Canadian Blood Services to recommend end to ban on men who have sex with men donating blood

An end to the ban on gay and bisexual men from donating blood — promised by Prime Minister Justin Trudeau in 2015 — is set to be recommended within weeks in favour of new screening criteria based on sexual history and behaviour.

Canadian Blood Services is preparing to ask Health Canada to allow it to scrap questions about gender or sexuality, basing screening on higher-risk sexual behaviour instead. Potential donors could be asked if they have had multiple sexual partners, and about their sexual behaviour instead of their sexuality and gender.

"Sexual behaviour, not sexual orientation, determines risk of sexual transmission of HIV. Our proposed criteria will aim to precisely and reliably identify those who may have a transfusion-transmissible infection, especially in the window period, regardless of gender or sexual orientation," said Catherine Lewis, a spokeswoman for Canadian Blood Services, who declined to comment on the specifics of the recommendation.

Currently, men volunteering to give blood are asked if they have had sex with a man in the last three months. Women wishing to donate are asked if in the last three months they have had sex with a man who in the last 12 months had sex with another man.

The blood service says it is preparing to cite evidence from countries that do not ask donors such questions, as well as research on risk of HIV transmission, in its submission to Health Canada within the next six weeks.

A study of research into HIV transmission between January 2001 and May 2012 by the Public Health Agency of Canada found that "all studies consistently reported that anal intercourse is a higher-risk act than vaginal intercourse, which in turn is a higher-risk act than oral intercourse."

The way the screening is currently set up lacks nuance, and also doesn't address people who are transgender, two-spirit or otherwise don't confirm to binary genders, said Nathan Lachowsky, one of several researchers whose work will inform Canadian Blood Services' application.

"There's a way in which to create solutions that are gender-neutral, meaning it's not about who you are in terms of your sex and gender," said Lachowsky, an assistant professor in the School of Public Health and Social Policy at University of Victoria. "That simplifies the system and makes it more accessible to more Canadians."

The U.K. criteria for blood donation, which Blood Services says it has been considering along with that from other countries, does not include questions about sexual orientation. It asks potential donors whether they have had multiple partners and engaged in anal sex.

Gay and bisexual men who have had the same partner for three months or more can give blood in the U.K. But anyone who has had anal sex with a new partner or multiple partners in the previous three months — regardless of their partner's gender — must wait three months before donating.

As it stands now in Canada, a gay man who has had sex with one partner in the last three months cannot give blood, but a straight man can, no matter how many partners he has had sex with during the same time frame.

While Canadian Blood Services tests all of its donated blood products for a whole host of diseases, including HIV, the agency says no test is 100 per cent accurate.

That's why eligibility screening is such an important part of limiting the risk to blood recipients, according to the agency's website.

Lachowsky, who did not comment on the specific questions that will be included in the Canadian proposal, said a neutral approach makes much more sense than basing restrictions on gender and sexuality.