australia, Japan, Hungary and Sweden have one-year deferral periods, while South Africa has a five-year deferral and New Zealand has a 10-year deferral.

The authors note that today's technology makes it almost impossible for HIV tests to produce false results, making one of the reasons for the ongoing ban moot.

The authors note that more than 95 per cent of homosexuals and bisexuals in Canada are not HIV-positive. Excluding all those potential donors "puts a huge burden on blood agencies and the blood supply," the authors note.

"We constantly have blood shortages that would not occur, perhaps, if we had a more reasonable policy," Gilmore said.

"Other jurisdictions, like Australia, have already replaced the lifetime ban with more balanced and realistic policies, and I think it's time that Canada and the U.S. did the same."

Wainberg added there's "a social justice aspect" to this issue as well that extends beyond the gay community.

"When a discriminatory policy isn't justified by the science, it leads to controversy. We've seen protests and boycotts of blood drives on Canadian campuses, so I think the blood agencies would be better off if they agreed with us.

"I suspect, honestly, that many of them already do, in private."

Comments are now closed for this story

R from Edmonton
said

In Response To:“The fact of the matter is that they can't test for everything because it would be prohibitively expensive, the entire blood donation would be routed to testing rather than patients, all tests yield some false-negatives (especially in small samples) and many tests are woefully inadequate.” - On the questionnaire that the CBS gives out to donors it specifically states “I agree to my donation being tested for HIV, hepatitis and other infections and that my positive test results will be given to me in confidence and reported to Public Health if required by law.” As well, the CBS website states: “Every donation given at a Canadian Blood Services clinic is tested for the presence of infection due to hepatitis viruses B and C, the AIDS virus (HIV), syphilis and another uncommon virus called HTLV (Human T-Lymphotropic Virus).”The argument that the CBS is making is that there is a period of time where HIV cannot be detected in the blood (following infection). So my question is this: why would the CBS oppose blood donation from sexually-active gay men who have been in a long-term monogamous relationship with the same man? Even if there is a short window of oppourtunity where HIV cannot be detected, surely periodic (and verified) HIV tests from 3 or 6 months previously (while in the same monogamous relationship) would be sufficient to almost undoubtedly rule out HIV infection?


PM
said

This isn't a gay rights issue, it's about saving lives.The average gay male is many times more likely to have AIDS than a straight male. Screening isn't 100%, therefore the risk has to be taken at face value and avoided. If you're willing to demand that they stop this fact-based 'discrimination', you should be willing to admit that the result will be a horrible death via AIDS for some innocent transfusion recipients.


PR
said

weather your gay or straight is not the issue, but because the system is set up to screen this way, it forces it to become the issue. Like one of the posts already said, the system/criteria to give blood is out of date PERIOD The system in 2010 needs to have a better criteria filter that places less focus on sexual orientation and more focus on increasing blood donation and increasing usable blood from everyone !!


Ex Blood Donor
said

Rubbish, I'm banned from donating blood because i lived in the UK during the mad cow outbreak...


mike
said

they also ban anyone who has eaten beef in england over the las t 15yrs or so also also and also this a safty thing not homopobia


james from Vancouver
said

Ki-Som, Victoria, BC - same here, in Vancouver, been with my partner for 7 years also...etc. etc. yet, I could not donate my blood if I wanted to? What's sad is I'm O - ...I understand the initial logic behind this policy even through the 90's. But it's now 2010... Perhaps more ideological now than science?


Ben
said

If I were to receive blood for whatever reason, contracted some disease and then found that we were allowing potential risk groups to donate, I doubt that the "failure to prove" argument would satisfy me.


MAL of TO
said

I didn't know we had this rule/law.... and I think the root cause is that non-gay society thinks the entire gay population is 'Jack's', wild, crazy and out-there... whereas a huge, huge majority of gay men are conservative in their lifestyle, fairly monogamous and living quiet lives just with same-sex partners. But the law is an A$$ in this case, I have no problem accepting clean and tested blood from any person of any sex of any lifestyle.


