A doctor writes: Is it time to reverse lifetime ban on gay men donating blood?

Is it time to reverse the lifetime ban on gay men donating blood?

Minister for Health Leo Varadkar says he is personally in favour of ending the 30-year-old policy and moving to a one-year deferral rather than the current total ban on gay men giving blood. He wants to hear from patients and his Chief Medical Officer before making a final decision.

At present, the ban affects men who are having sex with men. Under the deferral proposal, gay men could give blood if they have not engaged in certain sexual activity within a year of the planned donation.

The current Irish Blood Transfusion Service (IBTS) rules forever forbidding blood donation are quite specific: you or your partner have HIV; you are a male who has ever had oral or anal sex with another male, even if a condom or other form of protection was used; and if you have ever received money or drugs for sex.

While open to criticism for being homophobic, there are other “never donate” IBTS categories that are not based on sexual practices. These include anyone with cancer, a person who has had a heart attack or suffers with chronic fatigue syndrome.

Critics point out that science has moved on since the gay men ban was instituted. Tests for HIV, Hepatitis B and Hepatitis C viruses are more accurate now, although some tests have a “detection window” which raises the possibility of a false negative result during that period.

Screening of donors could also focus on actual sexual behaviour rather than categories of sexual practice, which would help to identify low-risk donors.

The Food and Drugs Administration (FDA) in the United States has recently come out in favour of a one-year deferral for gay men. It estimates this could increase the US blood supply by 2 per cent.

Disease

Some groups have responded by saying this ignores the science of testing, arguing that six months is the maximum it takes from initial HIV infection to having a positive test for the disease.

A one-year deferral for gay men is now health policy in the United Kingdom and Australia. Some 10 years after changing to the one-year rule, researchers in Australia were able to show that the risk of contracting HIV through blood transfusion had not significantly increased.

And the FDA estimates the current risk of finding a HIV contaminated unit of blood is one in 1.5 million.

It will be a major surprise if Ireland does not follow international best practice and relax its lifetime ban on gay men donating blood.