By Dr. Nathan Lachowsky and Dr. Daniel Grace
This week is National Blood Donor Week, and Canadian Blood Services is recruiting heavily for donors, but could they be doing more? Health Canada recently approved a joint application by Canadian Blood Services and Héma-Québec to reduce the donor deferral period for men who have sex with men from 12 months to three. With donor recruitment a constant worry for our national blood system, the rule change is a fine first step—in fact, the current federal government campaigned on a promise to end the ban completely—but the new policy continues to discriminate, and exclude, gay and bisexual men.
Relationship status: it’s complicated
Many gay men have a complicated history with Canadian Blood Services and Héma-Québec. For us, blood isn’t simply “in you to give”; rather it’s a matter of human rights and equity. Our blood has become political, which tends to blind policymakers to the science of HIV transmission in favour of sweeping generalizations about gay men’s sex lives.
It’s important to get the facts on the table before we unpack why this decision doesn’t go far enough. Importantly, all blood—literally every single vial of blood—donated in Canada is tested vigorously before it makes its way into the system. HIV can be detected nine days after infection.
Monogamous men still can’t donate because they sleep with men?
Canadian Blood Services and Héma-Québec should be screening applicants based on risk of infection, not sexual orientation. Science instead of sexual orientation. Evidence versus labels. The gay men we interviewed in Toronto, Vancouver, and Montreal overwhelmingly favoured the move to an evidence-based approach to blood donation.
Under the new donation rules, a straight man with dozens of sexual partners can give blood with no questions asked. A gay man in a monogamous relationship with one sexual partner cannot donate blood if he’s had sex with his partner in the past three months. Men who have sex with men may not be engaging in activities with any chance of HIV transmission. They continue to bear the added insult of being told they’re unfit to donate following any intimate contact with another man. For blood donation, “sex” is considered oral, vaginal, and anal sex.
When we rely on sexual orientation to make policy decisions instead of activities that lead to HIV transmission, everyone loses. Stigma persists. The new regulations are out of touch with the science of HIV transmission.
Thirty years ago, our understanding of HIV was nowhere near where it is today. Then, a blanket ban on gay men’s blood may have made sense. Today, with advances in science, research, and our understanding of HIV transmission, we know better.
We’re at the table
Gay men, community-based advocates, and scientists are at the table for this ongoing conversation. The Community-Based Research Centre is working with Canadian Blood Services’ Centre for Innovation to find an evidence-based solution to this deeply-entrenched problem. Our Sex Now survey is helping inform CBS’ understanding of gay men’s contributions to Canada’s blood supply, and we’re advocating with policymakers to develop a rigorous, safe, and science-based approach that doesn’t discriminate against gay or bisexual men.
Last summer we conducted a national survey of over 3,600 gay and bisexual men and interviews to understand attitudes and opinions on blood donation. We asked what they thought about the possible move to a three-month deferral period. While some men thought this would be a “stepping stone” on the road to becoming eligible, the overwhelming majority of men expressed that this policy move misses the mark and remains unfair. Over 90 percent of participants in the survey said they would donate in the future if they were eligible to.
We’re working toward the same goal: to ensure Canada’s blood supply is safe and readily-available.
We look forward to a day when our health agencies move past stigmatization of gay and bisexual men, and fully embrace the modern understanding of our communities.
After all, it’s in all of us to give.
Dr. Nathan Lachowsky is the Research Director of the Community-Based Research Centre in Vancouver BC and Assistant Professor at the University of Victoria. He specializes in community-based participatory health research, with a focus on sexual and gender minority health.
Dr. Daniel Grace is an Assistant Professor at the University of Toronto, Dalla Lana School of Public Health and an Affiliated Researcher at the Community-Based Research Centre. He is the Canada Research Chair in Sexual and Gender Minority Health.