Blood donor selection policy: the work of the FAIR steering group
The FAIR (For the Assessment of Individualised Risk) steering group has recently concluded that donors who have had the same sexual partner in the last three months and who don’t have an STI should be eligible to donate.
This new recommendation will mean changes to the current rules for men who have sex with men as well as other specific sexual behaviours that currently require people to wait for a period of time (deferral) before being allowed to donate blood in England.
This change will not come into effect until summer 2021 and the deferral periods are still in place. We are working on updating our processes to reflect the new recommendations.
The new FAIR recommendations
Current deferral decisions are based on how donors answer our donor health check questionnaire. FAIR looked at how to improve this process to ensure a fair and safe screening system for everyone.
FAIR carried out a review to understand the highest risk sexual behaviours for acquiring blood-borne sexually transmitted infections (STIs). They also identified methods for asking donors about their sexual behaviour in a gender-neutral way.
The guidance for any new regulations will be set out by JPAC, the Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee.
Highlights of the recommendations include:
- Donors who have had anal sex with a new partner or multiple partners in the last three months will be deferred, regardless of their gender or their partner’s gender
- All people who have had oral-only sex can donate and will not be deferred
- All donors will now be asked if they have had sex before
- Donors who have had new or multiple partners recently will be asked if they’ve had anal sex in the last three months regardless of condom use
- The current deferral for PrEP* will remain in place, pending the outcome of national PrEP guidelines review
- Syphilis screening will remain
What is the FAIR steering group?
The UK blood services (which includes NHS Blood and Transplant), Public Health England, Nottingham University and a range of stakeholders including LGBT+ groups are working together in the FAIR (For the Assessment of Individualised Risk) steering group.
The aim of the FAIR steering group has been to explore if a more individualised risk assessment approach to blood donor selection policy is possible whilst ensuring the safe supply of blood to patients.
FAIR membership includes representatives from the four UK blood services (NHS Blood and Transplant, Scotblood, the Welsh Blood Service and the Northern Ireland Blood Transfusion Service), Public Health England, Nottingham University, the National Aids Trust (NAT), Stonewall, Freedom to Donate, Terrence Higgins Trust (THT), and includes experts in epidemiology, virology and psychology and other key stakeholders.
The Government sets blood donation guidelines based on advice from a Department of Health and Social Care expert committee: The Standing Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO). In 2017, the UK (1) introduced a world-leading blood donation policy reducing the deferral for MSM, as well as other some other groups, to three months since last sexual contact. In many parts of the world the deferral for MSM is 12 months or longer and in some areas MSM are asked not to donate at all.
We appreciate that any deferral is disappointing if you want to save lives by giving blood. We want to give as many people as possible the opportunity to donate whilst continuing to ensure the safety of patients.
*PrEP (pre-exposure prophylaxis) is a medicine that people can take to prevent getting HIV from sex or injection drug use.