This initial policy response of an indefinite deferral for some groups including MSM was remarkably durable in Canada, remaining unchanged until 2013 when the donation policy was altered to a requirement of 5 years of abstinence from any sexual activity between men. When news spread that Canada’s blood system was compromised and thousands acquired HIV, and later hepatitis C, as a result of government wrongdoing, the idea that HIV had affected so-called “innocent” blood transfusion recipients gave way to “othering” dynamics that marked them off from groups perceived as morally culpable, including gay men, people who use drugs, and sex workers (see, p9).
Orsini and colleagues elucidate the legacy of this tragedy: It is estimated that approximately 2000 people in Canada, many of whom were hemophiliacs, contracted HIV through the blood supply, and many more with hepatitis, resulting in a billion-dollar compensation package for those affected. Blood donation “lifetime deferrals” or “indefinite deferrals” for MSM were first introduced in Canada as a response to the AIDS epidemic and the tainted-blood scandal. For over 20 years, Canadian Blood Services (CBS) along with Héma-Québec, its sister organization operating in the province of Québec, have been Canada’s blood operators, a role they took over from the Canadian Red Cross Society in 1998. ĭespite their ubiquity internationally, these MSM-specific deferral practices remain greatly disputed. As of June 3, 2019, this deferral period was reduced to 3 months. Since 2016, in Canada, a man had to meet all other eligibility criteria in addition to the following: “their last sexual contact with another man (anal or oral sex) was 12 or more months ago”. The current criteria for blood donation deferral range from being relatively uncontroversial, such as having had a dental cleaning in the last 24 hours or having had a tattoo or piercing in the last 3 months, to being highly contested, such as deferral practices for men who have sex with men (MSM). Multiple physiological and behavioural factors can disqualify a person indefinitely from donating blood in Canada or lead to a temporary donation deferral-a period of time during which one is not eligible to donate blood. Many participants believed that blood donation policy should be based on more up-to-date scientific evidence concerning risk factor assessment and HIV testing. ConclusionĪ predominant assertion was that a change from a 12-month to a 3-month deferral period would not resolve the fundamental issues of fairness and equity affecting blood screening practices for GBM in Canada. These preferences for a move away from MSM-specific exclusions aligned with their opinions concerning the possible change to a 3-month MSM deferral, for which participants shared three overarching perspectives: (1) step in the right direction (2) ambivalence and uncertainty and (3) not an improvement.
Participants believed that multiple “gender blind” and HIV testing-related strategies could be integrated into the blood donation process. A fair and safe policy was one that was the “same for everyone” and included screening for several risk factors during the blood donation process with no categorical exclusion of all sexually active MSM. Most participants were opposed to any deferral period in relation to MSM-specific sexual activity.
We interviewed GBM approximately one-year before this new deferral policy was approved by Health Canada. We focus on men’s preferred policy directions and their opinions about a policy change proposed by Canada’s blood operators: a 3-month deferral for all sexual activity between men. Interviews were coded in NVivo 11 following an inductive thematic analysis. To better understand the acceptance of existing deferral policies and possible future policy, we conducted 47 in-depth interviews with a demographically diverse sample of gay, bisexual, queer, and other men who have sex with men (GBM) in Canada’s three largest cities: Vancouver, ( n = 17), Toronto ( n = 15), and Montreal ( n = 15). Since 2016, in Canada, a man had to be abstinent from all sexual contact (anal or oral sex) with other men for at least 12 months in order to be an eligible blood donor.
Researchers and activists have long called for changes to blood donation policies to end what is frequently framed as unjustified bans or deferral periods for men who have sex with men (MSM).