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Ireland: Total ban on gay men's blood donation is no longer justifiable

category ireland / britain | gender | opinion / analysis author Saturday June 29, 2013 17:17author by Glykosymoritis Report this post to the editors

Photo from last years Dublin Pride
dublinprideparade201217lo2630x420_1.jpg

The other evening myself and my colleague were chatting and I happened to mention that I wanted to start donating blood again as I hadn't done so in some time.
He said to me that he had been a regular donor back in time but now he is not allowed to donate simply because he is gay!
On hearing this statement I looked at him in total disbelief, I asked him what was the reasoning behind this, but he couldn't give me any answer.
I decided to do my own research into this so my first port of call was the website of the Irish Blood Transfusion Services. On my search I found out that there was no information on either the test you partake in or in the FAQ section on the website, so I decided to ring them.
I got to speak with the Medical Officer Donor Vigilance from IBTS. I asked her for information re gay people donating blood.
She said to me that under Irish law gay people cannot donate blood because they belong to a high risk category.
I asked her did this apply to people who were in a stable relationship for years ..she said that it was irrelevant. I posed the same question to her re a straight man seeing lots of different women with little regard for protection did the same directive apply to them....she was momentarily silent...and finally said that this is how it is and that is the directive she had regarding the matter.
I replied by asking her if it was a directive from the Minister of health? She replied, that this was an EU directive, implying that their hands were tied and there were not much the Irish could do.
I left my name and email address and asked her to send me the link with the specific directive from the EU. I received the email with the below:

"The Irish Blood Transfusion Service (IBTS) has a responsibility to ensure that there is a sufficient supply of safe blood to meet the needs of patients.
This includes a duty to minimise the risk of a blood transfusion transmitting an infection to patients – the European Union directive requires that “all necessary measures have been taken to safeguard the health of individuals who are the recipients of blood and blood components”.
The Irish Blood Transfusion Service (IBTS) has a responsibility to ensure that there is a sufficient supply of safe blood to meet the needs of patients.

This includes a duty to minimise the risk of a blood transfusion transmitting an infection to patients – the European Union directive requires that “all necessary measures have been taken to safeguard the health of individuals who are the recipients of blood and blood components”.

In order to assure the continued safety of the blood supply, we currently ask those people who may have a particularly high risk of carrying blood-borne viruses not to give blood. This includes men who have ever had sex with another man / men. The reason for this exclusion rests on specific sexual behaviour (such as anal and / or oral sex). There is no exclusion of gay men who have never had sex with a man nor of women who have sex with women. The decision is not based on sexuality or orientation, only specific behaviours.

The reasons for IBTS maintaining its current policy of permanently excluding men who have ever had sex with men from blood donation are as follows:

Blood safety starts with the selection of donors before they give blood. By excluding persons with behaviours known to present a particularly high risk of blood-borne viruses, we are already reducing the risk of infected blood entering the blood supply.

Every blood donation is tested for human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis and human T-lymphotropic virus (HTLV). However, despite improvements in blood screening tests, a small number of infected donations may be missed because of the ‘window period’ i.e. a period of time after the person has become infected, but before his blood tests positive. If a donor donated during this time, his blood will test negative but may be infectious. There are many examples in the medical literature of such ‘window period’ donations transmitting infections to the patients who receive them. Such donations pose a major threat to the safety of the blood supply. See further reading
http://bit.ly/kD3UxQ .
While safer sex, through the use of condoms, does reduce the transmission of infections, it cannot eliminate the risk altogether. Men who have sex with men are disproportionately affected by HIV according to recent Irish Data.

IBTS does not believe that performing more detailed interviews prior to donation nor other risk assessments at donation clinics is effective or feasible. For those donors who test positive for HIV or other infections, the risk behaviour that likely led to the infection may not be admitted for some time after the donor is contacted. This does not give IBTS confidence that information would be freely provided as part of a more extensive pre-donation interview.

