Collaborative report into evidence on gay and bisexual men and blood donation still due in 2020

The FAIR steering group has been exploring whether some gay and bisexual men might be able to donate blood without a deferral.

The work has been delayed by the coronavirus pandemic but it is progressing and the group is hoping to submit a report before the end of the year.

FAIR (For the Assessment of Individualised Risk) was set up at the beginning of 2019 at the request of the Department of Health and Social Care.

The steering group includes representatives from the four UK blood services, LGBT+ groups, medical and scientific experts, and patient and donor representatives (1).

It is exploring whether there is sufficient evidence to change the current blood donor selection policy.

Currently, a man who has had sex with a man is deferred from donating blood for three months.

Blood donation guidelines are set by the Department of Health and Social Care based on recommendations from the Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO).

The current three month deferral uses ‘population based risk’ and the FAIR work could lead to the use of a more individualised assessment of risk, whilst still maintaining the safety of the blood supply. The change might enable some men who have sex with men but who are deferred under the current policy, to give blood.

FAIR is taking a collaborative, evidence led approach. This has included conducting focus groups with gay and bisexual men. Existing public health data and research is being examined to scope how best to identify individuals at high and low risk of infections. Thousands of current and potential new blood donors are being surveyed to examine how people would respond to possible new and more detailed questions about their sexual behaviours. A mixture of workshops, focus groups and interviews are being held with groups such as blood donation session staff, current blood donors and potential new donors.

Currently all blood donors are asked a series of questions on travel, health, tattoos, sexual behaviour and more, to help assess how safe it is for them to donate, and how safe it is for someone to receive their blood. A central part of FAIR’s work is considering which new questions could successfully be added to identify donors, including men who have sex with men, at lower risk of acquiring certain infections that can be transmitted through blood (2)(3)(4)(5).

Dr Su Brailsford, the chair of FAIR, said: “We are all committed to equality, diversity and inclusion and we are pleased to be working collaboratively with other organisations on this important issue.

“We need a donor selection system that is safe and can also cope with large numbers of people. We need to understand which questions are most relevant to assessing risk and whether there are some questions which might put people off donating.

“This work takes time and we need to make sure everything we do is based on good evidence with patient safety as the number one priority.

“We appreciate that any deferral is disappointing if you want to save lives by giving blood and recognise that people want to be considered as individuals as much as possible. We want to give as many people as possible the opportunity to donate whilst continuing to ensure the safety of both the blood supply and those patients who receive blood.”

Dr. Stuart Blackmore, Consultant in donor medicine at the Welsh Blood Service and representative on FAIR steering group said:

“The FAIR group is a hugely encouraging collaboration between UK blood services and key groups with an interest in LGBT+ issues and we are all committed to working together to explore ways in which men who have sex with men could be allowed to safely donate blood. Blood donation activity is a heavily regulated activity but we hope the work undertaken by FAIR could help inform eligibility criteria in the future.”

Debbie Laycock, Head of Policy at Terrence Higgins Trust, said: “As a member of the FAIR steering group, we are pleased that the important work of this group is progressing and that its recommendations will be released this year.

“We have long campaigned for a blood donation system that better reflects the realities of sexually transmitted infections. That’s why we welcomed the reduction in the deferral period to three months for those who are gay and bisexual men, and we will continue to support this work around exploring an individual risk assessment.”

A Stonewall spokesperson said: “We’re very pleased to be working with the Welsh Blood Service and other partners on this vital project exploring ways to stop the blanket restriction against gay and bi men looking to donate blood. Working towards introducing a system of individualised risk assessment is a crucial part of allowing people who want to save lives to safely donate blood.”