10. Blood donation
Resolution submitted by the RCN Greater Glasgow Branch
That this meeting of RCN Congress urges Council to lobby to remove the exclusion on gay and bisexual men donating blood
Submitted by: Greater Glasgow Branch
Council lead and committee assigned: Carol Evans, Nursing Practice and Policy Committee and Diversity Committee
Committee decision: No work required
Members involved: Greg Usrey, Greater Glasgow Branch and Ciaran Hurley, Sheffield Branch and RCN Perioperative Forum
Final summary report at May 2012
This resolution saw votes cast strongly in favour of lobbying to lift the ban on gay and bisexual men donating blood.
Following the publication of new guidance from the Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO) in late 2011, the lifetime ban of blood donation was lifted for men in England, Wales and Scotland, who have sex with men. The previous ban has been replaced with a one year donor deferral period. This means men whose last sexual contact with another man was more than 12 months ago will now be able to donate, if they meet the other donor selection criteria. Northern Ireland, however, stated an intention to continue with the ban. This prompted questions regarding the acceptance of blood from other parts of the UK where the ban has been lifted.
Some RCN members have expressed concern that this action does not go far enough. For example, it does not differentiate between men in long-term, monogamous relationships and those who participate in frequent indiscriminate high-risk sexual behaviour.
The RCN’s Nursing Practice and Policy Committee and Diversity Committees recommended that the RCN, in consultation with other leading stakeholders such as the Terrence Higgins Trust and Stonewall, should continue to review the impact of the new change in donation policy and consider what further work might need to be undertaken.
Update at November 2011
The RCN currently supports the Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO) guidance on the exclusion of men who have sex with men (MSM). This position was present at the time of the resolution discussion and has remained unchanged since April 2011. The RCN is currently awaiting further information and guidance from SaBTO regarding its advice on this issue following its long awaited review of current evidence.
Several media reports have emerged since April 2011 citing the possibility for a deferral period to be introduced allowing MSM to donate blood following a period of abstinence yet to be detailed. The report is cited to be published in the summer of 2011 (Tom Chivers writing in the telegraph blog 12 April 2011) and should include details of benefits and risks associated with the donation of blood by MSM in the context of demand for blood and blood component supplies and public health implications.
A BBC news article in May 2011 (Clare Murphy, 28 May 2011) also discussed this issue citing the need to the await SaBTO report and the diversity of experiences from other countries where changes have either been made or are in the process of being considered. The position of the Terrence Higgins Trust remains unchanged in supporting current SaBTO guidance on this issue.
The RCN is advised to await the SaBTO report and discuss its recommendations in light of the Congress resolution. Support for an outright removal of the lifetime ban is likely to be unsuccessful given the current epidemiological data (HPA 2010 – HIV in the United Kingdom report) however consideration of and support for the introduction of a deferral period may have a greater chance of success and may be one that balances the desire to donate blood with managing public concerns over transmission of blood borne viruses. (note: no discussions are currently underway to lift exclusions for persons who have previously injected IV drugs).
On 8 September 2011 the DH (England) announced the lifting of the life-time ban for the exclusion of men who have sex with men from donating blood. The previous ban has been replaced with a one year donor deferral period. This means men whose last sexual contact with another man was more than 12 months ago will now be able to donate, if they meet the other donor selection criteria.
Reasons to consider a change in the donor criteria included advances in donation testing and handling, changes to legislation, societal changes and recent information on donor compliance. This change in criteria was implemented by NHS Blood and Transplant (NHSBT) in England and North Wales on Monday 7 November and by the Blood Services of Scotland and Wales on the same date. Northern Ireland have stated the intention to continue with the ban which has resulted in questions regarding the acceptance of blood from other parts of the UK where the ban has been lifted.
It is important to note that despite the fact that the lifting of the life-time ban has now been approved, there have been concerns expressed by RCN members and the wider public in the media suggesting that this action does not go far enough in terms of right for gay men to donate blood. A specific example of limitations of the ban relates to the lack of recognition in a risk assessment process that acknowledges the difference in risk between men who have remained in monogamous relations for long periods of time and those that participate in frequent indiscriminate high risk sexual behaviour.
