The UK may lift its ban on sexually active gay and bisexual men donating blood – with a decision possible before the end of the year.
At the moment gay and bi men have to abstain from sex for three months before donating blood.
However, the UK may follow a ‘risk based’ approach in future.
Rather than having restrictions on gay and bi men as a group, this may mean a ban on people who are having risky sex with multiple partners. However those in monogamous relationships or only having safer sex may be able to donate.
Several countries have changed their blood donation policies this year. Both the US and Australia have dialled down their ‘abstinence period’ from 12 months to three months, matching the UK. Meanwhile Hungary has lifted the ban altogether.
Indeed, Northern Ireland only changed its blood ban from a year’s ‘deferral period’ to three months to match the rest of the UK in April. The decision followed three years of delay.
Their decisions came as the coronavirus pandemic put pressure on blood stocks.
In fact, the UK has not seen any shortage of blood. Because the National Health Service cancelled non-urgent surgery, less blood has been needed.
However blood bans in the UK and elsewhere are preventing many gay and bi men who have survived COVID-19 from donating plasma.
‘Convalescent plasma therapy’ involves giving plasma from survivors of the virus to people with serious COVID-19 infections to help them recover. Doctors are currently trialing it in the UK after early indications it helps save lives.
But because plasma is a blood product, it is covered by the same rules.
Giving more people the chance to donate
In the UK the government set up a group called FAIR (For the Assessment of Individualised Risk) early in 2019 to review the ban.
It includes representatives from the four UK blood services, LGBT+ groups, medical and scientific experts, and patient and donor representatives.
And now FAIR has confirmed it still plans to report by the end of 2020.
Dr Su Brailsford is the chair of FAIR and holds senior roles at both NHS Blood and Transplant and Public Health England.
She said: ‘We need a donor selection system that is safe and can also cope with large numbers of people.
‘We need to understand which questions are most relevant to assessing risk and whether there are some questions which might put people off donating.
‘This work takes time and we need to make sure everything we do is based on good evidence with patient safety as the number one priority.
‘We appreciate that any deferral is disappointing if you want to save lives by giving blood and recognise that people want to be considered as individuals as much as possible.
‘We want to give as many people as possible the opportunity to donate whilst continuing to ensure the safety of both the blood supply and those patients who receive blood.’
Why the UK may change the blood ban now
Countries around the world introduced the bans on gay and bi men at the height of another pandemic – the AIDS crisis.
Since then, new HIV infections in many countries have fallen among gay and bi men. PrEP, regular testing and putting HIV positive people on effective treatment have all slashed infection rates.
Moreover, the coronavirus pandemic, which has shut down many people’s sex lives may further cut HIV rates.
But the decision to change the UK’s rules is time consuming. Technically the government’s Department of Health and Social Care sets the rules, based on advice from the Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO).
Therefore, FAIR will give its evidence to SaBTO, to influence the ultimate decision.
Blood bans and restrictions around the world
However, given falling HIV rates and the pressure to find a system people trust as fair and non-discriminatory, a change in policy is likely in the UK.
If it happens, the UK may finally have a ‘world leading’ blood donation policy.
At the moment countries including Spain, South Africa, Italy, Russia and Mexico allow gay and bi men to donate blood without a wait. Hungary joined this group earlier this month.
By contrast, countries including Austria, Malaysia and Greece still impose a lifetime ban on gay and bi men’s blood.
And some otherwise fairly LGBT+ friendly countries still have a one-year wait period after sex for gay and bi men. They include Belgium, Ireland and Malta.
Meanwhile some other countries ask for a three month wait after sex. They currently include the UK, Canada. Both the USA and Australia have joined this group this year.