Blood donors to be screened based on sexual behaviour rather than orientation

The more Nick Comeau learned about the changes coming to Canada's blood donation rules, the angrier he became. 

Comeau, a 24-year-old Moncton nursing student, said he was initially excited when he heard the eligibility criteria was changing because he's always wanted to donate blood. 

"But I couldn't because of my sexuality," he said.

To him, the new policy feels like more than just a change in wording.  

Until now, all men who have sex with men have been required to undergo a three-month celibate waiting period before donating.

Starting Sept. 11, Canadian Blood Services will screen donors based on sexual behaviour rather than sexual orientation. Under the new rules, all donors, regardless of gender, will be asked whether they've engaged in anal sex with new and/or multiple partners within the previous three months.

If the answer is yes, that donor will be required to wait three months from when they last had anal sex to donate, even if they used a condom.

Canadian Blood Services declined an interview, but wrote in an email there will be "newly eligible" donors under the new screening criteria. 

"This means that many who could not donate when there were criteria specific to men who have sex with men may now be eligible."

The new rules mean a man who's been in a sexual relationship with another man for more than three months, and hasn't engaged in sexual activity with anyone else, is eligible to donate without undergoing a three-month waiting period.

The new policy also means women who've engaged in anal sex with new and/or multiple partners within the three-month period before donating will now be subject to the deferral. 

Canadian Blood Services stated that as a blood operator, it's concerned about any infection that is transfusion-transmissible, including sexually transmittable infections like hepatitis B and C, HIV, HTLV (human T-lymphotropic virus) and syphilis.

'So much stigma'

Comeau said since all the blood is screened anyway, he doesn't understand why the deferral period is still required.

For him, it's clear the new eligibility criteria, despite the different wording, still apply primarily to men who have sex with men.

"It just honestly feels like my blood isn't good enough for you," he said.

"There's already so much stigma and so much hate that people that are part of the LGBTQ+ community face in their daily lives, so this just kind of perpetuates that stigma."

Canadian Blood Services said it acknowledges some criteria still disproportionately impacts gay, bisexual, and other men who have sex with men.

"We still have considerable work to do to build trust and repair relationships with 2SLGBTQIA+ communities. We are committed to undertaking this work," said Delphine Denis, media relations manager at Canadian Blood Services.

The LGBTQ community was heavily involved in advocating for the changes taking place. An Ontario man named Christopher Karas filed a human rights complaint against Health Canada in 2016 when the deferral period for gay and bisexual men was an entire year, not three months. 

Comeau said it's encouraging to see other members of the LGBTQ community advocating for more inclusive changes in the screening process, and he hopes eventually there won't be a deferral period at all.

"I do want to fight this, but I wouldn't have a single clue of where to start. It's really nice to see there are people out there who are fighting."

Changes to donor eligibility based on science, doctor says

Dr. Marc Germain is the vice-president of medical affairs and innovation at Héma-Québec, the Quebec counterpart to Canadian Blood Services.

He said the work of the LGBTQ community accelerated the changes coming to eligibility criteria, but that they're still based on science.

He pointed out the federal government subsidized several research projects over the past few years to help speed the changes along.

"It's a long time coming, and it's been a while since the original policy has been modified," he said in an interview.

Starting in the 1980s, and due to widespread panic over the AIDS epidemic, men who had engaged in sexual activities with other men were permanently banned from donating blood. This changed to a five-year ban, then to a one-year ban in 2016 and again to a three-month deferral period in 2019. 

Germain said he doesn't envision a day anytime soon when a deferral period isn't required. 

He said infections like HIV are hard to detect in the early stages, which is why a three-month waiting period is required.

"The tests, by nature, they will never be perfect, if only because of this window period which cannot be reduced to zero, at least not with the currently known technologies." 

Research about how these changes impact the blood supply will continue, Germain said. Similar policy changes took place in the United Kingdom just over a year ago, and Germain said Canadian researchers are watching closely to see if the blood supply presented increased risk to recipients.

"So far, the answer is a resounding no," he said. "It had no impact whatsoever on the safety of the product."