Before the introduction of testing for human immunodeficiency virus (HIV) in the mid-1980s, thousands of Canadians were infected through tainted blood products. Being solely responsible for Canada’s blood supply at that time, the Canadian Red Cross Society introduced a donor eligibility criterion that excluded all men who have had sex with a man even once since 1977. This criterion was embedded into Health Canada regulations in 1992.
At Canadian Blood Services, we periodically review our donor eligibility criteria, including those related to men who have sex with men. In 2016, Health Canada approved Canadian Blood Services’ and Héma-Québec’s applications to reduce the men who have sex with men ineligibility period from five years to one year. In other words, as long as they meet all other donor eligibility criteria, a man is now eligible to donate blood if it has been at least one year since he last had sex with another man. These changes are important steps towards being as minimally restrictive as possible while also maintaining the safety of the blood supply.
This change in policy was made after extensive review of scientific and epidemiologic evidence. Equally important was the consultation with high-interest groups, including patient groups representing heavy users of blood and blood products as well as members of lesbian, gay, bisexual, trans and queer (LGBTQ) community groups.
Because the patterns, causes and effects of HIV differ by country, there is no international scientific consensus on an optimal deferral period for men who have sex with men. Some European countries have instituted lifetime bans on blood donations from men who have sex with men, while the United Kingdom and Australia have reduced their deferral periods to one year.
A man who has had sex with a man is eligible to donate blood one year after their last sexual contact with other men.
Blood is regulated as a drug by Health Canada.
Health Canada is the regulator of Canada’s blood system. Any change to donor eligibility criteria that may affect recipient safety must be sent to Health Canada for approval.
Health Canada approved reduction of the MSM waiting period to three-months (in April 2019) based on a joint submission made by Canadian Blood Services and Hema-Québec. This change takes effect on June 3, 2019 across Canada.
The previous reduction from a five-year to a one-year waiting period was introduced in August 2016, and it was in July 2013 that the indefinite deferral period was removed, and the five-year eligibility criteria was added.
Recommendations pertaining to donor eligibility criteria have all been based on the latest available data and scientific evidence.
Since Canadian Blood Services began managing Canada’s blood system in 1998, there has not been a single recorded instance of blood-borne infection from either hepatitis C or HIV.
At the outset of every blood donation, donors are screened to make sure they are healthy. This involves answering an extensive list of questions to ensure the safety of both the donor and the patient who will receive the blood products.
Each blood donation undergoes extensive testing for infectious diseases and contaminants. Within hours of collection, the test samples are sent to a lab and those samples are tested within the day.
Ultimately patients bear 100 per cent of the risk associated with blood transfusion, and of the consequences of changes made to donor eligibility criteria.
There is no international scientific consensus on an optimal deferral period for men who have sex with men. Donor screening criteria must address the Canadian context, which differs from that of other countries.
In partnership with Héma-Québec and with funding from Health Canada, Canadian Blood Services is supporting 15 research projects investigating various aspects of blood and plasma donors’ eligibility criteria and screening process.
We use antibody testing and nucleic acid amplification testing (NAT) to test blood for HIV. Introduced in 2001, NAT greatly reduces the length of time HIV can go undetected in a person infected with the virus. However, there is still an approximately nine day period shortly after infection when an individual may transmit HIV but the virus is not detected by our tests. That’s why we use screening questions before a donation is made as part of a multi-tiered safety system to protect patients.
Canadian Blood Services manages the national supply of blood, blood products and stem cells, and related services for all the provinces and territories (excluding Québec). We also lead an integrated, interprovincial system for organ donation and transplantation for all of Canada. Ensuring the safety of both donors and recipients is paramount at Canadian Blood Services. Through the testing of all donated blood and the adherence to strict donor eligibility criteria, including the deferral policy for men who have sex with men, we ensure that Canadians are not put at increased risk for infectious diseases that may be transmitted by blood transfusion, including HIV, hepatitis B and hepatitis C.
FOR MORE INFORMATION
To learn more about the eligibility criteria for men who have sex with men or about Canadian Blood Services’ practices and procedures, please contact: