The MSM Blood Ban Is Gone, But It Was Replaced

By Ruth Murphy | Jan 30 2017

Image above features on giveblood.ie questionaire on elegibility for blood donation.[br]With the lifting of the MSM Blood Ban UCD SU LGBT+ Coordinator Ruth Murphy looks at what changes have replaced it and why these changes are not wholly positive.Many articles have been published with the joyous title “Gay Blood ban has been lifted.” Unfortunately, this title is quite misleading. First of all, the ban is not on gay people giving blood it is a ban on men who have sex with men (MSM) giving blood. While the ban has technically been lifted it has only been replaced by a 12 month deferral. If a man who has ever had anal or oral sex with another man wishes to give blood they must abstain from such activities for a period of 12 months. Also, as it was before the change, if you are female and have had sex with a man who has had anal or oral sex with another man you must wait 12 months after the encounter before giving blood. These conditions do not reference or recognise trans identities but are based on anatomical parts. This change is a positive but it does not go far enough.Though this ban was based on certain sexual acts and not how someone identifies there was a case in 2013 where a gay man was invited to talk to the IBTS about his recent blood donation due to worries they had even though he had said that he had never had sex. Is this ban really about certain activities such as anal or oral sex, which are also performed by the heterosexual population, or is this simply discrimination against the gay men who we might be led to believe must have HIV? UCD SU Welfare Officer Róisín Ní Mhara in conversation with the Observer said that while this change is a positive step “the policy is still discriminatory against people by virtue of who they are, for example, a gay man in a monogamous long-term relationship can't donate blood unless they're celibate. While we welcome the change we hope the IBTS will work with the Government to end the discriminatory policy, leading to an increase in blood supply, and a more equal and just society.” How far have we come from fearing a hug from someone who has HIV in case we could contract it and thinking that being gay is a death sentence?

How far have we come from thinking that being gay is a death sentence?

The IBTS test every donor’s blood for HIV before they donate. There is however, a short window period just after someone has contracted HIV in which the test may not show the correct result. As this period is not one year in length there is no reason for a man who has had sex with a man to be deferred for this long.Explaining why the ban was lifted the IBTS (Irish Blood Transfusion Services) website states that “The IBTS held a conference on 21st/22nd April 2016 at which data was presented from countries that had changed their deferral criteria for MSM. The data showed that there had not been an increase in the number of HIV positive blood donations since the change in the deferral policy. It was concluded that international experience had shown that a one year deferral is as effective as a lifetime deferral from the point of view of protecting the blood supply against the risk of HIV transmission.” These words are not particularly soothing as they imply that the same stigma still exists around gay men and HIV but that the IBTS just discovered that they did not need to be so harsh in dealing with it. It is as if they are arguing that sexually active gay men will get HIV but if they can abstain from sex for a year then it will be ok. How many men who have sex with men are going to abstain from sex with men for a year so that they can give blood? We must remember that these men would still have to pass all the other rules about donating.

How many men who have sex with men are going to abstain from sex with men for a year so that they can give blood?

With the lifting of this ban also came some other changes. The website adds that “While the one year deferral will protect against the risk of transmission of HIV there is concern that it may not be sufficient to deal with an emerging infection. Therefore, the Board of the IBTS decided that any person who has had a notifiable sexually transmitted infection, such as chlamydia or genital herpes will be deferred for 5 years after completion of treatment. Persons who have had syphilis, gonorrhoea, lymphogranuloma venereum (LGV) or granuloma inguinale are already permanently excluded from donating.” The IBTS may have taken one step forward and two steps back. Changing the all out ban to a year-long deferral may gain some donors but that amount may not be as high as the number of people who will now be prevented from donating because of these stricter rules.It is intriguing that this ban has been altered now when the rate of HIV diagnoses is in fact on the rise. A HSE report on HIV in Ireland published in 2015 stated that “As in recent years, the highest number of new diagnoses was among MSM (183; 49%); and this is the highest number ever reported in MSM in Ireland. In the 10 years since 2005, the number of new diagnoses among MSM has increased threefold (from 60 to 183).” Many are unaware of these statistics and presume that HIV is an old issue. We are simply not educated enough on STIs. We are hardly taught about STIs in school and if we are taught about them it is only for heterosexual sex. In university we get plenty of condoms thrown our way but information on condom’s tearing, the actual cause of infection, which condoms work with what type of lube etc. is harder to come by. Many do not know that using two condoms is actually less effective than using one as the rubbing of the condoms can render them ineffective. While ignorance may exist about the spread of infection STI testing is encouraged among queer men. Men who have sex with men are more likely to get tested for STIs than the wider population. The HSE report says that “Late presentation was less common among MSM (38%) …than among heterosexuals (56% in females and 71% in males). Regular testing among MSM …is likely to be a major reason for this.” This means that men who have sex with men are less likely to find out late if they have HIV than the wider population. Men who have sex with men are getting tested which may lead them to medicine that can prevent them from spreading the disease further (a possibility unknown to many) but HIV is still being spread.

"In the 10 years since 2005, the number of new diagnoses among MSM has increased threefold (from 60 to 183).”

A major way that this could be combatted is through the drug PrEP or PEP (Pre or Post Exposure Prophylaxis) which is a drug that, when consumed regularly, can prevent HIV infection. UCD for PrEP is a student group in UCD that is spreading awareness of PrEP and is putting a motion through student council for UCD SU to campaign in favour of the drug and to educate people about it. This drug is unfortunately, difficult to procure in Ireland. It can be shipped to Belfast for £70 where you can collect it. Nicholas Murphy, a graduate from Smurfit Business school, was able to avail of the drug, also known as Truvada, when he worked in San Francisco. In conversation with the Observer he said “I felt so safe in San Francisco knowing I was taking a drug that was dramatically decreasing my chances of ever getting HIV.” His health insurance, provided by his employer, allowed him to obtain Truvada for free. He added that “In Ireland, I sometimes had sex with men (typically when drunk) and got scared that the condom split or in some cases I didn’t used a condom. It seems this is a common occurrence for insecure gay men who resort to sex only when drunk.” He mentions that “Drunk sex is dangerous, and frankly, not good” and that “being able to enjoy sober sex with truvada in a sex positive culture was amazing… A city that gives truvada to anyone shows it cares about its gay community.” Ireland could embrace this drug by researching it and then allowing the public to use it.

People who actively strive not to get HIV and are taking drugs to prevent infection are being prevented from giving blood.

Unfortunately, the IBTS does not recognise this route. They have gone so far as to prevent anyone who has taken these drugs from giving blood for five years. People who actively strive not to get HIV and are taking drugs to prevent infection are being prevented from giving blood. There is no sense in this. The likely reason for this deferral is that PrEP is not a well-recognised or supported drug in Ireland. People are still suspicious of it despite its success in other countries. There is little to no research on the drug in Ireland though research has been carried out in the other countries such as the US.Simon Harris has said “the IBTS will continue to keep all deferral policies under active review in the light of scientific evidence, emerging infections and international experience.” Let us hope that scientific evidence will explain to the IBTS why this change was not quite what we needed to increase blood supply.The lifting of the MSM blood ban is a positive step in the right direction but we must not stop there. The conditions for donating blood are too strict in this country. Ignorance and stigma around HIV infection is rampant. We need to educate and we need to fight this deferral. We need to support LGBT organisations and groups like UCD for PrEP and not allow discrimination and ignorance to flourish.