Change to Deferral Criteria for gbMSM Donating Blood
Why is the IBTS making changes on the 28th of March 2022?
The IBTS is introducing further changes to a range of eligibility criteria, including those related to gbMSM (gay and bisexual men who have sex with men) following a report to its Board in September 2021 by an independent advisory group that was established to review these criteria, while maintaining the safety of the blood supply. The group, called the Social Behaviours Review Group (SBRG) was chaired by Professor. Mary Horgan and made a number of recommendations.
What recommendations did the SBRG make to the IBTS?
The SBRG recommended that the 12month deferral period of gbMSM could be shortened to 4 months while maintaining the safety of the blood supply. It also recommended that the deferral of any person who takes pre or post-exposure prophylaxis (PrEP or PEP) - medication taken to reduce the risk of contracting HIV - could also be reduced from 12 months to 4 months.
What does this mean in practice?
This means that a man whose last sexual contact with another man was more than 4 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 4 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 4 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 of new infections emerging?
While the 4 month deferral will protect against the risk of a window period HIV transmission for example, there is always a concern that any deferral may not be of a sufficient duration to avert the risk of a novel agent entering the blood supply. Other deferrals the IBTS have in place will mitigate this risk, in conjunction with many other measures which will facilitate the efficient identification of an emerging agent. These measures include an international surveillance network, international and local (IBTS) horizon scanning processes, as well as international responses to emerging agents e.g. rapid development of new molecular tests.
How do the new recommendations impact people who were previously deferred?
People who were deferred under pervious criteria will be eligible to donate if they meet the new donor eligibility criteria.
When was the life-long exclusion from donating of gbMSM changed to a one year deferral?
This change was introduced on 16 January 2017.
Has this change resulted in an increase in the rate of Transfusion transmitted infections (TTIs)?
The IBTS is not aware of any TTIs since the introduction of this change. Therefore it was willing to review the deferral to see if it could be shortened further while maintaining the safety of the blood supply.
Will the IBTS consider further changes to the policy in the future?
The IBTS will closely monitor the effects of the current changes in order to ensure that blood safety is maintained.
The SBRG also recommended that the IBTS introduce an individualised risk assessment of donors' sexual behaviours, similar to the FAIR (For the Assessment of Individualised Risk) system introduced by the UK Blood Services in June 2021. This will make blood donation more inclusive. The IBTS is working towards introducing this system later in 2022.