Saturday, June 18, 2011

Blood ban on gay men despite appeal for donors

IN RECENT weeks the Irish Blood Transfusion Service has been appealing for thousands of blood donors to help replenish Irish blood stocks. On its well-designed and interactive website, give blood.ie, a list of criteria is laid out for potential donors.

Under the heading “Can I give blood”, those wishing to donate can take an online test to ascertain whether or not they may be eligible to donate. 

There are a host of questions asked of prospective blood donors, including age, weight, travel movements in the recent past and whether or not you have had tattoos or body piercing recently.

One question though, which rules out up to 10 per cent of Irish men from giving blood, is missing and it takes a little searching to find it. It is located under the “Keeping blood safe” section, where it states, a few lines down: “Never give blood if you are a male who has ever had anal or oral sex with another male, even if a condom or other form of protection was used.”

There is no time limit in the statementon, so if you as a man have at any time in your past had a sexual experience with another male, you cannot give blood in Ireland.

Make-up artist Aidan Corcoran (24) was made aware of this rule only when he offered to give blood as a student. “It was only then I realised I wasn’t allowed donate as a gay man. I went down to the head office of the Irish Blood Transfusion Service at the time and there is a section in its forms, which says if you have had anal sex with a man, you are prohibited from donating. From my point of view this is discrimination. Gay men are not the only men who engage in this type of activity, but the same question is not asked of heterosexual donors. Why not?”

Like many western countries, Ireland has put in place eligibility criteria that prohibit sexually active gay men from giving blood. This practice, first stemmed in response to the Aids epidemic in the US, is in place in virtually every European country.

In the US, gay men who have had sex with another man since 1977 are not permitted to give blood. 

In the UK, sexually active gay men are not permitted to give blood either, although the policy there is currently under review.

Dr Ian Franklin, the newly appointed medical and scientific director of the Irish Blood Transfusion Board (IBTB), explains the policy in Ireland.

“This policy was put in place by most western blood services before the HIV test became available in 1983 or 1984. The issue is that HIV and other sexually-transmitted infections are more prevalent and there are higher incidences of these in men who have sex with men,” says Franklin.

“There is also concern around other viruses and new infections that could be preferentially passed on because of men who have sex with men.”

While all blood donations are screened, none of the current testing methods are 100 per cent flawless. There are periods when tests for certain diseases may present negative when in the fact the donor could be positive.

For that reason, the view from the IBTB is that in order to maintain maximum safety, it is necessary to have very rigorous referral criteria. But what about the conscientious homosexual man, who has an active sex life, yet remains health conscious?

“Obviously there are many homosexual men who take their health very seriously,” says Franklin. “The problem is that you can only be as careful as your sexual partner. There is research on heterosexuals in relationships where one believes they are in a monogamous relationship and it turns out that is not the case.

“The bottom line is that you can only really attest for your own behaviour. But, let’s be clear, you can give blood if you are a homosexual man, it’s just that you have to have been a celibate homosexual man. We are often accused of being discriminatory, but the activity renders the risk, not your sexual orientation.”

Franklin points to the fact that women who have sex with women are not prohibited from giving blood.

Some countries though are beginning to review their blanket ban on sexually active gay men giving blood, with New Zealand, for example, deciding to impose only a 10-year restriction.

Any gay man who has not had sex in the past decade can give blood there, while the UK may adopt similar changes when reviews of current procedures are published. Other countries have imposed shorter restrictions.

Max Krzyzanowski, an organiser with Irish advocacy group LGBT Noise, says his members are lobbying hard for similar changes to the eligibility criteria in Ireland. He says that prohibiting sexually active gay men is stigmatising one group of society, and the manner in which the information is collected invites dishonesty.

“You will have people answering dishonestly out of fear of being stigmatised,” he says. “These criteria invite hypocrisy. There may be cases where someone such as a heterosexual man say, who had sexual contact with a man in college or in his past. Would they really want to put that down on a form they were handing in?

“If the premise is that by posing this question to blood donors, then you are eliminating those who pose health risks, then why not equally ask the question of everybody, ie have you had unprotected sex?

“The current system invites people to fudge the issue or to misrepresent themselves and find themselves in situations they may not have considered for 20 years. I think a more pertinent question would be have you had unprotected sex and then maybe put in a time limit of 10 years.”

Franklin says the IBTB will assess how changes have fared in other jurisdictions before taking any decision on the matter in Ireland.

“Personally, I don’t feel it would be appropriate to change the criteria. It would increase the risk to recipients even if it is hard to measure,” he says. 

“People in Ireland expect blood to be as safe as possible. We had some difficulty in times past and none of us want to go back there.”