The federal government will no longer automatically ban sexually active gay and bisexual men from donating blood to Canadian Blood Services, ending a policy that has long been criticized as discriminatory and lacking in scientific justification.
Health Canada announced the decision Thursday, years after Prime Minister Justin Trudeau promised to eliminate the ban. Canadian Blood Services expects to implement a new donor screening process, based on sexual behaviour rather than orientation, by the end of September.
Canada had previously eased the rules governing blood donations from some members of the LGBTQ community, but stopped short of treating them the same as donors who are straight. Prior to Thursday’s announcement, Canada blocked gay and bisexual men, as well as other men who have sex with men, from donating blood unless three months had passed since their last sexual contact with men.
Australia and the United States continue to use this same three-month restriction, while Britain and Israel already screen donors based on behaviour instead of orientation, according to the federal government.
Starting no later than Sept. 30, 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. If any potential donor replies yes, they will then be asked whether they have had anal sex with any of those partners. If they have, they will need to wait three months since that activity before donating blood. In its decision, the federal government noted that anal sex with new or multiple partners is associated with elevated risk of HIV transmission.
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Canadian Blood Services spokesperson Catherine Lewis said the new process is grounded in science.
“This criteria change is science-informed and will enable us to be more inclusive about who can donate while, as always, ensuring safe, adequate blood and plasma supplies for patients in Canada,” she said.
Advocates for the LGBTQ and HIV/AIDS communities greeted Health Canada’s announcement with muted celebration.
“It is not all roses and sunshine,” said Gary Lacasse, the executive director of the Canadian AIDS Society. “We need to see the nuts and bolts of how it is going to be implemented.”
It is important, he said, that staff and volunteers at blood donor clinics have the training necessary to avoid stigmatizing potential donors who were previously prohibited from giving blood.
While he welcomes the new screening process, Mr. Lacasse said it will still inappropriately exclude people from giving blood based on their sexual activity.
“If you’re having anal sex, they don’t ask if it is protected or not, so they are not evaluating the risk,” he said. “That opens up another set of stigmatizing and triggering issues.”
Ms. Lewis said Canadian Blood Services knows it needs to restore connections with people who were affected by the ban.
”This change is a significant step, but we know we still have considerable work to do to build trust and repair relationships with LGBTQ communities, and we commit to doing so.”
Canada banned men who have sex with men from giving blood in 1992, when HIV was poorly understood and thousands of blood recipients had recently been infected with the virus from donations. In 2013, Health Canada said gay men could donate blood, so long as they had not had sex with other men in the prior five years.
The Liberal Party promised to end the ban during the 2015 election campaign that brought the Trudeau government to power. Instead, the so-called deferral period was shortened to one year in 2016 and to three months in 2019.
Health Canada’s latest revision to the rules was made in response to a request from Canadian Blood Services.
The new policy shift does not apply in Quebec, where Héma-Québec operates blood services. However, that organization is moving in the same direction. In March, Health Canada said Héma-Québec could source plasma from men who have sex with men without the three-month deferral period, so long as all potential plasma donors were screened for high-risk sexual behaviours. The organization intends to implement this process in the fall.
Héma-Québec plans to extend the revised criteria to all blood products in 2023. The organization is taking a two-step approach in order to secure buy-in from potential recipients, according to spokesperson Laurent Paul Ménard.
The Canadian Hemophilia Society (CHS) said on Thursday that it was “disappointed” with Health Canada’s decision to change the screening process.
“We believe this change will result in an increased risk, albeit very small, of transmitting blood-borne pathogens such as HIV to recipients of fresh components,” said Wendy Quinn, president of CHS. She endorsed Quebec’s phased approach. “The CHS would have preferred that Health Canada introduce these new donor selection criteria in two stages: first for plasma donors and then, at a later date if data support, to donors of fresh components.”
Mr. Trudeau said ending the ban was “good news for all Canadians,” but had taken too long.
Speaking at a news conference in Ottawa, he said the ban should have ended 10 to 15 years ago, but research proving it would not affect the safety of the blood supply had not been done by previous governments.
He said his government had invested $5-million in research into the safety aspects of changing the blood donation rules, and that multiple scientific reports had shown “our blood supply will continue to be safe.”
Ken Monteith, the executive director of a coalition of Quebec community organizations fighting against HIV/AIDS, said the change is long overdue. Tests to screen for HIV and other pathogens came into existence years ago, he noted.
“Do you celebrate when someone stops discriminating? I guess so,” he said.
With a report from the Canadian Press
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