The issue of monogamous partners is difficult. Evidence from heterosexual partnerships suggests that ‘innocent’ partners are very often entirely unaware that their partner / spouse are unfaithful. IBTS considers therefore that individuals can only attest to their own behaviour when donating and not speak for their partner.

While there is always a need for new blood donors and for existing and previous donors to continue to provide support to the transfusion service, the blood supply is not expected to increase greatly should, for example, a finite limit for deferral of 12 months since the last MSM activity be introduced. The safety of blood transfusions and the supply of blood to patients in Ireland are two independent essential functions of the IBTS.

The following UK Blood Services: NHS Blood and Transplant, the Scottish Blood Transfusion Service and the Welsh Blood Service have announced that with effect from 7 November 2011, the permanent exclusion of MSM from donating blood will change to a 12 month fixed period deferral from the most recent relevant sexual contact. This decision was made by the UK Health Ministers following advice received from the Advisory Committee on the safety of Blood, Tissues and Organs (SABTO).

The IBTS has reviewed the report produced by SABTO, but has decided not to make a change to its current permanent exclusion of MSM. The Health Minister for Northern Ireland has recommended that no change is made to their permanent exclusion at present.

In Spain, there has been a recent transmission of HIV by a donor found later to have admitted to MSM behaviour. In Australia a one year deferral after MSM activity has been in force for a few years. Recent publications on the safety of this measure suggest that it is too early to be confident that this is a safe measure for HIV.

For other infections that cannot yet be tested for, or that are currently undiscovered, and may be preferentially transmitted by MSM behaviour [in the same way that HIV and hepatitis B are] it will clearly not be effective. Other countries have a permanent deferral after MSM behaviour, including the USA and the Netherlands.

Finally, while the primary requirement is to protect recipients, it is acknowledged that in order to supply blood for transfusion all decisions are based on a review of the evidence, bearing in mind the desire of individuals to donate, the safety of the recipient, and the tolerance of society in general of any transfusion related infection occurring. For Ireland, the view of the IBTS is that taking all of these aspects into account a permanent exclusion for men with a history of MSM behaviour is justified.

I would like to take this opportunity to thank you for your interest in our service. I am sorry that you feel our policy is discriminatory but I trust that you have found the above information useful. (1)

In order to assure the continued safety of the blood supply, we currently ask those people who may have a particularly high risk of carrying blood-borne viruses not to give blood. This includes men who have ever had sex with another man / men. The reason for this exclusion rests on specific sexual behaviour (such as anal and / or oral sex). There is no exclusion of gay men who have never had sex with a man nor of women who have sex with women. The decision is not based on sexuality or orientation, only specific behaviours.

The reasons for IBTS maintaining its current policy of permanently excluding men who have ever had sex with men from blood donation are as follows:

Blood safety starts with the selection of donors before they give blood. By excluding persons with behaviours known to present a particularly high risk of blood-borne viruses, we are already reducing the risk of infected blood entering the blood supply.

Every blood donation is tested for human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis and human T-lymphotropic virus (HTLV). However, despite improvements in blood screening tests, a small number of infected donations may be missed because of the ‘window period’ i.e. a period of time after the person has become infected, but before his blood tests positive. If a donor donated during this time, his blood will test negative but may be infectious. There are many examples in the medical literature of such ‘window period’ donations transmitting infections to the patients who receive them. Such donations pose a major threat to the safety of the blood supply. See further reading
http://bit.ly/kD3UxQ .

While safer sex, through the use of condoms, does reduce the transmission of infections, it cannot eliminate the risk altogether. Men who have sex with men are disproportionately affected by HIV according to recent Irish Data.

IBTS does not believe that performing more detailed interviews prior to donation nor other risk assessments at donation clinics is effective or feasible. For those donors who test positive for HIV or other infections, the risk behaviour that likely led to the infection may not be admitted for some time after the donor is contacted. This does not give IBTS confidence that information would be freely provided as part of a more extensive pre-donation interview.

