In 2017, the Australian Red Cross Blood Service began a review on its sexual activity deferrals. You would not be alone if you have not heard much since. As of June 2019, the Blood Service announced that it received the report from its external committee and would consider different options before its submission to the Therapeutic Goods Administration (TGA).
Currently, the Blood Service's guideline defers people for 12 months based on its list of risky sexual activity. This includes men who have had sex with men (MSM) including anal or oral sex with or without a condom. This policy, however, has been accused of being discriminatory, an assessment with which I would agree.
The general principle behind blood donation deferrals is to either protect patients from infectious diseases or to protect potential donors from any possible complications. In the case of sexual activity deferrals, it is the former. In order to protect patients, the Blood Service tests all blood donations for HIV, Hepatitis B, and Hepatitis C. Syphilis and HTLV are also tested for, unless a donation is only being used to create plasma products.
The primary argument for the MSM deferral is that gay and bisexual men have higher levels of HIV transmission and therefore pose a risk to patients. In a FAQ on the MSM deferral, the Blood Service suggests HIV as being the primary reason for this deferral. However, there is one point where the FAQ is somewhat misleading.
The Blood Service mentions that while it tests all donations for HIV, it cannot rely on testing alone. This is due to its window period, the time when a recent infection cannot be detected. However, what is not mentioned is the length of the window period for HIV.
Both HIV and Hepatitis C are normally considered to have maximum window periods of three months. In particular, fouth generation antigen/antibody HIV tests detect infections in 95 per cent of people by four weeks. However, these are nowhere near the 12-month deferral period the Blood Service has in place.
By this understanding, it would not make sense to have a deferral period of more than three months, or four months if you were being very cautious. If you could be certain of the accuracy of these tests, then regardless of the number of positive results, there would not be any increased risk to the blood supply.
"This not only perpetuates harmful stereotypes but ignores current HIV trends."
However, the