The Spinoff: Why has the 'gay blood ban' still not been lifted in New Zealand? & More News Here

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OPINION

Screening potential donors is critical – however does successfully banning sexually lively homosexual males still make sense? It could not be as black and white because it appears.

Despite current information tales reminiscent of the important scarcity of A+ blood, authorities right here proceed to withstand strain to overturn the ban on blood donations by homosexual males. Just final month, Canada lifted its personal “gay blood ban”, prompting the query: is Aotearoa now out of step internationally?

Aotearoa has traditionally been a pacesetter in the discipline of blood donation. But sustaining the security of the blood provide now comes at the price of stigmatising a neighborhood with an sadly wealthy historical past of social and coverage discrimination. So is anybody really doing something to vary the state of affairs? To perceive the path we’re heading in, we’ve to start out at the starting.

In the early Nineteen Eighties, after an growing variety of heterosexual haemophiliacs got here down with what was once referred to as the “gay-related immunodeficiency disease”, specialists made the connection between blood, homosexuality, and HIV/AIDS. Shortly thereafter, banning homosexual males from donating blood turned a worldwide phenomenon. These insurance policies still persist to at the present time as a result of the ongoing international HIV epidemic.

Here, restrictions on homosexual, bi, and different men-who-have-sex-with-men (MSM) would not exist till the improvement of the New Zealand Blood Service (NZBS) in 1998. Although it is now referred to as a “deferral’ policy”, NZBS’ stand-down interval of three months for males who’ve any intercourse with different males is successfully a “ban” for many homosexual males.

Gay males are understandably upset and lots of view this coverage discriminatory. As a coverage, it dangerously perpetuates outdated myths round the risks of homosexual intercourse. However, in the sea of opinion items, most fail to contemplate the most important function of the blood service: to maintain the blood provide secure for these in want.

In order to guard susceptible blood recipients, round 20% of all first-time donors are prevented from giving blood for quite a lot of causes. You could have just lately injected medicine, or maybe you lived in the UK throughout the Nineteen Eighties and Nineties so that you’re in danger for passing on bovine spongiform encephalopathy, or mad cow illness.

Whether we prefer it or not, MSM in New Zealand are 348 occasions extra prone to be identified with HIV than their heterosexual counterparts (the international price is estimated at 28 occasions increased). Despite our low inhabitants prevalence, there may be an HIV epidemic concentrated amongst homosexual males in Aotearoa.

With that in thoughts, is the coverage discriminatory? Or is the exclusion justified? I consider there are parts of each. Singling out homosexual intercourse as harmful is certainly in dangerous style contemplating the historical past of oppression in direction of the neighborhood and the now availability of efficient HIV prevention methods. But in our nation, the NZBS is justifiably risk-adverse as a result of homosexual males pose a comparatively increased danger of passing undiagnosed HIV onto blood recipients.

You can see the conundrum researchers face when making an attempt to debate the complexities of blood donation. Is there a approach we are able to strike a good stability?

Moving the needle?

Places like the UK and Canada have just lately adopted an individualised danger evaluation method to their blood donor coverage as an alternative of a blanket exclusion on MSM. Every presenting donor is assessed on their “high-risk” behaviours – the variety of current new companions, for instance, or intravenous drug use – no matter intercourse or gender.

Decentralising the subject of intercourse between males removes the inequality at the coronary heart of the homosexual blood ban. An individualised method additionally reduces the social hurt that the present coverage perpetuates by means of its affiliation of homosexual males with harmful intercourse. Remember, homosexual intercourse itself does not carry dangers of HIV – what issues is how you might have intercourse and who you might have intercourse with.

An individualised method additionally permits for low-risk MSM (e.g. these in monogamous relationships) to soundly donate blood. In Aotearoa, researchers estimate there may very well be as many as 35,000 further eligible donors per yr who at the moment cannot give blood.

Adopting this new method looks like a no brainer, proper? Not fairly.

Firstly, keep in mind there isn’t any assure that the variety of eligible donors will enhance with an individualised danger evaluation method. It’s doable that the threshold for “low risk” people would possibly take away extra eligible heterosexual donors than it provides MSM donors. Secondly, whereas it is smart to look to different international locations for coverage steerage, a blood donor coverage for Aotearoa have to be tailor-made to our particular HIV epidemiology. The drawback we run into right here is that we merely do not have the up-to-date information we want. For instance, the final HIV behavioural surveillance research was undertaken in 2014, effectively earlier than the arrival on the scene of pre-exposure prophylaxis, or PrEP, a every day capsule which enormously reduces your probabilities of buying HIV.

Late final month, the University of Auckland’s Dr Peter Saxton, in partnership with the NZBS, launched the Sex and Prevention of Transmission Study (SPOTS), which goals to gather information to fill this proof hole.

“Ultimately we all want blood donation to be more inclusive, but also safe for blood recipients,” says Saxton. “The [NZBS] lacks evidence to improve the policy further. Our study will be the first to provide that evidence.”

As a homosexual man myself, I really feel that calling the homosexual blood ban “discrimination” wrongly ascribes malicious intent, particularly when the coverage goals to supply Hippocratic oversight in managing actual threats to actual susceptible sufferers. Perhaps “outdated” is a greater time period for a coverage that has not but tailored to the new methods in which MSM can practise safer intercourse or to the new instruments accessible to stop HIV transmission.

As lengthy as there is not any substitute for blood, discussions round blood security and blood donor insurance policies will proceed to be contentious. The inherent social and epidemiological complexities of the topic make that unavoidable. Future policymakers might want to rigorously stroll the tightrope to make sure blood donor coverage is inclusive and truthful, whereas sustaining the security of the blood provide and all sufferers who depend on it.

Tony Koson Sriamporn is a public well being and well being psychologist researcher who has labored in the HIV sector since 2018. He is finishing his doctoral analysis in the School of Population Health at the University of Auckland, specializing in blood donation amongst homosexual and bisexual males in Aotearoa inside the SPOTS mission.

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