The issue of monogamous partners is difficult. Evidence from heterosexual partnerships suggests that ‘innocent’ partners are very often entirely unaware that their partner / spouse are unfaithful. IBTS considers therefore that individuals can only attest to their own behaviour when donating and not speak for their partner.

While there is always a need for new blood donors and for existing and previous donors to continue to provide support to the transfusion service, the blood supply is not expected to increase greatly should, for example, a finite limit for deferral of 12 months
since the last MSM activity be introduced. The safety of blood transfusions and the supply of blood to patients in Ireland are two independent essential functions of the IBTS.

The following UK Blood Services: NHS Blood and Transplant, the Scottish Blood Transfusion Service and the Welsh Blood Service have announced that with effect from 7 November 2011, the permanent exclusion of MSM from donating blood will change to a 12 month fixed period deferral from the most recent relevant sexual contact. This decision was made by the UK Health Ministers following advice received from the Advisory Committee on the safety of Blood, Tissues and Organs (SABTO).

The IBTS has reviewed the report produced by SABTO, but has decided not to make a change to its current permanent exclusion of MSM. The Health Minister for Northern Ireland has recommended that no change is made to their permanent exclusion at present.

In Spain, there has been a recent transmission of HIV by a donor found later to have admitted to MSM behaviour. In Australia a one year deferral after MSM activity has been in force for a few years. Recent publications on the safety of this measure suggest that it is too early to be confident that this is a safe measure for HIV.

For other infections that cannot yet be tested for, or that are currently undiscovered, and may be preferentially transmitted by MSM behaviour [in the same way that HIV and hepatitis B are] it will clearly not be effective. Other countries have a permanent deferral after MSM behaviour, including the USA and the Netherlands.

Finally, while the primary requirement is to protect recipients, it is acknowledged that in order to supply blood for transfusion all decisions are based on a review of the evidence, bearing in mind the desire of individuals to donate, the safety of the recipient, and the tolerance of society in general of any transfusion related infection occurring. For Ireland, the view of the IBTS is that taking all of these aspects into account a permanent exclusion for men with a history of MSM behaviour is justified.

I would like to take this opportunity to thank you for your interest in our service. I am sorry that you feel our policy is discriminatory but I trust that you have found the above information useful. (2) "

In the meantime I found out that even though the majority of EU countries have a total ban, In Czech Republic, Hungary, Sweden and UK operate under the following directive: Any man who reports having sex with another man within the twelve months will remain deferred from donating.
Italy, Poland and Spain have no ban whatsoever! That to me proves that the case of banning gay men from giving blood is a social, political and economic issue that is dealt differently in different countries not on the grounds of health and safety alone but on moral stereotypical sexist reasons that were formulated during the 80's HIV/AIDS crisis and still dictate policy regarding donation of blood regardless of rationality and today's factual evidence.
My colleague is an ex-Sargent of the Irish Army of 14 years of service. At the time he served and got decorated as a peacekeeper under UN in Lebanon under challenging times, put his life at risk and lost colleagues while in service, I do strongly believe that he deserves better.
This man, this gay man still wants to offer a service to society, by donating his blood as he used to do, but the Irish state doesn't allow him to do so because of sexist barriers that are raised on the leftovers of theocratic morality that has nothing to do with health and safety but just a pathetic excuse to discriminate against people that they still regard as second class citizens.
Today is the "Dublin Pride", except the party and the celebration that it will take place in Dublin commemorating the struggles of the LGBT community spare a thought for my colleague!

source http://glykosymoritis.blogspot.ie/2013/06/ireland-total....html

author by mk hernandez - All R Equal, Inc.publication date Mon Jul 01, 2013 21:44author address author phone Report this post to the editors

Allow gay and bi men the right to donate blood by signing the petition at http://chn.ge/Kyplf0
You can also follow our efforts at www.facebook.com/weallrequal

Related Link: http://www.weallrequal.com
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