OTTAWA - It's time to stop barring gay men from giving blood, argue some of Canada's top experts on HIV-AIDS.
In an analysis Tuesday in the Canadian Medical Association Journal, they argue the longtime policy of Canadian Blood Services to refuse donations from gay men out of fear they will transmit HIV is out of date.
"Highly sensitive" testing for HIV is now routinely available, meaning the chance of infected blood getting into the system is almost nil. In addition, argues Dr. Mark Wainberg from the McGill AIDS Centre, lifetime bans on gays giving blood are simply discriminatory.
"We're obviously not saying men who are infected should donate blood; they clearly should not donate blood," said Wainberg.
He says the policies of the blood agencies were appropriate in 1983 "when all we had were very imprecise tests in regard to determining who might be HIV-infected." "The science has advanced by hundreds of miles. Yet our policies are still in a time warp," he said.
From a practical point of view, inviting gay men back into the donor system could significantly increase the amount of blood available, the article says.
Since the early 1980s, most diagnosed cases of AIDS have occurred in gay men. Any man who had had sex with another man since 1977 was excluded from giving blood.
In Canada, the policy became more specific in 1997: any man who had had sex with a man even once since 1977 was indefinitely "deferred" from giving blood.
But Wainberg and his colleagues, including Canadian AIDS expert Dr. Norbert Gilmore, note that many blood agencies around the world are now working to shorten that "deferral" period. In 2006, for instance, the American Red Cross and other blood groups unsuccessfully asked the Food and Drug Administration for a deferral period of just one year.
He also notes that for women who have had sex with a man who himself had sex with another man, the deferral period is only one year in Canada.
The authors argue there would be major benefits to reducing the deferral period for men who have had sex with men. Hema-Quebec, Quebec's blood agency, estimated the number of donors could increase by 1.3%, and concluded that letting gay men donate after a one-year deferral period meant a risk of "only one HIV-positive unit escaping detection for every 11 million units of blood donated." In the United States, a one-year deferral rate was estimated to add 139,000 additional blood donors.
"A delicate balance must also be reached between the risk of contaminating the blood supply and the benefits associated with increasing the donor pool," the authors argue.
They also point out that gay men willing to donate organs are deferred for only five years, "in response to Canada's low rate of organ donation and the life-saving potential of such procedures." "Were the numbers of individuals willing to donate blood to diminish, there is little doubt that current restrictions on men who have had sex with men as blood donors would be relaxed," Wainberg and his colleagues write.
An Ontario court is expected to rule soon on a lawsuit between Canadian Blood Services and a gay man who says he lied about his sexual history when he donated blood.
Kyle Freeman says the ban on gay men donating blood is discriminatory.
Wainberg said the new article in the CMAJ is not intended to influence the court case, and he is not recommending potential gay donors lie or flout the current rules.
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