MSM BLOOD DONATION DEFERRAL- NEUFELD- MARCH 18, 2018
Canadian Blood Services (hereinafter referred to as CBS) regularly makes calls for blood donation, with three news releases in the past four months citing “urgent need” as supplies are at “critically low levels”. However, a large demographic faces an obstacle to donating. Canadian law states that men who have sex with men (MSM) must wait one year after sexual contact before donating blood, focusing mainly on the possible transmission of HIV. Advancements in technology and societal beliefs have made the one year deferral period excessive and discriminatory, and it should be reformed.
According to a report by the Centre of Communicable Diseases and Infection Control, of reported HIV cases in 2016 whose exposure categories were known, 44.1% were from MSM contact, with heterosexual contact a close second at 32.3%. (Exposure by injection-drug use made up only 15.1% of reported cases.) Further, the Public Health Agency estimated in 2014 that 21% of Canadians infected with HIV were undiagnosed. “Amongst people whose HIV infection was acquired through MSM exposure, approximately 18% were unaware of their infection. Among those whose HIV infection was acquired through heterosexual contact… approximately 28% were unaware of their HIV-positive status.” MSM have a slightly higher statistical likelihood of being infected with a blood-borne illness, but they are also more likely to be aware of being infected. The blood donation screening process relies heavily on trust; what of those “trustworthy” donors who are oblivious to their infection?
CBS acknowledges that “most public health research has focused on men who have sex with men with behaviours that are considered high risk for infectious disease”. Current regulation is based on inadequate research differentiating high and low risk MSM. Introducing behaviour-based criteria would allow more men to come forward- for example, those in long-term monogamous relationships. All blood is tested for infectious disease; screening criteria should be amended to allow low-risk MSM to donate.
CBS says that HIV and Hepatitis C can be detected “within 1 to 2 weeks of the donor being infected”, and Hepatitis B with in a month. In England, MSM are permitted to donate blood after a three month deferral period. Why does Canada still impose a one year deferral? The answer: fear. According to Historica Canada’s Canadian Encyclopedia, between 1980 and 1985, 2000 Canadians contracted HIV from tainted blood; another 30,000 contracted Hepatitis C between 1980 and 1990. This led to overhauls in Canada’s blood system to prevent such a catastrophe from reoccurring, and advances continue to be made. The McLaughlin Centre for Population Health Risk Assessment states that though risk levels of receiving tainted blood are currently so low that they “can only be expressed as complex estimations”, residual fears have meant that there is zero tolerance for even minute changes to blood-safety regulation policies.
Such stagnation will not answer the urgent calls for blood donation. It is time to put aside fear and discriminatory beliefs, take advantage of technological advancements to reduce the one year deferral period, and develop screening criteria that is mindful of MSM from all backgrounds.
References
https://blood.ca/sites/default/files/External_Surveillance_Report_2015.pdf
https://www.canada.ca/content/dam/phac-aspc/documents/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2017-43/ccdr-volume-43-12-december-7-2017/ccdr-43-12-ar01-eng.pdf
http://www.catie.ca/en/fact-sheets/epidemiology/epidemiology-hiv-canada#footnote1_z5abanr
I agree with you. It does seem like a discriminatory practice and not in line with other standards of practice. I understand the fear given the track record in Canada but as you have stated the blood donation system was overhauled and those same issues no longer exist. I generally find Canada is overly cautious when it comes to medical issues. For example there are limits on medications we can access here which have been approved for use in the UK, and USA, but because they have yet to pass Canada's rigorous testing cannot be used here. I'm all for the Government protecting me but sometimes I think we should be allowed to receive information and make an educated decision to take on the risk or not. I think if someone, or their loved one needed blood to save their lives right now, they may be willing to take the risk, especially if the risk is as small as you have noted it is.
ReplyDeleteIn a country that is otherwise progressive in social rights, it seems very backwards that Canada would not allow MSM to donate blood. As you covered however, it does seem to be a decision based upon numbers rather than the social aspect. I feel that Canada is slow when making medical based decisions and it's only a matter of time before the government allows for MSM blood donations.
ReplyDeleteDespite how medically advanced Canada is, it really is absurd that MSM blood donations aren’t supported. With you mentioning how small the risk is, it seems silly for CBS not to take the blood that could save someone’s life. I’m hoping that the Canadian government can make smarter medical decisions, and hopefully find a way to incorporate MSM donations.
ReplyDeleteI agree. This type of discrimination is unbelievable. I didn't know about this situation in Canada, and couldn't imagine this happening in a country that preaches about diversity and gay rights. Just goes to show we as a society have much more to go in the battle of social inequality and justice.
ReplyDelete