Give Blood England and Wales

Frequently Asked Questions

• What does the term "MSM" mean?

  MSM or "men who have sex with men" refers to any man who has or has had anal or oral sex with another man. The term does not refer only to gay and bisexual men but also heterosexual men who have had sex with a man/men. Blood donor selection criteria are not applied to MSM on the basis of their sexuality, but due to specific sexual behaviours (anal and oral sex between men) which increase the risk of transmission and infection with blood-borne viruses and other sexually transmitted infections. The only sexual behaviours between men that would result in any exclusion from blood donation are anal or oral sex. Other activities that many people consider "sexual", for example mutual and solo masturbation, would not be cause for exclusion from blood donation.

• What is the current blood donor selection criterion for MSM?

  The blood donor selection criterion for MSM changed on 7^th November 2011. Before that date, men who had ever had anal or oral sex with another man were asked not to donate blood permanently. On 7^th November, this changed following an evidence based review by the Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO).

  Men who have had anal or oral sex with another man in the past 12 months (with or without a condom) are ineligible to donate blood. Men whose last relevant sexual contact with another man was more than 12 months ago are eligible to donate (subject to meeting the other donor selection criteria). The only sexual behaviours between men that result in any exclusion from blood donation are anal or oral sex. Other activities that many people consider "sexual", for example mutual and solo masturbation, are not cause for exclusion from blood donation.

• What will the change mean in practice at blood donation sessions?

  NHS Blood and Transplant implemented the change at blood donation sessions across England and North Wales on 7 November 2011.

  At blood donation sessions, all donors are asked to complete a questionnaire to assess whether they meet the criteria. This is to ensure that the supply of blood to patients is as safe as possible. The questionnaire has been changed so that the question regarding sex between men determines whether a potential donor is a man who has had anal or oral sex with a man in the past 12 months (even with a condom), rather than ever in their lifetime.

  If a potential donor answers 'yes' to any question that could suggest they are at an increased risk of carrying blood-borne infections they are asked to speak in confidence to a registered nurse. Further appropriate questions are then asked to understand the risk factors associated with the behaviour disclosed. The registered nurse makes a decision based on the individual situation presented. For men who have had anal or oral sex with another man in the previous 12 months, they are asked not to donate until 12 months have passed since this contact.

  Health screening areas are set up to minimise the risk of being overheard, and background music reduces the opportunity for this. Any record relating to identifiable individuals of a confidential or sensitive nature is always written on a separate record and sealed in an envelope to maintain confidentiality.

  Blood donation works on the principles of kindness and mutual trust and we ask all potential and existing donors to adhere to the blood donor selection criteria by providing completely honest answers to all the questions asked, both for the protection of their own health and that of others. Compliance with all donor selection criteria is crucial in order to ensure the continued safety of the blood supply. Anyone may require a blood transfusion in the future and it is in the best interests of us all to ensure that we strive to maintain blood safety.

• How has the blood donor selection criterion for MSM changed?

  The criteria across all of the UK Blood Services for accepting blood donors are recommended to the UK Government by the Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO). These criteria are regularly reviewed to ensure they are appropriate and based on the most up to date scientific evidence. Donor selection policies that are proportionate and based purely on evidence are necessary to help ensure that donors comply with the health check process.

  A previous review of the permanent exclusion of men who have sex with men in 2006 found that despite developments in testing and improved knowledge of the epidemiology of blood-borne infections, there was insufficient data regarding compliance to determine the potential impact of any changes, therefore no changes to the policy were recommended at that time. A study was commissioned to increase the understanding of compliance with the permanent deferral. This study reported in December 2010.

  • Improvements in blood donation testing, including universal Nucleic acid Amplification Technology (NAT) testing and smaller donation pool sizes which increases sensitivity, have been implemented since the last review and these have greatly reduced the various 'window periods' for detection of infections in donated blood
  • All tests are fully automated and are monitored by advanced IT systems, reducing the risk of any error in the testing process
  • The introduction of a 12 month deferral would maintain blood safety and bring the criterion for MSM in line with those for other groups that are at an increased risk of carrying blood-borne infections
• What new evidence prompted a change to the blood donor selection criterion for MSM?

