Should we remove bans on gay men donating blood? The arguments for and against

NZ 16/05/2022

Via Tova O'Brien from Today FM
Data from Otago University shows new cases of HIV have dropped to their lowest rates since the 1990s. So today, we’re looking at the rationale behind restricting blood donations from gay men.

The NZ Blood service describes it as a 'deferral' period, which means men cannot donate blood for three months after having sex with other men, essentially a ban for most.

To get two sides of this discussion, activist and founder of End Conversion Therapy NZ Shaneel Lal and Associate professor Peter Saxton who is also a fellow of the AIDS foundation spoke to Tova O'Brien on Today FM on Friday morning.

Tova asked Lal, with new HIV cases at their lowest point in decades, is it time we reviewed some of these policies when it comes to donating blood? 

"New Zealand Blood Services does have an obligation to keep the blood safe, and that keeps the people that they're giving blood to safe," said Lal.

"But they also have an obligation to queer people to uphold our rights and not to discriminate or further stigmatise our community.

The reason that the blood ban exists has a historical reason.

"If someone in this country is living with HIV for a year, the test the New Zealand Blood Services uses will pick it up but the problem that we have is with the newly acquired HIV that is generally picked up in seven days. 

"However, some persons may live with the virus for three months for the test to pick it up. According to New Zealand Blood Services, three months is the absolute maximum amount of time that is needed for the test to pick up newly acquired HIV.

"This is why the New Zealand Blood Services asks gay men to abstain from sex for three months before they donate blood. If they have acquired HIV with their last sexual partner, the test may take up to three months to pick that up. 

"That is all fine. But I think the issue really, for me, stems out of the blanket ban that they've put on gay men donating blood.

"So a monogamous gay couple that has only had sex with each other for the last three months is also banned from donating blood. So if two gay men have only had sex with each other for the last three months, the only way HIV could be introduced in their relationship is if one of the partners was already living with HIV or before they started their monogamous relationship.

"This means that if they go to donate blood three months into their relationship, the New Zealand Blood Services test will pick up HIV if either person is living with it. If they do not test positive for HIV three months into their relationship, it means that neither partner has been living with HIV and they should be able to donate blood.

"I think researchers have been approximating that. Thousands of people will become eligible if this is the approach we take, and I think this is a fundamental flaw of the blood donation ban. 

"It rules out people who can safely donate blood but are not allowed to because they are gay.

Associate Professor Peter Saxton spoke to Tova shortly after Lal to give a second perspective on the topic.

"We know in New Zealand that gay and bisexual men and other men who have sex with men are more at risk of HIV. That's been true for 40 years," said Saxton.

"I think this community is over 350 times more likely to have HIV. But, the winds of change are blowing in the direction of removing discrimination.

"Just yesterday the ACB group at Otago showed that we had the lowest number of new diagnoses for 20 years. So that's fantastic news and I think that argues really strongly that we need to review this policy. 

"The key thing here though is that although the new diagnoses are very low, they're diagnoses. So these are people who have proactively gone and sought testing, they've had access to testing.

"What we know less about is undiagnosed HIV, and that's of huge concern to the blood service because, as Shaneel said, although they can pick up long-standing infections, it's the very recently acquired infections that people don't know about that potentially pose a risk to the blood supply. And if that's passed on, it will be transfused to up to three people.

There are high stakes here. And the last time we did a study like this, we found that about 1.3 percent or one in 77 gay and bisexual men had evidence of undiagnosed HIV. So we need to take this very seriously.

"So what we're doing at is a survey for men who have sex with men looking at both of their safe sex practices, their attitudes to blood donation but also this issue of undiagnosed HIV.

"People can do a survey and they can then opt to provide a dry blood spot by finger-prick, and we'll test that for evidence of undiagnosed HIV, Hepatitis C and Syphilis, and use that to guide the Blood Service as to what a new policy might look like."