We Must End The Gay Blood Ban, And It Starts With Smart Policy

As a researcher, I have spent more than a decade working at the intersection of HIV and sexuality. I was motivated by my own experiences of discrimination, including being denied the opportunity to donate blood because I am sexually active gay man.

Last summer, working with Community Based Research Centre, we collected over 3,500 surveys from gay, bi, queer, trans and Two-Spirit men at 15 Pride festivals across the country. It turns out that over 85 per cent of sexual minority men in Canada also felt this blood donation policy was discriminatory.

Equitable blood donation policies for sexual minority men have always been elusive. From blood bans to lengthy deferral periods, it’s never been easy for men who have sex with men to donate. Despite some recent improvements, Canada has a long way to go to open up its blood-donation practices and create fair, science-based policies.

In this battle against discrimination, the blood deferral period for men who have sex with men has been lowered to just three months. It wasn’t too long ago that a man who had any kind of sex with another man wasn’t allowed to donate at all. However, even with the new time frame in place, the policy itself still remains discriminatory and offensive to many gay, bisexual and queer men.

This “population-based” approach is built on the faulty assumption that all men who have sex with men are likely to acquire HIV. While HIV is certainly an inequitable burden among gay men, the majority of gay men are HIV-negative and will remain HIV-negative their entire life. Our research has demonstrated the acceptability of using an individual behaviour-based approach to blood donor screening that does not discriminate on the basis of a person or their partner’s sex or gender.

The blanket deferral period against men who have sex with men was first introduced in the mid-1980s as a safety measure to ensure that if a donor had acquired HIV, no matter how recently, it would not enter the blood supply. When it was first introduced we had barely discovered HIV and didn’t have a test available to identify HIV. Nowadays, our scientific advancements allow us to detect HIV in the blood nine days after exposure. So, why does Canada continue to defer all men who have sex with men for three months?

Canadians, the Canadian Blood Services, Health Canada and many gay, bisexual and queer men have the same goal — to provide Canada with a safe and readily available supply of blood. In fact, in our national survey last year, 92 per cent of participants said that they would be willing to donate blood if they were eligible. Rather than perpetuate a cycle of discrimination, our institutions should prioritize gender-neutral risk-based assessments to create the most sustainable blood supply system possible.

The Summit, formerly the Gay Men’s Health Summit developed by the Community Based Research Centre (CBRC) and presented by ViiV Healthcare, is the biggest LGBTQ2+ community health conference in Canada with a specific mandate to explore the health of gay, bi, queer and other men who have sex with men (cis and trans) and Two-Spirit people (GBT2Q) and related issues.

The Summit 2019 is taking place at the end of the month in Vancouver with the theme “Queering Healthcare Access & Accessibility.” As GBT2Q are more likely to face unnecessary barriers to accessing the health care they need, and with political parties promising new investments in health and safety this election, it comes at a very important time.

During the Summit, I’ll be speaking about the CBRC’s two-decade, community-based research program called the Sex Now survey. In addition to the 3,500 surveys collected, participants also gave us dried blood spots to test for HIV and Hepatitis C. We found that extremely few (few than 0.1 per cent) men had HIV and were unaware. We need to update our health policies to reflect this latest evidence. We are also launching our Sex Now 2019 online survey across Canada, which will collect the latest information on the acceptability of the new three-month deferral period.

Although scientific advancements have given us the answers, it’s clear that stigma continues today. We must make blood donor discrimination a thing of the past. Society continues to relies on old science to justify the exclusion of men who have sex with men. Now, we know better.

We need to attack this ignorance head on and educate the public with facts. We need to take gender and sexual orientation out of the debate and stop making blood donations political, because these bans don’t just affect those who want to donate blood, but also everyone who depends on it. If a new generation of Canadians perceive our blood donor system as unfoundedly discriminatory, we risk the sustainability of a safe and sufficient blood supply for the country.

Everyone may need blood at some point in their life. We all have a responsibility to make sure this critical resource is available to all Canadians. We need a sustainable system that works for the 21st century and new generations of blood donors.

Dr. Nathan Lachowsky is Research Director at CBRC and Principal Investigaytor of the Sex Now survey. He is also an Assistant Professor in the School of Public Health and Social Policy and a Michael Smith Foundation for Health Research Scholar at the University of Victoria.

He has conducted HIV and sexual health research with sexual and gender minoritized men, including Indigenous Two-Spirit and ethnoracial minority men. His principal area of research focuses on social and behavioural epidemiology and the importance of developing and analyzing mixed methods data to inform public health practice, health service provision and policy.

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