  The Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO) and an expert Steering Group comprised of relevant experts and stakeholders reviewed detailed scientific research and other evidence including:

  • The results of a mixed methods study which explored compliance with the current permanent exclusion of men who have sex with men, assessed the possible consequences of a revision to this criterion and examined how best any revision might be formulated and communicated
  • Data from a qualitative study involving compliers and non-compliers with the current lifetime deferral
  • Modelling studies on the impact on risk of the introduction of fixed-period deferrals for MSM
  • Epidemiology of donors with markers of infection
  • Data on risk factors and reasons for non-compliance (where appropriate) collected from donors with markers of infection.

  For more information on SaBTO's review : http://www.dh.gov.uk/ab/SaBTO/index.htm

• Should patients receiving blood donations be concerned about the changed blood donor selection criterion for MSM?

  No. All of the policies in place to ensure the safest possible blood for patients are based on the most up to date scientific evidence and are reviewed on a regular basis. The review carried out by the Advisory Committee on the Safety of Blood, Tissues and Organs in 2011 (SaBTO) concluded that changing from a permanent exclusion to a 12 month fixed period deferral would not impact on the safety of the blood supply.

  Whilst there is an acceptance that no medical treatment can have zero risk for patients, we would like to reassure patients receiving transfusions that the blood supply is as safe as it reasonably can be and amongst the safest in the world. NHSBT and other Blood Services have a clear responsibility to minimise the risk of any blood transfusion transmitting an infection.

  Clearly any transmission would be one too many and the purpose of the blood donor selection criteria, alongside other safety measures, is to minimise any potential harm to recipients of blood donations (as well as to protect the health of donors). A 12 month fixed period deferral since the latest relevant sexual contact between men is considered sufficient to ensure the continued safety of the blood supply. The change brings the criterion for men who have sex with men in line with those for the majority of other groups that are deferred from blood donation for 12 months due to sexual behaviours.

  Donor adherence with this and all donor selection criteria is key to the safety of the blood supply.

• Were blood recipients / patient groups / donors consulted as part of the review?

  Yes. As part of the review, new research was presented in July 2009 and a public meeting was held in October 2009 attended by a range of organisations representing the interests of donors, blood recipients and people affected by current blood donor selection criteria related to sexual behaviour.

  SaBTO has also been supported by a Steering Group of relevant experts (http://www.dh.gov.uk/ab/SaBTO/index.htm) and stakeholders in carrying out its review, including representation from the various groups that were likely to be affected by, and interested in, the outcome. The Steering Group reviewed the research and available evidence and provided advice to inform SaBTO's review.

• Was the policy changed because of Equalities Laws?

  The Equality Act 2010 was considered as part of the review. The Act states that blood services do not contravene anti-discrimination legislation by excluding people from donating blood as long as this exclusion or deferral is based on a reasonable and reliable assessment of risk to the public or the individual.

  The criteria for blood donors across all of the UK Blood Services are recommended to the UK Government by the Advisory Committee on the Safety of Blood, Tissue and Organs (SaBTO). In order to ensure the continued safety of the blood supply, currently those in groups shown to be at an increased risk of carrying blood-borne viruses are asked not to give blood for either a fixed period or permanently.

• How can it be fair to treat all gay men as high risk?

  Blood donor selection criteria are not applied on the basis of sexuality but due to specific sexual behaviours (anal and oral sex between men).

  Men who have sex with men as a group have been shown to be at a statistically higher risk of acquiring HIV and other sexually acquired infections including HBV in the UK. See the Health Protection Agency (HPA) website for further information: http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1314807668695

  Although some would prefer a system that assesses every individual's behaviour and level of risk rather than applying deferrals to groups, SaBTO's review concluded that there is insufficient evidence available to be able to determine the impact on blood safety of such a system. It is also not certain that all people could objectively assess their own level of risk.

  We appreciate that it can be disappointing for anyone who wishes to donate blood but is not able to meet the donor selection criteria. The criteria are based on complex assessments of risk and must by their nature be based on evidence and statistics that are recorded at a population level. However, this results in assessments of certain groups as being at a higher risk than others of carrying blood-borne infections, and can make those that are deferred from donation feel they are being placed into a 'category' even if they feel that their own sexual behaviour and risk-taking would not be a risk to the blood supply.

  As there is a small possibility that the tests we use may not pick up infections, particularly those which have been recently acquired, we must follow deferral rules that estimate risk based on behaviour. We are sorry for any inadvertent offence this causes and would welcome anyone that does not currently meet the donor selection criteria to come forward if this changes in the future.

