Britain has announced changes that will allow more gay and bixsexual men to donate blood – a major victory for campaigners who had sought changes to the rules they said treated all gay and bi men as posing an increased risk of infection.
Previously, the government's donor policy dictated that men who have sex with men had to abstain for three months in order to donate.
The new rules do away with asking about gender and sexuality, and instead focus on individual behaviors to assess risk. The changes will go into effect in summer 2021.
Under the new policy, anyone who has the same sexual partner for more than three months — irrespective of gender or sexuality— will be eligible to donate, so long as there is no known exposure to a sexually-transmitted infection or use of the HIV prophylaxes PreP or PEP.
"Donors will no longer be asked to declare if they have had sex with another man, making the criteria for blood donation gender neutral and more inclusive," the National Health Service explains. "A set of other deferrals will also be introduced for the other higher risk sexual behaviours identified, such as if a person recently had chemsex [using drugs to enhance sex], and updated for anyone who has had syphilis."
The policy change should help an effort by the NHS to get more men to donate blood. In January, the public health body set a target to get 26% more male blood donors, noting a significant gender imbalance among donors. "This is a concern because men have higher iron levels, and only men's blood can be used for some transfusions and products," it explained.
The changes announced Monday were made on the recommendations of a working group called FAIR (For the Assessment of Individualised Risk), which brought together U.K. blood services and LGBT organizations to see if sexual behaviors could be an effective method of assessing individual risk of STIs, which can be transmitted via blood transfusions.
FAIR's evidence review found that "people with multiple partners or who have chemsex are the most likely to have blood-borne sexual infections; a strong link between HIV and a history of syphilis or gonorrhea; and receiving anal sex was identified as the easiest way to acquire a sexual infection from a partner."
Su Brailsford, Associate Medical Director at NHS Blood and Transplant and chair of FAIR, said the changes are "just the beginning" of assessing blood donation eligibility in a more individualized way.
"Patients rely on the generosity and altruism of donors for their lifesaving blood. We are proud to have the safest blood supply in the world and I'm pleased to have concluded that these new changes to donor selection will keep blood just as safe," she said in a statement.
The U.K. health secretary also trumpeted the new policies. "This landmark change to blood donation is safe and it will allow many more people, who have previously been excluded by donor selection criteria, to take the opportunity to help save lives," Matt Hancock said in a statement. "This is a positive step and recognises individuals for the actions they take, rather than their sexual preference."
Beginning in 1985, the U.K. had a lifetime ban on blood donations from men who have sex with men. From 2011 in most of the U.K., gay men were permitted to donate after 12 months of abstinence. In 2017, the U.K. changed that deferral period to 3 months.
The organization Freedom To Donate had pushed for the policies to change.
"This is just huge," Ethan Spibey, the group's founder, said in an interview with Sky News.
He said his grandfather had a major operation where he needed eight pints of blood, and Spibey wanted to repay the donors' generosity. He said his heart sank when he looked at the questionnaire to donate blood, and realized he would be barred from doing so: "I felt guilty, I just felt shame."
Spibey said they worked since 2014 to campaign for "not just a fair and equal policy, but one which can unlock potentially thousands of safe donors in a way that allows gay and bisexual men to donate and be judged as people, not on the basis of their sexuality."
In 2015, the U.S. lifted its lifetime ban on men who have sex with men from donating blood — a policy that had been in place since 1983.
The U.S. Food and Drug Administration announced in April that it was relaxing its rules on blood donations by men who have sex with men, shortening the required period of abstention before donating from 12 months to 3 months.
Two weeks later, more than 500 doctors, public health specialists and researchers sent a letter to the FDA objecting that the changes had not gone far enough, and advocated for a policy focused on specific high-risk behaviors rather than sexuality and gender.
The Red Cross said in June that it was facing a drastic shortage of blood amid the coronavirus pandemic, which has led to the cancellation of blood drives and a "staggering" drop in supply.