Change to Deferral Criteria for MSM Donating Blood
Why did the IBTS decide to change from the lifelong deferral to one year for MSM since their last sexual contact?
There are many reasons why a person may not be eligible to donate on the day they attend a donation clinic. The IBTS constantly reviews these deferral criteria and makes changes as appropriate. In the case of men who have sex with men (MSM) a lifelong deferral has been in place since the emergence of HIV in the 1980s. In light of changes to this deferral criterion in other countries the IBTS decided to review its lifetime deferral. The IBTS held a conference on 21 & 22 April 2016 at which data were presented from countries that had changed their deferral criteria for MSM. The data showed that there had not been an increase in the number of HIV positive blood donations, since the change in the deferral policy. It was concluded that international experience had shown that a one year deferral is as effective as a lifetime deferral from the point of view of protecting the blood supply against the risk of HIV transmission.
What does this mean in practice?
This means that a man whose last sexual contact with another man was more than 12 months ago will be eligible to donate if he meets the other donor selection criteria. A man who has had oral or anal sex with another man in the past 12 months will still not be eligible to donate, even if he used a condom or pre or post exposure prophylaxis (PrEP/PEP). People who take medication to prevent HIV infection i.e. pre or post exposure prophylaxis (PrEP/PEP) will be deferred from donating for 12 months thereafter. This is because the use of PrEP or PEP may interfere with testing for HIV by delaying seroconversion or giving unclear results in a positive donor.
What about the risk from Emerging Infections?
While the one year deferral will protect against the risk of transmission of HIV there is concern that it may not be sufficient to deal with an emerging infection. Persons who have had syphilis, gonorrhoea, lymphogranuloma venereum (LGV) or granuloma inguinale are permanently excluded from donating. It is hoped that deferring people with these infections will add an extra layer of protection against emerging infections. In addition there are other measures in place to quickly identify new emerging infections if they occur and to help to protect against these infections entering the blood supply. These measures include an international surveillance network and rapid development of new molecular tests.
When was the life-long exclusion changed to a one year deferral?
This change was introduced on 16 January 2017.
How do the new recommendations impact people who were previously deferred?
Persons who were deferred under previous criteria will be eligible to donate if they meet the new donor eligibility criteria.
Why did it take this long to implement the change?
We had to ensure that there was full communication and engagement around this change. We also had to change our donor health and lifestyle questionnaires, guidelines for staff, information on our website and our IT systems.
Will the IBTS consider further changes to the policy in the future?
The IBTS will closely monitor the effects of the current changes over the next few years in order to help ensure that blood safety is maintained. At the same time, the IBTS will continue to work in this area and review its donor deferral policies to ensure they reflect the most up-to-date scientific knowledge. This process must be data-driven, so the timeframe for future changes is not something that can be predicted.