HIV virions (green) budding from a lymphocyte cell (red). While HIV is relatively easy to detect, hepatitis B is more difficult. Image courtesy of the US Centers for Disease Control and Prevention.
The UK Government today announced that it would lift the lifetime ban on blood donation from men who have sex with men, replacing it with a one-year deferral period. The new regulations, which come into force from 7 November and apply in England, Wales and Scotland, bring most of the UK in line with many other countries with a one-year waiting period, and have been welcomed by major sexual health charities. Northern Ireland, however, will retain the ban for the time being as it undertakes further study, and some activists said they felt the changes did not go far enough.
The new regulations will mean that any man who has had protected or unprotected oral or anal sex with another man will be banned from giving blood until a year after exposure. The rules are to change in England, Wales and Scotland after their health ministers accepted recommendations by the Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO).
SaBTO said it recommended the deferral period because men who have sex with men remain at a high risk of HIV and other blood borne illnesses – including hepatitis B, a highly infectious virus that can cause chronic liver diseases including cirrhosis and cancer. Although HIV can be detected in blood four weeks after exposure, the hepatitis B virus can remain undetectable for up to a year in some cases.
Sexual health charities welcomed the end of the lifetime ban. Carl Burnell, the chief executive of GMFA, the gay men’s health charity, noted that some gay and bisexual men would still be frustrated that they would be unable to donate blood, but said that ‘the one-year deferral is based on scientific evidence to ensure the safety of the blood supply’. This was partly due to hepatitis B’s longer ‘detection window’ – the period during which it is hard to test for the disease reliably.
Hepatitis B is preventable, and nearly 85 per cent of countries routinely vaccinate children against it; however, in the UK the vaccine is only available to at-risk groups, which include men who have sex with men. Sir Nick Partridge, the chief executive of the Terrence Higgins Trust, said he hoped that, in time, the new deferral period could be reconsidered if the gay population’s risk of blood-borne infections declined. ‘We will continue to campaign to improve gay men’s sexual health to a level where the regulations can be the same for all, regardless of sexuality,’ he added.
Despite broad approval for the new rules – including from GMFA, the Terrence Higgins Trust and the National Aids Trust – some activists complained that the new rules remained excessive. Chris Ward, a former Liberal Democrat councillor and co-founder of Lib Dems Against the Blood Ban, welcomed the end of the life ban; speaking to So So Gay before the Government’s announcement, however, he said the deferral period was ‘a ban by any other name’.
‘I would be happy with a twelve-month referral if, and only if, it was based entirely on risky behaviour, such as unprotected anal sex,’ Ward said. ‘In this case, even oral sex with a condom leads to a ban. I also think we need to differentiate between men who are in long-term relationships and those who have multiple partners; there are so many people who do not fit into the at-risk pigeon-hole who can’t give blood, and plenty who can who are at high risk. HIV doesn’t care who it infects.’
In a leader column for So So Gay, the magazine’s Editor-in-Chief welcomed the new rules, but called for health authorities to do more to raise awareness of hepatitis B. ‘We can’t help but think that the public would be better served if the NHS spent more on hep B awareness, and rather less, perhaps, on homeopathy,’ he said.
Men who have sex with men are entitled to be vaccinated against hepatitis B. For more information talk to your local GUM clinic or GP, or visit NHS Choices.