NHS Blood and Transplant has introduced new eligibility rules that will allow more men who have sex with men to donate blood, platelets and plasma, “a historic move to make blood donation more inclusive while keeping blood just as safe”, reports MedicalBrief. A “discriminatory anti-African restriction” however remains.
The questions asked of everyone when they come to donate blood in England, Scotland and Wales will change. Eligibility will be based on individual circumstances surrounding health, travel and sexual behaviours evidenced to be at a higher risk of sexual infection.
Donors will no longer be asked if they are a man who has had sex with another man, removing the element of assessment that is based on the previous population-based risks. Instead, any individual who attends to give blood – regardless of gender – will be asked if they have had sex and, if so, about recent sexual behaviours. Anyone who has had the same sexual partner for the last three months will be eligible to donate.
The changes to the re-named Donation Safety Check form will affect blood, plasma and platelet donors. The process of giving blood will not change.
A major UK charity, however, has criticised a “discriminatory restriction” which will affect black communities' ability to give blood. The restriction relates to a three-month deferral period for anyone who has a "partner who has, or you think may have been, sexually active in parts of the world where HIV/Aids is very common" and references “most countries in Africa”.
Ella Poppitt, Chief Nurse for Blood Donation at NHS Blood and Transplant, said: “Patient safety is at the heart of everything we do. This change is about switching around how we assess the risk of exposure to a sexual infection, so it is more tailored to the individual.
“We screen all donations for evidence of significant infections, which goes hand-in-hand with donor selection to maintain the safety of blood sent to hospitals. All donors will now be asked about sexual behaviours which might have increased their risk of infection, particularly recently acquired infections. This means some donors might not be eligible on the day but may be in the future.
“Our priority is to make sure that donors are able to answer the pre-donation questions in a setting that makes them feel comfortable and safe and donation is something that continues to make people feel amazing. Our staff have been trained to make sure these more personal conversations are conducted with care and sensitivity and accurate information is captured.
“We are asking all blood, plasma and platelet donors to please consider the new questions alongside the existing health and travel questions before their appointment, and to re-schedule if they do not meet the changed criteria to donate right now.
“We want donation to be a positive experience and we are looking forward to welcoming donors as we move forward with these changes.”
Under the changes people can donate if they have had the same sexual partner for the last three months, or if they have a new sexual partner with whom they have not had anal sex, and there is no known recent exposure to an STI or recent use of PrEP or PEP. This will mean more men who have sex with men will be eligible to donate.
Anyone who has had anal sex with a new partner or with multiple partners in the last three months will be not be able to give blood right now but may be eligible in the future. Donors who have been recently treated for gonorrhoea will be deferred. Anyone who has ever received treatment for syphilis will not be able to give blood.
The changes follow an evidence-based review into individualised criteria by the FAIR (For the Assessment of Individualised Risk) steering group led by NHS Blood and Transplant. FAIR concluded on a new donor selection system which is fairer and will also maintain the UK’s status “as one of the safest blood supplies in the world”. The findings were accepted in full by the UK government last December.
Data around the impact of the donor selection changes will be kept under review and assessed 12 months after implementation to determine if changes are needed. Feedback from donors, LGBT+ individuals, patients and representatives will be a key consideration in this review.
These changes come at a time when demand for blood is increasing. This year, as life and the NHS start to return to normal, patients need blood donors more than ever.
The changes were welcomed by charities including the National Aids Trust, Stonewall and Terrence Higgins Trust.
However, the Terrence Higgins Trust said the government had kept a "discriminatory restriction" in England which will affect black communities' ability to give blood. The restriction relates to a three-month deferral period for anyone who has a "partner who has, or you think may have been, sexually active in parts of the world where HIV/Aids is very common" and references "most countries in Africa", the charity added.
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