Prime Minister Justin Trudeau acknowledged that the 'discriminatory and wrong' ban should have been dropped 10 to 15 years ago but failed to explain why his government had not acted sooner.Jeff McIntosh/The Canadian Press
It’s about a generation too late, but Canada has finally gotten around to scrapping the shamefully homophobic ban on blood donations by men who have sex with men.
What Canadian Blood Services and Héma-Québec (the agencies responsible for blood collection) will now do is screen potential high-donors for risky behaviours instead of gender or sexuality.
This is what the science says we should have been doing long ago.
This move will not make the blood supply less safe. If anything, it will make it safer by weeding those who are truly at higher risk. It could also increase the pool of blood donors.
Health Canada ends ban on blood donations from gay men
Prime Minister Justin Trudeau acknowledged that the “discriminatory and wrong” ban should have been dropped 10 to 15 years ago but failed to explain why his government had not acted sooner. (The Liberals promised to lift the ban in their election platforms of 2015 and 2019 but dithered.)
The ban on blood donation by gay men has been a long, sordid saga that has irked the community for decades.
It all goes back to the beginning of the AIDS pandemic. In 1981, when the first reports surfaced of a deadly new pathogen, those hardest hit were gay men. Before the virus was discovered and AIDS (acquired immune deficiency syndrome) got its name, the illness was often called the “gay plague.” Discrimination was rampant.
The Red Cross (which ran the blood system at the time) actively tried to cover up the risk of contracting HIV-AIDS from blood. It also fiercely resisted any screening based on sexual practices for fear of scaring off donors. Instead, in 1983, it began asking about sexual orientation and discarded the blood of gay men.
A year later, HIV, the human immune deficiency virus, was discovered and it became undeniable that HIV was transmitted by bodily fluids such as blood and semen, and some practices, such as anal sex, increased risk markedly.
A formal lifetime ban on gay and bisexual men donating blood was introduced in 1992; any man who had sex with another man, even once since 1977, was not allowed to donate. That policy remained in place until 2013, when it was announced that men who had sex with men could donate blood but only if they had been abstinent for at least the past five years. In 2016, the deferral period was reduced to 12 months, then in 2019 to three months.
No such restrictions were placed on heterosexuals, no matter their coital proclivities.
On Thursday, the rules became more sensible, with the focus shifting largely to sexual practices for everyone. While rates of HIV and AIDS have dropped sharply, largely because of antiretrovirals that can be used for treatment and prevention, people who have anal sex or use injection drugs remain at higher risk of infection.
Some advocates are still unhappy with the new rules, saying they are unnecessary. Testing is much more precise than in the early days and there hasn’t been a documented case of HIV transmitted by blood in Canada in a quarter century.
Yet there is some history that’s hard to forget. The tainted blood saga remains one of the worst public-health disasters in Canadian history. More than 30,000 hemophiliacs and blood-transfusion recipients were infected with HIV and hepatitis C because of the disastrous failure to protect the blood supply.
A big part of that failure was not screening properly and blaming specific communities such as gay men instead of focusing on what mattered.
The underlying assumption of the blood ban was that all gay, bisexual, transgender men are promiscuous, which is simply not true. Most gay, lesbian and non-binary people, like heterosexual people, are in stable relationships.
It should not have taken us until 2022 to acknowledge that in public policy.
Starting in September, all potential donors will be asked if they have had new or multiple sexual partners in the past three months, no matter their gender or sexual orientation; and, if they say yes, they will be asked if they had anal sex with any partner. If yes, they will need to wait three months to donate.
These questions can make people uncomfortable, but they are justified.
We need to strive for the safe blood supply possible, and that requires being discriminating – but not discrimination.
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André Picard