Blood: not everyone’s gift to give
Canadian Blood Services has changed the eligibility criteria for MSM donors (men who have had sex with men), they are still unable to donate unless they have been abstinent for five years
Canadian Blood Services (CBS) came to campus on Jan. 16, recruiting students and faculty to donate blood but not all were welcome to donate.
Andrew Neild stood by the clinic that day and rallied with a sign that said “Is my blood not good enough?”
An able and willing candidate for blood donation, Neild has one problem standing in his way: Question 19 on the donation form, which reads “Male Donors: In the last five years, have you had sex with a man, even once? Y/N”
“Frankly, I really hate the question. I mean, it’s really none of their business. If they are really concerned and trying to protect the public, there are a heck of a lot of groups that are having significant risks concerning HIV and STI infections, specifically certain age populations in heterosexual women,” Neild said.
“They are not keeping up with the times.”
Canadian Blood Services representative Marc Plante said their rationale for Question 19 was based on Health Canada’s most recent statistics.
“The most recent statistics, as published in the Public Health Agency of Canada’s 2011 report, HIV and Aids in Canada: Surveillance Report to December 31, 2011 indicates that in terms of risk of HIV, MSM (men who have sex with men) is still the leading risk exposure in Canada; MSM accounted for 48.6 per cent of all new infections reported to PHAC,” said Marc Plante, Communications Specialist for the Canadian Blood Services, in an email interview with the Reflector.
“Answering YES to [Question 19] would make that person ineligible to donate blood for five years.”
Neild confirmed that the data was correct.
“In terms of the population growing, not the percentage of cases currently, you’re looking at an increase in Aboriginal females at the moment,” Neild said.
The Canadian Blood Services board of directors passed a motion in 2011 for there to be more discussion surrounding the conditions for MSM blood donations. The McLaughlin Report, commissioned in 2007, indicated that changing the condition from a life-time ban to a one year requirement of abstinence would not be considered safe. However, they determined that there was no clear evidence that a five-year deferral would be problematic.
“After extensive consultation and data, it was agreed that five years was an acceptable first step by patient and community groups in reducing the current deferral policy,” said Plante.
But who outlined these criteria to begin with?
In the mid-1980’s, the Canadian Red Cross Transfusion Service introduced a donor selection criterion that excluded all MSM since 1977 in order to protect the blood supply from HIV.
In 1992, blood products became regulated by Health Canada and thus the precedent carried through. Finally, Canadian Blood Services took over as operator of the national blood system in 1998.
“The decision to change from life-time to five was a good one,” said Neild. He says he also understands the rational for the previous criteria.
“A life-time ban really didn’t make a lot of sense. But at the same time I understand why they had to put in a life-time ban in the first place: when they put it to lifetime after the issue with AIDS in the 80’s I understand why they did it because at that time they were dealing with a huge epidemic and they really didn’t have another option.”
When asked whether they thought the rationale for the exclusion for homosexual males to donate stemmed from an outdated paradigm, Plante said: “No, it is based on current statistics from PHAC. As well, any changes to the record of donation or how we collect blood must be met and approved by our regulator, Health Canada.”
Despite the fact that the Canadian Blood Services has deemed the one year requirement of abstinence too short, Neild argues for it.
“But since [the AIDS issue in the 80’s] they have gotten significantly better in terms of medical advancements and I think that five years is still too long. You can accurately see if someone is going to have AIDS or HIV.”
Neild says that in the U.K. and in Australia they have pushed it to one year.
But another rationale that the CBS has for Question 19 is that, despite the diligent testing systems they have in place, no test can be 100 per cent perfect and so, in light of that, elimination of that possibility is what they say is necessary – a “better safe than sorry” approach.
“In fact, there is still a window period of one to two weeks in which a person who has been infected with HIV will not test positive. In addition, tests can fail for technical reasons or because the pathogen has mutated. Furthermore, for some pathogens there is no test that exists to detect them,” said Plante.
“Canadian Blood Services tests every single unit of blood we collect using state-of-the-art testing methods. We test for blood group and antibodies to determine blood and Rh type; syphilis, hepatitis B and C, West Nile Virus, Chagas disease, and Human T-Cell lymphotropic virus HTLV-I and II. We also test every unit of blood for HIV, using world-class nucleic acid testing.”
Neild understands their precautions in blood testing but argues that the accuracy in testing blood is a limitation in all blood, not just cases of MSM.
“And they might be able to come up with procedure, and I’m sure they are working on something right now, to be able to test it without having to use all the blood but at this point they don’t have guarantee 100 per cent that it is going to be clean,” Neild said.
“Having a one year [criteria for abstinence] I can definitely understand, because you’re not going to necessarily show the signs … Because we are still the number one group [at risk] it makes sense to keep it at one year. But five [years] is just too long.”
The Canadian Blood Services explained that they are not targeting the characteristics of an individual, but that they create the plans in place based on historical risks of diseases spreading.
One example of this is the spread of Mad Cow disease that occurred in the U.K between 1980 and 1996.
“[…] people who spent more than three months in the U.K. between 1980 and 1996 are deferred from donation due to vCJD risk due to potentially eating contaminated beef. This is true even if the specific person in question was a vegan during their residency in the U.K. The blood donor screening system is simply not sophisticated enough to take individual risk profiles into account,” said Plante.
“Blood donor clinics are not staffed to provide individual medical risk consultation for each donor. Thus, donors are accepted or not based on population risk categories, not on their individual risk.”
Neild said that he will continue to advocate and make students aware of Question 19.
“What I would like students to know is that it is there in the first place. Just so that they are aware of it and so that if they feel the same way that I do that they would put some pressure on the Canadian Blood Services to change their policy,” he said.
“As for where I see the overall picture, you know on the radio the Canadian Blood Services needs blood campaign? It infuriates me every single time, it’s like you don’t want my blood and yet you’re begging for it at the same time. If they truly want it they should be able to take it.”