Specialist GP Nikki Vadgama provides some tips to make your next paediatric eczema consult easier. She includes a review of new guidelines, resources, websites and medications for paediatric eczema management
Blood donation rights and wrongs: Risk versus reward of allowing gay and bisexual men to donate
Blood donation rights and wrongs: Risk versus reward of allowing gay and bisexual men to donate
![Peter Saxton](/sites/default/files/styles/cropped_image_16_7_/public/2023-05/Image%2004_Dr%20Peter%20Saxton.jpg?itok=WeJbiPW2)
We, as a society, place high moral value on donating blood
Denying a group of New Zealanders the opportunity to donate blood may be discriminating against them, says HIV prevention researcher Peter Saxton.
New Zealand Blood Service tells gay, bisexual and men who have sex with men that they cannot donate blood in certain circumstances – but it’s difficult to see how these are justified, Dr Saxton says.
The service states that, following oral or anal sex with a man, with or without a condom, a male must not donate blood for three months.
While this community is often at a higher risk of acquiring HIV, this criterion is not scientifically justified, says Dr Saxton.
An argument against allowing gay, bisexual and men who have sex with men to donate blood is that they can have a negative HIV test result but still be positive up to eight days later. That could place up to three blood recipients at risk of HIV, he says. But it doesn’t make a three-month ban necessary for all sexually active gay, bisexual and men who have sex with men.
To donate blood in New Zealand, you must meet the criteria through an eligibility quiz. Most of the eligibility is based on:
- age
- height and weight
- current health status, and
- travel history.
Donors must also not donate for three months following:
- oral or anal sex with or without a condom with another man (if you are a man)
- engaging in sex work (prostitution) or accepting payment in exchange for sex, and
- getting a tattoo or body piercing.
He agrees anal sex carries a greater risk of HIV transmission than vaginal sex (1.4 per cent versus 0.1 per cent), but says the risk from oral sex is negligible.
It’s unclear whether the criteria are discriminatory, Dr Saxton says, as there is no specific right to donate blood in New Zealand.
However, “we, as a society, place high moral value on donating blood”, he says.
The University of Auckland associate professor of social and community health raised the issue with delegates at the Goodfellow Symposium in Auckland in March.
Thousands of people globally have acquired HIV through blood donation but times have changed and New Zealand has access to tools to eliminate HIV, Dr Saxton says.
Following New Zealand’s largest peak of cases in 2016, Pharmac funded HIV-prevention drug Pre-Exposure Prophylaxis (PrEP), which reduces people’s risk of acquiring HIV by over 99 per cent.
PrEP, along with other public health tools such as normalising sexual health education, has seen the number of local infections drop to 29 people being diagnosed in 2021.
In March this year, the Ministry of Health launched an HIV Action Plan with the goal of eliminating local HIV transmission by 2030.
Dr Saxton leads the Sex and Prevention of Transmission Study, which has twice surveyed almost 4000 gay, bisexual and men who have sex with men to understand their attitudes towards blood donation in New Zealand.
Early results showed four out of five participants were interested in donating blood, and less than 15 per cent supported the exclusion policy.
“We now have a community which is still relatively higher in risk of HIV than other New Zealanders, but absolutely, that number is very, very small,” Dr Saxton says.
This community is acutely aware of HIV risk: “They are engaging in safe sex and the absolute probability of them having an undiagnosed infection is declining over time.”
The risk of their contaminating blood is very low, says Dr Saxton says.
He says the blood donation eligibility requirements are also inconsistent with safe sex advice.
“Gay men know that condoms work. They know that PrEP works.”
Sex and Prevention of Transmission Study participants were asked to comment on the New Zealand Blood Service policy towards gay, bisexual and men who have sex with men. The participants were:
- 3838 people aged 16-plus
- men who have sex with men, trans women and non-binary people who have sex with men who have sex with men
- 13 per cent Māori
- 10 per cent of Asian decent
- 3 per cent of Pacific descent, and
- 4.5 per cent living with diagnosed HIV.
The blood service relies on clients disclosing their HIV status and risk but, if they lack trust in the service and decide to donate dishonestly, there could be a threat to blood safety, argues Dr Saxton.
He says New Zealand could adopt a policy based on a person’s sexual acts rather than their gender or sexuality.
Or the answer may be to narrow the deferral window further (up until 2008, it was 10 years).
In France, blood from high-risk donors is collected and stored for 30 days and then retested for HIV.
Dr Saxton and the study team are analysing the survey data and will share the findings with the blood service, which is expected to consider updating its policy.
We're publishing this article as a FREE READ so it is FREE to read and EASY to share more widely. Please support us and our journalism – subscribe here
One of the benefits of subscribing is you will also be able to share your thoughts about what you read with other in our Comment Stream. You can also take notes on what you read with Capture