Give Blood England and Wales

Our main priority is to make sure that we have a safe blood supply for patients. In order to do so, we follow a number of strict procedures to keep the risk of the transmission of infections through blood to an absolute minimum. This has resulted in a safe blood supply in this country for many years.

Blood safety starts with the selection of donors. We ask groups of people shown to be at an increased risk of carrying bloodborne viruses and other infections not to give blood, either permanently or for a fixed period after any behaviour known to increase the risk of transmission. This includes anal and oral sex between men (even when a condom is used). Men who have sex with men as a group have been shown to be at a statistically higher risk than the general population of acquiring HIV and other sexually acquired infections including HBV in the UK. Of 6,658 new diagnoses of HIV during 2010, an estimated 45% were in men who have sex with men, despite this group representing just 2.6% of the male population.

Changes to donor selection criteria

Decisions on who can and can't give blood in some specialist areas are made by the Department of Health (DH) and other UK Health Departments. The Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO) is responsible for recommending changes to the donor selection criteria in these areas. SaBTO regularly reviews donor selection criteria based on the most up-to-date scientific evidence.

Prior to 7th November 2011, men who had ever had sex with another man were permanently excluded from blood donation. However, SaBTO carried out an evidence-based review during 2011 and recommended to Government that this permanent exclusion should be changed to a fixed period deferral of 12 months from the last relevant sexual contact (anal or oral sex between men).

NHS Blood and Transplant implemented this change at its blood donation sessions on 7th November 2011. 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.

Testing blood donations

To maintain a safe blood supply, we also test every blood donation for:

• Human immunodeficiency virus (HIV)
• Hepatitis B virus (HBV)
• Hepatitis C virus (HCV)
• Treponemal antibodies (Syphilis)
• Human T-lymphotropic virus (HTLV)

Despite recent improvements in blood screening tests, it is still possible for an infection to be missed if the blood is donated during the 'window period'. This is the period between a person acquiring an infection and the infection being detectable in the blood by our screening tests. The length of the window period varies for different infections. The window period for HIV using current tests is approximately 9 days, however, hepatitis B virus can remain undetectable in the blood for several months.

Any transmission is one too many

The reason why we ask men who have had sex with men in the last 12 months not to give blood rests on specific sexual behaviour (namely anal and oral sex between men) rather than the sexuality of the person wishing to donate.

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 sufficient.

Assessments of risk at population level

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 blood donor selection 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. Such an approach results in certain groups being assessed as at a higher risk than others of carrying blood-borne infections, and can make individuals who are deferred from donation feel they are being placed into a 'category', even if they believe their own sexual behaviour and risk-taking would not be a risk to the blood supply.

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 of the blood donor selection criteria concluded that there is not the required level of evidence and data available to be able to determine the impact on blood safety of such a system. It is also unlikely that all people could objectively assess their own level of risk.

Therefore SaBTO did not recommend moving to individual risk assessments related to sexual behaviour. They concluded that a 12-month deferral for men who have sex with men brings this deferral in line with other groups who are ineligible to donate due to a sexual activity with a known increased risk of transmission of blood-borne viruses.

Explaining the rule

If you are a man who has had oral or anal sex with a man (with or without a condom) in the last 12 months you are not eligible to donate blood.

You can decide whether this exclusion applies to you without the need to discuss your personal life with our staff. If you need to talk to a member of staff to determine if the rule applies to you please be assured that the discussion will remain confidential.

Our requirement to apply this rule is based on our responsibility to ensure the safety of blood transfusions for all patients. We ask that you observe our blood donation rules for this reason.

Further information:

If you are worried or require further information you can obtain advice by ringing our donor helpline on 0300 123 23 23

Men who have sex with men (PDF, 207K)

Men who have sex with men Welsh (PDF, 428K)