Blood donation rights and wrongs: Risk versus reward of allowing gay and bisexual men to donate

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.”

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.