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South Africa ends ban on homosexual blood donations, but no change in Canada

South Africa ends ban on homosexual blood donations, but no change in Canada

Recent changes to the way South Africa accepts and rejects blood donations will not likely echo in Canada, where we currently retain the questionable practice of banning sexually active homosexual men from donating blood.

The South African National Blood Service (SANBS) announced this week that it would do away with a ban on blood donations from men who have had sex with other men and replaced it with a less directed policy of taking donations from celibate or monogamous residents, regardless of sexual orientation.

SANBS spokesperson Vanessa Raju told Mamba Online that, “The policy wasn’t meant to be discriminatory, but it was seen as such. We then worked closely with the Department of Health and other organisations to reassess the situation.”

Before the shift, South Africa's policy had already been more liberal than Canada's. The South African National Blood Service had allowed donations from gay men if they had been celibate for more than six months. In Canada, that threshold is and remains five years.

Canadian Blood Services remains hesitant to make a similar move, still declining donations from any man who has had sex with another man (known internally as MSM) in the past five years. And South Africa’s shift is not likely to impact that position.

Dr. Mark Bigham, a medical officer with the Canadian Blood Services, says the epidemiology of HIV patients is distinctly different in the two countries. In South America, about 12 per cent of the population has HIV, and if affects every walk of life almost equally. According to Avert, 13.6 per cent of South African females and 7.9 per cent of males had HIV in 2008.

In Canada, only 0.2 per cent of the population has HIV, and homosexual males are still most frequently impacted, though those numbers are changing.

“In Canada, the significant majority of cases are attributed to the MSM population. That is not to say that HIV doesn’t exist in the heterosexual community,” Bigham told Yahoo Canada News. “Whereas in South Africa, they have a very different epidemiology. The HIV epidemic there is essentially driven by heterosexuals, and the prevalence is so high in the general population that it washes out any effect of homosexual contact.”

Canada, along with other countries, has historically declined blood donations from gay men over the fear of HIV and AIDS in the community, an issue that came to a head during a tainted blood scandal in the early 1980s.

But with improved screening methods and the disease itself spreading through all demographics of society, the ban no longer seems to serve its purpose. Even Canadian Blood Services acknowledged that as recently as last year.

Prospective male donors were previously asked as part of the screening process if they have had sex with a man "even once, since 1977." Last May, the criteria were lowered and male applicants are now asked if they'd had sex with a man in the last five years. Those who responded positively were declined as donors.

But banning actively sexual homosexual men from donating blood is not the last line of defence. We currently have the technology to scan blood donations quickly and effectively. As the Canadian Federation of Students notes as part of its "End the Blood Ban" campaign, laboratory tests used to take weeks or months to determine the health of a sample. There are now tests that can detect HIV in a single sample within days.

Bigham says no changes are currently being considered, though he concedes that blood testing technology is very good and the waiting period is getting shorter. Still, he says the five-year ban requirement is a matter of being extra cautious.

“The concern is that there could be a lab error. That’s why we have multiple redundancies in place. To make sure we don’t put all our eggs in one basket,” Bigham said.

There is no current consideration about going to a model that weighs the personal risk of infection rather than the statistical population breakdown. That is a system, however, already in place in several other countries.

France, Spain, Italy, Russia and Portugal already have blood-donor policies based on personal risk measurements. Mexico ended its ban on blood donations from gay and bisexual men in 2012, becoming the first North American country to do so, and replaced it with a screening process based on sexual history, rather than orientation.

That is, in essence, what South African did this week.

According to the South African National Blood Service, the new policy states that anyone who has been in a monogamous relationship for the past six months may donate blood, regardless of sexual orientation.

Meaning, a heterosexual man who recently began sleeping with a new partner would need to wait six months before he could donate. A homosexual man who has been monogamous for six months, however, would be free to donate immediately.

None of this negates or subverts the need for a screening process, but it is a nod to modern reality. AIDS isn't something that is limited to homosexual men, not even in Canada.

According to the AIDS Council of Toronto, nearly one-quarter of all HIV cases reported in Canada in 2012 were females, and 32.6 per cent of all reported cases were spread through heterosexual contact. If the Canadian Blood Services' ban on blood from men who have sex with men is about playing the odds, there are serious holes in their strategy.

Maybe it's time to do away with the ban targeted man-on-man sex participants and introduce one based on personal risk. Maybe it’s time we’re all asked to earn our right to donate blood.