• Why is it not possible to introduce a system through which every donor’s individual level of risk is assessed as they have done in Italy, Latvia and Spain?

  SaBTO's review concluded that there is insufficient evidence available to be able to determine the impact on blood safety of such a system. Any changes made to blood donation policies must be evidence based. It is also not certain that all people could objectively assess their own level of risk.

  The review also found that the introduction of extensive donor questions regarding sexual behaviour could lead to a loss of existing donors who would be likely to find the process intrusive, potentially impacting upon the sufficiency of the blood supply. The Blood Services are therefore required to follow deferral rules that estimate the statistical risk of certain groups based on behaviour (e.g. anal or oral sex between men).

• What is a window period?

  All blood donations are tested on every occasion for evidence of infection with Human Immunodeficiency Virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), Human T-cell Lymphotropic Virus (HTLV), and syphilis. In addition, donors who have been exposed to a risk of certain infections found outside the UK, but which are transmissible by blood transfusion (e.g. malaria and Chagas' disease), undergo specific testing before their blood is released for use.

  There have been great advances in testing which have significantly improved blood safety in the UK in recent years. However, if a person donates blood during the "window period", the infection may not be detected as the immune response may not yet be evident in the blood. This means the infection could be transmitted via a blood donation during this period.

• Why is the deferral period for MSM 12 months?

  All blood donations are tested on every occasion for evidence of infection with Human Immunodeficiency Virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), Human T-cell Lymphotropic Virus (HTLV), and syphilis. In addition, donors who have been exposed to a risk of certain infections found outside the UK, but which are transmissible by blood transfusion (e.g. malaria and Chagas' disease), undergo specific testing before their blood is released for use.

  Although in recent years there have been great advances in testing which have significantly improved blood safety in the UK, if a person donates blood during the "window period" the infection may not be detected but could be transmitted via a blood donation.

  The evidence reviewed by SaBTO showed that men who have sex with men as a group continue to be at a statistically higher risk of contracting blood-borne viruses such as HIV and HBV in the UK. Due to the nature of HBV infection, and of the screening tests used, it is necessary to allow 12 months from any higher risk behaviour as this is long enough for the donor to have undergone and recovered from an infection. A deferral period of 12 months is considered sufficient to allow for the complete clearance of HBV in a recovered individual. Those individuals who do not recover from HBV infection will be detected by the screening tests.

  The change brings the criterion for men who have sex with men in line with other groups that are deferred from blood donation for 12 months due to sexual behaviours. Donor adherence with this and all donor selection criteria is key to the safety of the blood supply.

• I’ve recently had a negative HIV test result and know that I am negative, so why can’t I donate blood?

  As there is a small possibility that the tests we use may not pick up infections, particularly those which have been recently acquired, we must follow deferral rules that estimate risk based on behaviours. We are sorry for any inadvertent offence this may cause and would welcome anyone that does not currently meet the donor selection criteria to come forward if this changes in the future.

• I always use condoms, why can’t I give blood?

  While safer sex, through the use of condoms, does reduce the transmission of infections, it cannot eliminate the risk altogether. Condoms have one of the highest success rates at preventing many sexually transmitted infections and they are made to strict standards, with a very low failure rate when used correctly. However, people do not always use them correctly and so reliance upon this method to ensure the safety of the blood supply is not considered sufficient.

• Why hasn’t SaBTO recommended a deferral / exclusion for promiscuous heterosexuals?

  Men who have sex with men as a group have been shown to be at a statistically increased risk of acquiring blood-borne viruses in the UK. It is specific sexual behaviours rather than sexuality that increase the risk of virus transmission (e.g. anal or oral sex between men).

  Although some would prefer a system that assesses every individual's behaviour and level of risk rather than applying deferrals to groups, SaBTO's review concluded that there is insufficient evidence available to be able to determine the impact on blood safety of such a system. It is also not certain that all people could objectively assess their own level of risk.

  Based on published data, the review also concluded that the introduction of extensive donor questions regarding sexual behaviour could lead to a loss of existing donors who would be likely to find the process intrusive. The Blood Services are therefore required to follow deferral rules that estimate the statistical risk of certain groups based on behaviour. We are sorry for any inadvertent offence this may cause.

• There is no shortage of blood in the UK, so why was the review carried out?

