MSM and Blood Donation
Prior to January 2017, men who have sex with men (MSM) were permanently deferred as blood donors in Ireland. The Irish Blood Transfusion Service (IBTS) gave a commitment in 2016 to review the requirement for this deferral. As part of that review, the IBTS organised a scientific conference on this topic in Dublin in April of 2016. The conference was attended by blood transfusion experts and epidemiologists from many countries with experience and knowledge of the relevant issues. Following the conference, the IBTS Board recommended changes to the deferral of blood donors. These changes were accepted by the Department of Health and implemented in January of 2017.
There were 3 changes:
- The lifetime deferral of MSM donors was reduced to a 1-year deferral. This means that potential MSM donors can now give blood if they have not had sex with another man in the previous 12 months.
- There was currently in place a lifetime deferral for individuals, regardless of gender, who previously had syphilis or gonorrhoea. This remains unchanged but an additional deferral has been added for any person who has had any one of a long list of sexually transmitted infections (STI’s) in the past 5 years. Any person who has had one of the listed STI’s is deferred from donating blood for a period of 5 years after they have finished treatment for the STI.
- Prior to January, the sexual partner of a person with haemophilia was deferred. A specific question was asked on the blood donor questionnaire; “In the past 12 months, have you had: Sex with anyone with haemophilia or other blood clotting disorder who has EVER been treated with Clotting Factor Concentrates?”. Given the exemplary safety record of plasma-derived clotting factor concentrates since 1991 and the fact that we have used only recombinant factor VIII since 1997 and recombinant factor IX since 1999, this question was unnecessary. This question has now been removed.
Our initial concern in relation to any change in the donor deferral for MSM donors related to the possible emergence of any new blood-borne virus which could also be transmitted sexually and could be prevalent in the MSM population. MSM donors at risk would be more likely to be those with many sexual partners and more likely to be those who have had an STI. The change to a 1-year deferral combined with the deferral of any person regardless of gender who has had an STI is, in our view, a reasonable approach. This should maintain the safety of the blood supply while removing what many in the community felt was an unfairly restrictive policy.