A critical shortage of O-negative blood across Australia has sparked the latest Red Cross Blood Service appeal for donors to come forward.

The blood service is urging people with O-negative blood to make a donation as its reserves dip to just two days’ supply.

An increase in demand for O-negative blood, combined with a fall in donor numbers due to cold and flu symptoms, is behind the decline in supply, with as many as 1000 cancelled donations per week.

So what does this mean for Men who have sex with men?

The blow outlines the policy for Australian Red Cross [1]

Men who have sex with men
The Donor Questionnaire includes a question asking whether male donors have had sex with another man in the past 12 months. ‘Sex’ in this context means oral and anal sex with or without a condom.

Unfortunately, we will have to defer your donation if you answer ‘yes’ to this question. This is based on extensive research, and we continue to work with the research bodies such as the Kirby Institute in gathering scientific risk data to determine when and where further changes can be made to this policy.

Women who have sex with women
There is no deferral for a woman who has had sex with another woman. If you meet our other criteria, a woman who has sex with other women will be eligible to donate blood.

Transgender donors
Blood Service policy allows gender to be self-identified and self-reported. This enables blood donors to register as the gender by which they identify.

However, there are important physical differences between males and females which might change during gender transition. In these cases, we’ll make certain adjustments to the donor assessment and blood collection process.

In addition, transgender donors will be deferred if they have had sex with a male in the last 12 months. This applies to both transwomen and transmen.

The Australian @ 12:00AM January 24, 2018 [2]

Health regulators will again be asked to relax the rules on gay men donating blood, almost six years after experts first called for change amid an ongoing shortage of certain locally sourced blood products.

In 2012, an expert committee advised the Australian Red Cross Blood Service that sexual activity-based donation deferrals, which also apply to sex workers and some others, could be safely reduced from 12 months to six months.

But two years later, the Therapeutic Goods Administration controversially rejected the ARCBS recommendation, arguing it could increase the risk of an infection being passed on to a blood recipient with no significant boost to donor numbers or to the blood supply.

Late in 2016, the Council of Australian Governments Health Council gave the ARCBS approval to bring forward a planned five-year review of the issue, with the TGA still having the final say.

The ARCBS has re-established the original review committee with the same chair, Professor Steve Wesselingh, and 50 per cent of the original review members, who will be specifically asked, again, whether the 12-month deferral period should be six months.

A Department of Health spokeswoman said the ARCBS would make a recommendation within months for a TGA decision by the end of the year.

The Therapeutic Goods Administration’s Position

The two reasons cited by the TGA in rejecting the expert panel recommendations were:

  • a decrease in the deferral period was unlikely to significantly increase the blood supply
  • a background of increasing HIV diagnoses, being “10% in Australia in 2012…. This is the largest annual increase in new cases in 20 years and can only partly be explained by increased HIV testing.”

afao.org.au [3]

The Australian Red Cross Blood Service (the Blood Service) requires that a man who has had sex with a man within the previous year be deferred from donating blood.1-2 This 12-month period is known as the deferral period. The current deferral period was put in place following the introduction of nucleic acid testing in 2000. Following legal challenges in a number of Australian jurisdictions (generally brought under antidiscrimination laws), the Blood Service initiated an expert review of its donor deferral policies in 2012. After seeking broad stakeholder input, including from AFAO and its members, the expert panel recommended that the deferral period for sexual activity between men be reduced to six months.

HIV transmission

  • The main route of HIV transmission in Australia continues to be sexual contact between men, which accounted for 70% of notifications in 2016, a further 21% of cases were attributed to heterosexual sex, 5% to sexual contact between men and injecting drug use, 1% to injecting drug use only, and 3% to other/unspecified.
  • Among notifications attributed to heterosexual sex, 17% were in people born in countries recognised by UNAIDS as having a national prevalence above 1% (high prevalence), and 17% in people with sexual partners born in high prevalence countries.

Late diagnoses

  • Based on tests for immune function, over a quarter (33%) of the new HIV notifications in 2016 were late. This means that they were in people likely to have been living with HIV for at least four years without being tested.

Australia

[1] https://www.donateblood.com.au/lgbtqi-donors

[2] https://www.theaustralian.com.au/national-affairs/gay-blood-donation-regulations-back-on-tgas-agenda/news-story/1c66f063de64f95054c262af88f1ae9e

[3] https://www.afao.org.au/wp-content/uploads/2016/12/Blood-Donor-Deferral-AFAO-Update-April-2017.pdf

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