  It is important to ensure that all donor selection criteria are based on the most up to date scientific evidence to ensure the continued safety of the blood supply and of donors.

  New blood donors are needed all the time and it is crucial to regularly review the donor selection criteria to ensure as many people as possible are able to donate to meet the demand for blood for patients.

• Isn’t there a risk of those men who have sex with men who don’t agree with the policy donating anyway?

  There is always that possibility for any of the blood donor selection criteria. Blood donation works on the principles of kindness and mutual trust and we ask all potential and existing donors to adhere to the blood donor selection criteria by providing completely honest answers to all the questions asked, both for the protection of their own health and that of others. Compliance with all donor selection criteria is crucial in order to ensure the continued safety of the blood supply. Anyone may require a blood transfusion in the future and it is in the best interests of us all to ensure that we strive to maintain blood safety.

• I don’t feel comfortable answering questions about my sexuality and sexual behaviour in the blood donation environment, why should I adhere to the donor selection criteria?

  You can check the donor selection criteria before you attend a blood donation session through information available on UK Blood Service websites and donor telephone lines.

  • NHS Blood and Transplant: www.blood.co.uk or call 0300 123 2323
  • Welsh Blood Service (covering South, West and part of Mid Wales: http://www.welsh-blood.org.uk/ or call 0800 25 22 66
  • Scottish National Blood Transfusion Service: http://www.scotblood.co.uk/ or call 0845 90 90 999.
  • Northern Ireland Blood Transfusion Service: http://www.nibts.org/ or call 028 9032 1414.

  For anyone who books an appointment to donate blood NHSBT also send a donor health check questionnaire in advance, which contains information on the donor selection criteria.

  Blood donation sessions are designed to provide as confidential an environment as possible. We do not ask potential donors to answer any questions in front of anyone other than the health screener. If sensitive information is disclosed a check is made to ascertain that this was not answered in error. Once this is confirmed the donor is referred in confidence to a registered nurse. The nurse will ensure there is a secure environment to reassure the donor that their confidentiality will be maintained.

  Blood donation works on the principles of kindness and mutual trust and we ask all potential and existing donors to adhere to the blood donor selection criteria by providing completely honest answers to all the questions asked, both for the protection of their own health and that of others. Compliance with all donor selection criteria is crucial in order to ensure the continued safety of the blood supply. Anyone may require a blood transfusion in the future and it is in the best interests of us all to ensure that we strive to maintain blood safety.

• Is it against the law to lie about my sexual history in order to give blood?

  Currently there is no law regarding sexual history and blood donation. However, a legal case was recently successfully brought against a blood donor in Canada who was found to have knowingly donated blood despite not meeting the selection criteria, resulting in an infection being identified through testing in his donation.

  Blood donation works on the principles of kindness and mutual trust and we ask all potential and existing donors to adhere to the blood donor selection criteria by providing completely honest answers to all the questions asked, both for the protection of their own health and that of others. Compliance with all donor selection criteria is crucial in order to ensure the continued safety of the blood supply. Anyone may require a blood transfusion in the future and it is in the best interests of us all to ensure that we strive to maintain blood safety.

• What are the donor selection criteria for MSM in other countries?

  A 2009 European Blood Alliance (EBA) survey of 23 blood services reported that 20 countries defer MSM permanently (or since 1977) and three countries (Latvia, Spain and Italy) reported that they have fixed period deferrals in place. For Latvia a deferral is used if indicated by individual assessment. For Spain a deferral of at least six months operates after a change of partner (heterosexual or MSM), with permanent exclusion for individuals with more than one sexual partner. In Italy a deferral of four months from the risk behaviour operates for multiple partners or change of regular partner.

  In Australia, Argentina and Japan, a 12 month fixed period deferral operates, and in South Africa six months. In 2008, a review in New Zealand led to a reduction in the deferral period from 10 to five years after last relevant sexual contact. In the USA and Canada, men who have sex with men are permanently excluded.

  It should be noted that the evidence on which donor selection criteria are established include detailed epidemiological information about the extent of infection with blood-borne viruses in the local population, and the methods of donation testing in use. This is why policies can vary from country to country.

• What are the other donor selection criteria related to sexual behaviour?

