Just in time for World Blood Donor Day, the U.K. has dropped its celibacy requirement for men who have sex with men (MSM) that wish to donate blood. The changes were announced in December, and they shift the focus of donation criteria from questions based on identity to behavior, which both expands and limits the donor pool.
Under the previous guidelines, MSMs were barred from donation for three months after their most recent sexual contact with another man, regardless of safer sex methods or relationship status. According to a press release, the new rules stipulate that anyone of any gender will be allowed to donate “if they have had the same sexual partner for the last three months, or if they have a new sexual partner with whom they have not had anal sex, and there is no known recent exposure to an STI or recent use of PrEP or PEP.”
Those who have recently been treated for gonorrhea or had anal sex with a new partner will be deferred, as will anyone who has ever undergone treatment for syphilis.
Ella Poppitt, chief nurse for blood donation at the National Health Service’s (NHS) Blood and Transplant authority, said in a statement that the policy change was driven by a concern for “patient safety.”
“This change is about switching around how we assess the risk of exposure to a sexual infection, so it is more tailored to the individual,” she said. “Our priority is to make sure that donors are able to answer the pre-donation questions in a setting that makes them feel comfortable and safe and donation is something that continues to make people feel amazing.”
Under the new donation guidelines, patients will be asked whether they have had sex with anyone has had syphilis, hepatitis, or HIV. Other questions will include whether the patient has engaged in sex work or had sex with someone who has engaged in sex work in the past, whether they hve had sex with anyone who has injected drugs, and whether or not they have used drugs during sex, excluding prescription medications for erectile dysfunction or marijuana.
An NHS steering group, For the Assessment of Individualized Risk (FAIR), developed the guidelines following an evidence-based review, according to the U.K. government. It’s unclear, however, what evidence led to barring those who have used PrEP or PEP from donating, as PrEP is approximately 99% effective at preventing HIV transmission from sex when taken as prescribed.
The new rules have been met with mixed reactions. Some advocates celebrated the fact that sexually active MSMs will no longer be subject to a blanket ban from blood donations, but others said more work needs to be done.
“We welcome today’s historic change, which will help ensure more gay and bi men can donate blood and represents an important step towards a donation selection policy entirely based on an individualised assessment of risk,” said Robbie de Santos, director of communications and external Aafairs for Stonewall, the U.K.’s largest LGBTQ+ organization, in a statement.
De Santos added that advocates “want to see a blood donation system that allows the greatest number of people to donate safely. “We will continue to work with [the] government to build on this progress and ensure that more people, including LGBT+ people, can donate blood safely in the future,” he said.
Deborah Gold, Chief Executive of National AIDS Trust, referred to the changes as “only a first step in achieving a more inclusive approach.”
“We now want to see other exclusionary criteria urgently reviewed so donors are asked questions that successfully identify higher risk, without unnecessarily excluding people or groups,” Gold said in a statement.
Among the criteria criticized by advocates is a stipulation barring potential donors who have “a partner who has, or you think may have been, sexually active in parts of the world where HIV/ AIDS is very common.” While that description is vague, the NHS website specifies that the prohibition “includes most countries in Africa.”
Gold signed onto an open letter protesting this discriminatory policy, which advocates claimed “perpetuates stereotypes and an overly simplistic understanding of travel related HIV risks” and disproportionately affects Black Britons.
Currently, MSMs in the United States must wait three months after their last instance of same-sex sexual contact before donating blood, a policy that was unveiled last year during the early months of the COVID-19 pandemic. While the U.S. government had signaled revisiting the guidelines, it has yet to do so.
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