As Canadian Blood Services moves to end its policy that restricts men who have sex with men from donating blood for three months after being sexually active, an advocate who fought to change it says the new policy is still discriminatory.
According to the new policy, which has been approved by Health Canada and first reported by The Canadian Press, all donors will be asked if they have had new or multiple sexual partners in the last three months, no matter their gender or sexual orientation.
Instead of being asked about gender or sexuality, potential donors will be screened on higher-risk sexual behaviour, such as anal sex. If the individual has had anal sex with those partners, then they will need to wait three months since that activity before donating blood.
Christopher Karas, who filed a human rights complaint against Health Canada to remove the deferral, says the policy still stigmatizes gay, bisexual men, and some transgender people.
"I want to be excited about this news. I really do. I think that this is in some way historic in that we're seeing the end of the deferral," he said in an interview with CBC News.
"But I know that a lot of gay, bi men and trans people will still be barred by this policy, so I think it's a bit unfortunate that the government has decided this is the approach they want to take," said Karas.
The new policy will be implemented no later than Sept. 30. The agency says asking about sexual behaviour, rather than sexual orientation, will allow it to more reliably assess the risk of infections such as HIV that can be transmitted through infusions.
It also says the shift comes after "countless hours" of work by LGBTQ and other groups, who have long advocated for a change in policy.
Anal sex is high risk factor, says doctor
Karas notes there are no questions about vaginal sex in the questionnaire, even though it is one of the primary modes of HIV infection.
"They won't be screening for vaginal sex, they won't be screening for condom use or any other risk behaviour that they should be screening for," he said.
"What they're saying is that gay and bi men and transgender [people]... are engaging primarily in anal sex. They're stigmatizing us through this new policy. That's what they're saying with this new policy," said Karas.
WATCH | Canada ends ban on blood donations:
Dr. Graham Sher, CEO of Canadian Blood Services, says the policy is based upon extensive domestic and international research.
"The evidence is really clear that anal sex is still a significantly higher risk factor for transmission of diseases, such as HIV. Then it's vaginal sex or oral sex," Sher said.
When asked about why individuals who use condoms can't be exempt from the deferral, Sher says it's difficult for donors to recall with accuracy whether they used a condom for every sexual interaction.
"While it is a very important public health measure and a safe sexual practice to do, over a body of time, it's not the primary risk factor. Evidence speaks to anal sex as the risk factor," said Sher.
Individuals who use PrEP and PEP — medication to prevent HIV infections — must also wait four months since they were last on the medication to donate blood.
Sher says it's true that individuals taking PrEP and PEP have a lower risk of transmitting infections through sexual intercourse and they might have a low viral load, but that doesn't necessarily apply to blood, especially for people who might be getting half a litre of it.
"We don't know that it can't be transmitted through a transfusion where there may be enough viruses in the bag of blood," he said.
Sher says Canadian Blood Services will continue to work with companies that manufacture tests for blood samples looking for diseases like HIV and Hepatitis B.
"CBS will continue to evaluate the science and the evidence and continue to modernize our policy as new evidence comes along," said Sher.
'Should've been done 10 years ago:' Prime Minister
Prime Minister Justin Trudeau said his government welcomes the decision and "it's been a long time coming."
"The current approach was discriminatory and wrong. This is a significant milestone for moving forward on both the safety of our blood supply, but also, non-discriminatory blood practices," Trudeau said Thursday.
Previously, the federal government has tried to block Karas's court challenge that argues Health Canada is discriminating against gay men by overseeing a ban that prevents men who have sex with other men from donating blood.
When pressed by reporters on whether Health Canada played a complicit role in the discriminatory policy, Trudeau said scientific evidence was needed and didn't exist.
"This should've been done 10 years ago, 15 years ago," he said.
"But the research, science, investment to be able to ensure that our blood supply continues to be safe, based on data, based on research, simply wasn't done by any previous government," the prime minister said.
Trudeau said the federal government invested more than $5 million into the research and funded a dozen studies to arrive at the outcome.