  A number of groups in addition to MSM are deferred or excluded from blood donation due to sexual behaviours which place them at an increased risk of acquiring a blood-borne virus. The table below sets out the current deferral period and exclusions related to sexual behaviour:

  	Behavioural risk	Duration
  1	Sex with a sex worker	At least 12 months after last relevant sexual contact
  2	Accepting money or drugs for sex / commercial sex workers	Permanent
  3	Sex with an intra-venous drug user	At least 12 months after last relevant sexual contact
  4	Sex with anyone who has ever had sex in parts of the world where HIV/AIDS is common	At least 12 months after last relevant sexual contact
  5	Sex with anyone infected by HIV, hepatitis B or C virus	At least 12 months after last relevant sexual contact
  6	Females who have sex with a man who has had sex with another man	At least 12 months after last relevant sexual contact
  7	Men who have ever had anal or oral sex with a man (MSM)	At least 12 months after last relevant sexual contact

• Why are women who have sex with MSM still deferred from blood donation for 12 months?

  Although the criterion for MSM has changed to a 12 month deferral, women who have had sex with a man who has previously ever had sex with another man are still subject to a fixed period deferral of 12 months following this sexual contact. However, if a woman in this category has had sex with a man who is now eligible to be a blood donor as a result of the change, it will be possible for NHSBT to screen the man’s blood when he attends to donate blood. If tests confirm that no virus is present and we are able to establish that no further higher-risk sexual activity (such as anal or oral sex between men) has taken place, the female would be able to donate subject to meeting the other donor selection criteria. If this change to our processes means you will be eligible to donate blood, please ask about this when you attend a blood donation session.

  The reason that the deferral of women who have had sex in the past 12 months with a man who has ever had sex with another man will continue to apply is that if we do not know whether the partner of the female donor has an infection, we are at risk of taking blood from the female donor during the 'window period' when viruses would not be detected, but could be transmitted via the blood donation.

  If the man had sex with another man he is at a statistically increased risk of carrying a blood-borne virus (such as HIV or Hepatitis B). It can be a number of years before he becomes symptomatic so if he is not tested there is no reason for he or his partner to suspect he is carrying a virus. The transmission of virus in a heterosexual relationship may occur some time into that relationship (years), whilst viruses are more likely to be transmitted more quickly through sex between men.

  Although it could well be more than 12 months since the male partner took part in an activity that places him at a statistically increased risk of carrying a virus (in this case sex between men), transmission to his female partner may only occur in the few days/weeks before his partner attends to give blood, and she could therefore be in the window period.

• Why has the criterion for commercial sex workers not changed from a permanent exclusion to a fixed period deferral as a result of this review?

  The review carried out by the Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO) found that there was insufficient evidence on virus prevalence in commercial sex workers to allow modelling of the impact on virus risk through donation of any changed donor selection criteria for this group.

  There was also no evidence on how compliance might be affected by any change in criteria. SaBTO recommended that high quality evidence on these areas should be obtained to allow future consideration of changing the criterion for commercial sex workers. Whilst it is recognised that risks may vary amongst different groups of sex workers, it is not possible to question donors in detail to establish individual risk. In addition, permanent exclusion remains in place for any individual with a history of intravenous drug use. Changing the criterion for sex workers could potentially cause confusion and possibly lead to individuals who do not meet with selection criteria because of previous drug use donating in error.

Summary of International Policies relating to the Exclusion of Men who have Sex with Men from Blood Donation

Europe
EC Directive 2004/33 states that “persons whose sexual behaviour puts them at high risk of acquiring severe infectious diseases that can be transmitted by blood" must be permanently deferred from donating blood. The directive is legally binding for all EU Member States and is in place to protect the recipients of blood and safeguard a safe, high-quality blood supply in the EU. Donor selection criteria are laid out in the directive, and Member States must implement these in their national laws.

In March 2008, the Council of Europe also issued a "Resolution on Donor Responsibility and Limitations of the Right to Donate Blood or its Components" ( Resolution CM/Res (2008)5). This resolution concluded that the fundamental right of the patient to receive the safest possible blood overrides all other considerations, including individuals’ willingness to donate blood. This resolution was adopted by all Member States.

It is important to note that although donor selection policies in Europe are guided by EU law, each member state must make decisions within this legislative framework based on evidence regarding patterns of diseases which can be transmitted by blood in their population. Although men who have sex with men are deferred from donating in most European countries, this can account for occasional variations in policy within the EU.