Kat Kanata
said

I am a healthy woman, and CBS would not accept my blood because I had been in the UK for a three month period in the 80's. They were concerned about mad cow disease I think, even though I have always been a vegetarian! I am furious when I hear the urgent calls for blood and they won't accept mine.


Graeme
said

Although banning gay men was not inerintly discriminatory (statistically speaking, gay men were and still are more likely to have HIV ), I think a lot of these outright bans are no longer necessary. For example,if a gay man has been in a comitted relationship for the past year and both he and his partner have recent HIV tests which show they are both negative, there is little reason to ban them. Similarly, if a man once paid for sex five years ago and recent tests show he does not have HIV, I'm not sure a lifetime ban is really necessary.


Jay in Stoon
said

HEAR HEAR! Finally someone supporting MY side. Do you know how embarassing it is to not be able to donate blood? At some point I will use it...it would sure be nice to be able to give back. I've been in a stable, monogamous gay reltionship for over two years now, and yet I am put in the same category as any gay person in the last 33 years. Don't complain about blood when your crtieria are based on antiquated ideas.


Dave
said

I don't want a transfusion from blood that comes from a high risk group!


mike
said

i have given 56 times and i think they test for a lot but they have to stop some where these folks are very high risk almost the same as some one traveling to say africa this is done not out of hate but safty for us all so , stop this crying.


realist
said

Greg: I commented here, and I'm straight. Supporting gay rights doesn't automatically make you gay yourself, y'know. You can climb back under your rock now.


Brain from Toronto
said

It's about time.


Sam
said

Taking someone elses blood will always be a risk. Good intentioned people with risky lifestyles give blood. Whether straight or gay. I would never feel completely confident receiving the blood. Even our medical system has let us down in the past. *sigh*I just hope neither myself or my loved ones ever need blood.


Jeremy
said

I am gay and 22, I have only had gay sex once and I got tested afterwards, I still donate blood and lie on the form. I'm sure many other homosexual men do the same. This rule is outdated and people who think it should stay the same, get with the times it's 2010 or move to some other country with little to no rights.

Jack R
said

Although I concur with the authors of this paper that the policy needs to be re-evaluated in light of recent technological and medical advances, the reality is that this is still a question of risk to the blood supply. While 95% of the gay and bisexual population may not be HIV Positive, there is still that 5% who are; this number is *huge* compared to the population at large who are HIV positive, and that is simply an unacceptable risk. While certainly unfortunate, it is not bigoted or discriminatory - policy must be guided by reality, and the reality is that accepting blood from any high risk population places the general population at increased risk o contracting infectious diseases.


Statman
said

It's just simple statistics. The percentage of HIV people within the gay community is much higher than the one in the heterosexual one. That's all. Let's stop making dirty noise where there is nothing dirty.

reece
said

This ban suggests thatnot all blood is screened properly? Are we gonna have another hepatitus scandal? Assuming that a high risk donor shows up...he´s been living la vida loca and doesnt admit to it. So, are we testing our friend or not? And if we are, and the blood is clean, why are you being such a punk and refusing it? None of this makes sense unless they are suggesting that the blood being accepted is not all good. You are in hospital and given life saving blood only to contract a more deadlier disease? Ummm...NOT GOOD!


Greg in Cambridge
said

Seems like a lot of the posters here are not straight. No wonder the comments are one sided. A risky lifestyle dictates that there is more chance of infections. How could anyone have a problem with that? IF i needed an infusion,I'd want to know where it came from,if I have a change to ask.


William
said

Actually, for all of you who have not given blood before, there are still rules for any straight people who want to give blood. One of the questions is "have you ever had sex with someone and you don't know there complete sexual past" so this for example would remove people who had sex with someone they met in a bar or who sleeps around allot. I do agree this rule about gays giving blood should be changed, but to the same rules as a straight person. By the way, a lot of people protest and yell discrimination without knowing the whole thing. Do a little research and you might always be surprised.


