Regulating the Risk of Blood-borne Related Infections: Men Who Have Sex with Men Deferral Policy

• Main Author: Melissa Berman
• Format: Article
• Language: English
• Published: McMaster University Library Press 2018-01-01
• Series: Health Reform Observer - Observatoire des Réformes de Santé
• Subjects: blood regulation; MSM; The Krever Commission; Canadian Blood Services; Hema-Quebec
• Online Access: https://mulpress.mcmaster.ca/hro-ors/article/view/3220/2947

In Canada, from 1989 to 2013, a man who had had sex with another man (MSM), even once since 1977, was categorically excluded from the blood donor pool. Although the LGBTTQ community and student groups argued that this exclusion, based solely on sexual orientation, was discriminatory and promoted homophobic attitudes, the painful legacy of the tainted blood scandal and the desire to maintain public trust in the blood supply, prevented Canadian Blood Services from relaxing the eligibility. The recent changes to the MSM blood deferral policy primarily aimed to align the ban with new epidemiological evidence of risk. Implicitly, another goal was to increase blood supply by enhancing young Canadian's perception of blood services, prompting them to become regular donors. An extensive consultation process, lasting almost a decade, was necessary to reach a compromise amongst patient groups opposed to changes to the legislation, and the LGBTTQ and student groups who wanted to eliminate the deferral for MSM altogether and reform screening practices. A consensus amongst high interest groups was reached in 2013, resulting in the implementation of a 5-year deferral (meaning MSM become eligible donors after five years without sex with other men) and three years later, a change to a 1-year deferral. The changes to the deferral policy have had a small impact on net blood supply; nevertheless, they have succeeded at improving donor compliance, satisfying activists, and advancing the possibility of introducing novel and improved screening tools that tackle the risk inherent in sexual practices rather than the risk related to sexual orientation.