The table below shows which EU member states also belong to the European Blood Alliance (EBA), an organisation established in 1998 for the purpose of contributing to the safety and security of the blood supply for the citizens of the Europe by developing and maintaining an efficient and strong network of partner blood services across Europe.

In 2005, the EBA reviewed policies on men who have sex with men and blood donation amongst its members. It also examined whether the exclusion of men who have sex with men was warranted on the grounds of blood safety. The conclusion of the report, to which all EBA members subscribed, was that available data on patterns of disease transmission indicates that sex between men has an associated high risk of acquiring infections which can be transmitted by blood (including HIV). The report further concluded that, despite improvements in testing, donor selection is the most powerful safety measure for recipients of blood. This report has been regularly reviewed.

Italy
Since 2001, donors who engage in sexual activity with a high risk of transmission of diseases which can be transmitted through blood are permanently deferred from donating . If a person has sex with an occasional partner or a person infected with HIV, or hepatitis B or C, they are temporarily deferred for four months after the last relevant activity.

Spain
The Spanish Red Cross defers donors who have engaged in risky sexual behaviour (such as sex without a condom) for twelve months, but does not explicitly exclude men who have sex with men from blood donation.

United States
Donor selection criteria relating to donor and patient safety in the United States are determined by regulations and guidance publicly reviewed at meetings of the US Food and Drug Administration (FDA) Blood Products Advisory Committee. These are published as regulations and guidance.

At present, men who have ever had sex with men since 1977 are indefinitely excluded from donating blood or blood components. This policy was introduced in 1983 following changes in patterns of diseases which can be transmitted by blood, such as HIV, in the US population. In 2000 and then again in 2006, blood banking organisations in the United States recommended modification of the deferral criteria for blood donation by men who have had sex with men based on the availability of new tests and consideration of the decreased risk. The FDA has not, to-date, accepted these recommendations.

Canada
The Canadian Blood Service (CBS) currently excludes men who have ever had sex with men since 1977 on an indefinite basis. This policy is based on the much higher prevalence and incidence of HIV in men who have had sex with men, than among the exclusively heterosexual population in Canada (as per Public Health Agency statistics – December 2006).

The most recent review of the policy took place in 2007. This included an examination of existing literature, analysis of surveillance data, assessment of international MSM policies, an independent risk assessment, and stakeholder consultation.

Following this review, it was determined – in June 2007 - that the current policy of excluding men who have had sex with men from blood donation should continue, while conducting research to inform future decision-making on the issue. CBS is currently taking steps to improve understanding of emerging pathogens in specific populations, examine the risks and benefits of behavioural-based donor screening questions and monitor the experiences of blood services which have shortened the deferral period for men who have had sex with men.

Australia
Men who have sex with men and their male and female partners are deferred for twelve months after their last sexual contact in Australia. The policy was implemented on a national basis in 2000. Before then, each Australian State blood bank operated a range of policies, including permanent deferral of men who had had sex with men since 1977 and twelve-month deferral following the last relevant sexual activity.

Blood and blood components constitute therapeutic goods as defined in the Therapeutic Goods Act 1989 (Cth). As the manufacturer under a licence from the Therapeutic Goods Administration, the Australian Red Cross Blood Service is required to comply with the Act in relation to blood safety and quality. The Act requires blood and blood components to be manufactured in accordance with the Council of Europe document Guide to the Preparation, Use and Quality Assurance of Blood Components. This document therefore determines donor selection criteria.

New Zealand
The New Zealand Blood Service (NZBS) is responsible for establishing and managing donor selection criteria. NZBS is a government organisation, and, as such, is subject to the New Zealand Bill of Rights. The law requires that the restriction on individual rights should be no more than is required to achieve the goal, in this case, a safe blood supply. Any changes to the donor selection criteria must also be reviewed and endorsed by Medsafe (the regulator) before implementation.

Currently, men who have sex with men are deferred from blood donation for a period of ten years. This was introduced in 1999 as part of the standardisation of practice following the establishment of a national blood service. Before this, different policies were in place across the country, including permanent deferral and ten-year deferral.

At the end of 2007, an independent expert team was commissioned to review the current policy. The review concluded that the period of deferral for men who have sex with men should be changed to five years. This was based on an analysis of the scientific literature and epidemiology (disease patterns in the population) of HIV in New Zealand. Approval has since been obtained from the regulatory authority to make the change, and systems are currently being designed to support implementation of the new policy in March 2009.

March 2009