A policy change years in the making, on Thursday Health Canada approved Canadian Blood Services’ submission to eliminate the three-month donor deferral period for gay and bisexual men as well as some other folks in the LGBTQ2S+ community.
Moving away from a blanket ban, the national blood donor organization will be able to screen all donors regardless of gender or sexuality. Instead, donors will be screened based on their sexual behaviors.
Canadian Blood Services (CBS) is expected to introduce the new behaviour-based questionnaire approach by Sept. 30. It will apply to both blood and plasma donations.
It will mean that when donors are screened before rolling up their sleeves, they’ll be asked whether they have recently engaged in anal sex in the context of new or multiple sexual partners within a certain amount of time.
“Sexual behaviour, not sexual orientation, determines the risk of sexual transmission of blood borne pathogens,” said Dr. Isra Levy, Canadian Blood Services’ vice-president of medical affairs, at the organization’s latest board meeting on Dec. 3, just prior to the organization submitting the request to change their policy.
The agency took longer than the aimed 90 days to complete their review of Canadian Blood Services’ submission to make this change, but Health Canada says their authorization “is based on a thorough assessment of evidence supporting the safety of the revised donor screening.”
The policy started in 1992 as an outright lifetime ban following the tainted blood scandal that played out between the 1980s and 1990s and saw thousands of Canadians infected with HIV after receiving donor blood. During that scandal, the Canadian Red Cross — which was the predecessor to Canadian Blood Services and Hema-Quebec — failed to properly test and screen donors, resulting in thousands of Canadians being exposed to HIV through contaminated blood products.
During the nearly three decades since, the policy has been gradually eased, starting with a change in 2013 that saw the lifetime ban knocked down to a five-year deferral period. That meant, rather than outright refusing donations from men who had sex with men, or the “MSM” community as some have coined it, donations would be accepted only if the donor had not been sexually active for five years.
In 2016, the five-year deferral period was reduced to one year, and then in June 2019, the current three-month deferral period came into effect.
As it currently stands, Canadian Blood Services prohibits gay and bisexual men who have sex with men, as well as certain trans people who have sex with men, from donating blood unless they have been abstinent for three months. Earlier this year a pilot project was approved for plasma donations at centers in Calgary and London, Ont., provided donors have not had a new sexual partner or their partner has not had sex with another partner in the last three months.
The evolutions to the policy over the last several years were the result of Health Canada approving regulatory submissions, which included risk modeling showing it would be safe to do so.
As part of this review, Health Canada agreed to a panel of medical and scientific experts in the blood safety field to advise on the change.
“Today’s authorization is a significant milestone toward a more inclusive blood donation system nationwide, and builds on progress in scientific evidence made in recent years,” Health Canada said in a statement.
As CTVNews.ca has previously reported, amid questions about why the policy has been slow to evolve, Health Canada “required” two-year intervals between when the donor screening criteria could be updated to monitor potential blood safety impacts of the updated donor screening criteria , according to documents.
Canadian Blood Services has been consulting with stakeholders including the LGBTQ2S+ community and patient groups throughout this process. For years LGBTQ2S+ advocates and those who are prohibited from donating have voice their frustration, saying the policy is discriminatory and not based on science.
As has been the case for some time, every blood donation in Canada is tested for HIV. Under current testing capabilities, HIV can be detected in a “window period” of approximately nine days after infection.
Easing the amount of time impacted donors have to be abstinent for in the past has not resulted in an increase in the risk of transmissible disease, according to Canadian Blood Services.
The federal government has been under fire for years, including from LGBTQ2S+ opposition MPs, for failing to follow through on their long-stated promise to lift the ban. Prime Minister Justin Trudeau has also been criticized for making recurrent pledges in recent years that the policy change was imminent.
Key cabinet ministers responsible for the file over the years have dismissed calls to force a change to Canada’s Blood Regulations rules unilaterally, saying the agency has a “limited role” to intervene and that it was up to Canadian Blood Services to ask for a change to the policy.
The Liberals did fund research projects that were aimed at helping bolster the evidence-based, decision-making process, including studying donors’ eligibility criteria and alternative screening processes. CBS has said this evidence, risk modeling based on Public Health Agency of Canada data, and also international research informed their 2021 submission.
Canadian Blood Services operates blood donations in all provinces and territories other than Quebec, which is managed by Hema-Quebec. That agency was not involved in this submission, but has already been granted approval to move to a more including screening process for plasma donations.
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