The Blood Donation System: Is it Still Discriminatory?

The leaves are falling – and so are blood stocks.

How many of us were cautioned of this during our morning get-up or daily drive? It’s true; blood stocks are low and a series of recent radio commercials has seemingly done all it can to warn of this. However, rather than encouraging donors new and experienced alike to contribute, have recent changes to blood donation legislation had the opposite effect?  Furthermore, do such changes in legislation reflect objective, scientific observations or does the taint of subjectivity still remain?

I was most curious to read a prior SCAN article regarding gay blood donation by YOURlgbtq* executive Aaron Spence. Akin to Spence, I too initially celebrated the recent removal of the lifetime ban on blood donation in England, Scotland and Wales for men who had previously engaged in sex with other men. However, this proved premature: unlike heterosexual donors, gay donors must abstain from sex with other males for an entire year before being allowed to donate.

Changes to the lifetime ban were made on the basis of recent scientific studies, including one prominent study in which researchers found that gay donors who had abstained for a year did not pose a significantly increased risk to blood stocks. Worries regarding the discrimination of the gay population also stimulated the removal of the lifetime ban. However, is it not still discriminatory to request that gay male donors dispose of a major component of their identity for an entire year if they wish to donate? The new legislation also fails to address the central issue that HIV and other transmittable viruses are passed on by the likes of unsafe sex and the sharing of needles: not by being gay.

Currently it is not possible to detect infections of HIV or other viruses – such as hepatitis B and C – in blood until such viruses have been present for a determined amount of time. Until that time is over, there is a ‘window period’ in which a person may have contracted a virus but it is not yet detectable. Although the window period for such viruses was much longer previously, technological advances have significantly reduced such periods: meaning that viral infections can be detected much sooner. For HIV – the virus that initially caused widespread panic of gay blood donation in the 80s – this window period has been reduced to an estimated average of nine days with one of the newer methods now routinely used to screen blood. The longest window period for blood-borne viruses has been estimated at about 67 days: less than three months. So why a year-long wait for homosexual men? And why aren’t other potentially high-risk individuals restricted in this way?

As per why homosexual men are categorised as a homogenous group rather than on the basis of their individual behaviour, the National Blood Service has stated that there is ‘insufficient evidence available to be able to determine the impact on blood safety’ for such a system, despite the fact that the blood service already relies upon the honesty of its donors through a mandatory donor health questionnaire. The blood service has also stated that the introduction of further questions related to sexual behaviour may lead to ‘loss of existing donors who may find the process intrusive’. However, no valid studies regarding this opinion have been conducted. Additionally, would the incorporation of a few simple extra questions truly have this effect within a questionnaire that is already rather ‘intrusive’ as it stands?

It is indisputable that homosexuals engaged in safe sexual activities with committed partners are at a lower risk of contracting transmittable diseases than promiscuous heterosexuals with a penchant for unsafe sex, yet presently the latter are not restricted in the same way. While the removal of a lifetime ban for homosexual male donors is a step in the right direction, one cannot help but feel that discrimination persists in the 12-month deferral rule. Other first world countries, such as Spain and Italy, have already removed any such deferral from gay donors – instead recognising that deferrals should be made on the basis of unsafe sexual activity, rather than sexual orientation.

In 2007, researchers from the University of Sheffield developed ‘plastic blood’: an artificial substitute for blood that could be used in emergency situations. There have also recent been developments in the creation of red blood cells from pluripotent stem cells for use in transfusion. While these approaches could potentially help ease pressure on donors in the long run, there still remains many challenges before they present an applicable option. Until that point, isn’t it all the more vital that donors that do not present a significant risk to blood – such as male gay donors in committed relationships – are able to donate without lengthy deferrals?

Rational, scientifically-rooted deferral periods should be applied fairly and consistently to all donors engaging in activities of similar risk, but at present? It’s highly questionable that this is at all the case – particularly considering recent technological advances in screening.

YOURlgbtq* is presently running the positive ‘Donate in My Place’ campaign, encouraging those who do not face restrictions on blood donation to donate in the place of bisexual and homosexual males who are currently unable. Blood drives have been undertaken on campus in the Great Hall throughout November, with the next taking place 1pm-7pm Monday 21st November. Other blood donation sessions in and around Lancaster are also available on a regular basis. To book an appointment visit blood.co.uk or call 0300 123 23 23