Mike
said

"The authors note that more than 95 per cent of homosexuals and bisexuals in Canada are not HIV-positive." This means that almost 5 per cent of them are HIV-positive. Which is about 10 times higher than the rate of HIV infection in all Canadians. The risk is still too high. Sorry, these rules are about keeping the blood supply safe. If it seems discriminatory it's not. And just so we're all aware, gay men are not banned from donating. I have a gay friend who donates blood. The rule bans 'men who have had sex with other men'. Many gay men are still virgins. Many men who have had sex with other men are not gay.


Shwan
said

I have often wondered about this this. I have read on the CBS website that it has been proven that homosexual men are more likely to contract disease then their heterosexual counterparts. While I may not be a doctor but that just doesn't make sense. How does a virus know if the person they are infecting is a man or women? And if that is possible then why do men and women contract the same diseases? Without having the scientific research to back my opinion up, it would make sense that everyone who engages in risky behavior is just as much at risk as anyone else.Finally, if the blood is all screened it would make sense that any potential for diseased/infected blood would be found before it becomes a threat. I would say unless it can be proven by today's standard that homosexual men have 'issues' with their blood then it is time to move forward and update this rule.PS: not that it matters but this is not a homosexual male wanting equality...I am a heterosexual male who doesn't want to see others excluded because of their choice.


Henry Wysmulek
said

Unfortunately, around 90% of all new hiv positive people are still active homosexual males! Why should people be forced to play russian roulette with their lives to satisfy a minority group? This is not discrimination as some would claim, as their are other people who are banned for being on medication, or other health issues.

Chris From Kitchener
said

I don't think that homosexual people should be able to donate blood. Gay sex puts people at a higher risk for contracting HIV & AIDS, yes all the blood is tested. However there remains a question of honesty. Simply asking someone questions about their sex life is inadquete. Until the day that one's blood can be tested on site homosexual and bi-sexual people shouldn't be permitted to. Blood transfusions are currently a high risk thing. with all the different things one can contract. Why allow people ALL people who engage in high risk behavior to increase the risk. Alternatively, what we should consider is making the requirements more strict. Yes this would ultimately cause a problem with the supply. However it would also reduce chances of something going wrong.


Graham
said

Totally agree. This is discriminatory and VERY outdated thinking. They can test the blood. To discriminate against all gay men like they do is antiquated.


#49 Tomorrow
said

The fact of the matter is that they can't test for everything because it would be prohibitively expensive, the entire blood donation would be routed to testing rather than patients, all tests yield some false-negatives (especially in small samples) and many tests are woefully inadequate. I had a 6-month deferral for a tick-bite because they don't/can't test for lime disease and the other tick-borne diseases. Nobody's blood is indisputably clean, and no battery of tests can prove it clean! I agree with their current precautionary policies and people are welcome to my blood...


realist
said

Absolutely 100% agree with you, Kim-Som! They would have no problem with a ridiculously promiscuous STRAIGHT person, but would ban a person in a monogamous committed relationship just because they are GAY? It's 2010 folks, seriously.


reece
said

The entire donor system is outdated. I am an organ donor - should something happen to me. What I find unfair is that my organ could go to those people who never registered as organ donors. I believe our system needs to give priority to patients who are on the registry over those who refuse to register. Lets reexamine the entire system from top to bottom. I´m thinking the beauracratis who are in these positions are not doing the work they were appointed to be doing. WORK! Stop thinking about your next pay cheque but actually get your hands dirty and bring us up to speed.


Stu from London
said

I heard straight people can get HIV, too...best way to go about this is to test all blood being donated before it's provided to a patient.


Ki-Som Victoria BC
said

It's about time. When I went in, not evening knowing this rule, I was so embarrased as they told me that my blood was unclean. I am in great shape and have been with the same partner for over seven years, and never in my life had any STDs, which include HIV. I have straight male friends, who have more sexual partners then I have been alive, yet I am the unclean one?


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