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'Gay men who've had sex in a year can't give blood, but those involved in risky sexual behaviour can'

The Irish Blood Transfusion Service should focus on risky sexual behaviour instead of sexual orientation, writes James Larkin.

James Larkin Health researcher

TWENTY FOUR YEARS after homosexuality was decriminalised, the lifetime ban on men who have had sex with men (MSM) donating blood was lifted.

It was replaced by a one year ’deferral’ so that if a man has had protected or unprotected anal or oral sex with another man in the last year then they cannot give blood.

One discriminatory rule is replaced by another discriminatory rule under the pretext of safety and practicality.

It is admirable that a state institution might try to address systematic discrimination by removing the blanket ban on MSM donating blood. However, it is not acceptable that even after a two year review, blood donation policy in Ireland still unnecessarily discriminates against gay men, albeit to a lesser extent.

It is not men having sex with men that should be of concern to the Irish Blood Transfusion Service (IBTS), but risky sexual behaviour.

There is a higher rate of HIV amongst the male homosexual population than most other populations. However, it is arguable that there is a population with an even higher rate of HIV; people engaging in risky sexual behaviour, be they heterosexual or homosexual.

‘Focus on risky sexual behaviour instead of sexual orientation’

At the moment a man who has had safe oral sex with another man once in the last year is considered by the IBTS as higher-risk than a man who has unprotected anal sex with several different women over the last year.

There is potentially a cohort of males and females who frequently have unprotected anal sex that are far more likely than the general population to have HIV. Yet, because they have no particular identifier they are less likely to be excluded from blood donation.

If, instead of asking about males having sex with males, the IBTS asked about engaging in unprotected anal or oral sex then they would reduce discrimination and decrease the number of high-risk individuals donating blood.

To focus on risky sexual behaviour instead of sexual orientation is not a radically progressive act. Italy currently has no deferral period for men who have sex with men. Instead, an individual risk assessment is carried out which asks questions unrelated to sexual orientation. There is no evidence that this has had an effect on transfusion transmission rates of HIV in Italy.

By having a discriminatory policy like the deferral period, it does not just exclude gay men from donating blood but serves to promote a stereotype as well as potentially engendering distrust of the healthcare system amongst gay men.

‘Unwise to alienate the gay community’

Blood donations are a necessity for a well-functioning healthcare system. They are used for women who have complications during pregnancy, for people who have experienced severe trauma, and patients undergoing major surgery. But for certain blood types, the IBTS currently only have enough stocks to last three days.

To keep up with demand, 3,000 donations are needed per week. According to the minister for Health Simon Harris; “Only 3% of the eligible population of Ireland are active blood donors”.

The gay community, in the past, has given great impetus for HIV research and prevention. There is no reason not to think that they could make a substantial contribution to blood donation in Ireland.

Given how invaluable blood donations are to the health of patients it seems unwise to alienate the gay community and it is generally unwise to discriminate based on sexual orientation.

James Larkin is a health researcher with a master’s in global health from University College London

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James Larkin  / Health researcher

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