In recognition of this, we recommend that following a period of implementation and evaluation of the impact of this change in donation policy and, following consultation with other leading stakeholders such as the Terrence Higgins Trust and Stonewall, the RCN should review what further work might evolve in order to progress further on this issue.
Congress voted strongly in favour of lobbying to lift the ban on gay and bisexual men donating blood, with few speakers arguing against the motion.
The motion, proposed by Grey Usrey of Greater Glasgow, was passed with a majority of 86.65 per cent despite recently-leaked Government proposals to change the rules on gay and bi blood donation.
Under the new plans, suggested by Sabto (the advisory committee on the safety of blood, tissues and organs), men could give blood as long as they waited 10 years after having homosexual sex before donating.
Usrey said allowing gay and bisexual men to donate was “a matter of trust”, and that society and science had “come a long way” since the 1980s blanket ban that deferred the acceptance of blood from any man who had had sex with a man. He urged the blood donation service to carry out proper risk assessments that were not based on prejudice against a particular group of people.
Other speakers agreed that the existing rules were discriminatory. George Burrows of Lothian branch said: “If you’ve had sex for payment you only have to wait a year before you donate. If 10 years is the safe period then let’s apply that across the board.”
But Jason Warriner of the Public Health Forum said that the debate was “not about discrimination, but about public health”. He said that Sabto had undertaken a systematic review of the 1980s ban and was due to release its findings very soon.
“The work has already been done and is near completion,” he said. He also urged members to avoid prejudice against other groups such as sex workers in their arguments.
For: 86.65% (383)
Against: 13.35% (59)
The current UK blood donation position is to exclude donation from individuals who may be at risk of having contracted blood borne viruses (BBV) such as HIV and Hepatitis B and C. The use of a donor health check helps to identify risks associated with lifestyle that may place some donors at increased risk of contracting BBVs. This is deemed necessary as current screening tests for BBVs may not identify infectious agents (viruses) in the early stages of infection known as the ‘window period’. To date this has excluded donation by men who have sex with men (MSM) along with injecting drug users. However, women who have sex with bisexual men are not excluded with a lifetime ban, but instead undergo a deferral period.
A review of current evidence investigating risks for donation associated with MSM by the Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO) is expected in the near future. This report will advise the UK Government and the devolved administrations, as well as UK health departments, on whether the current exclusion should be amended.
The current policy position of excluding MSM from donating blood has been cited as discriminatory and scientifically unjustified by those supporting donation by gay men. Periodic shortages of blood and the ongoing advertising for potential donors serve to highlight questions as to why the UK continues to enforce a complete ban in contrast to Australia, Japan and Argentina which have adjusted donation criteria to include ‘deferral periods’ of up to 12 months following male-to-male sex.
A recent study of the Australian deferral programme showed no evidence for increased blood recipient risk; however, the study did recognise limitations in transferability to other countries due to differences in epidemiology.
Campaigners argue the current policy is discriminatory as it fails to recognise gay men who do not participate in at risk sexual practices, and promotes the myth that all gay men carry infections (RCN, 2008). Supporters also argue that a greater proportion of new HIV infections have occurred as a result of heterosexual sex (HPA, 2010) and that the current policy does not recognise this risk.
The safety of blood and organs for transplantation remains a key area of public interest. While tests to identify HIV infection have improved since the 1980s, there remains a risk of non-detection in the early phase of infection (the window period). Furthermore, the number of new HIV cases continues to be greatest amongst MSM (HPA, 2010) and the use of a donor check questionnaire cannot be considered a fail-safe method for excluding risk; non-compliance with self deferral is complex and includes misinterpretation of deferral criteria as well as deliberate non-disclosed risk.
The potential number of increased donors that would result from relaxing the current ban is unknown and may not result in a significant increase in blood donations. The implementation of a deferral period is therefore at risk of being seen as a political decision rather than one based on evidence and risk.
Currently the RCN supports the SaBTO guidance on the exclusion of MSM.
References and further reading
Health Protection Agency (2010) HIV in the United Kingdom: 2010 report, London: HPA. Available at: www.hpa.org.uk/Publications/InfectiousDiseases/HIVAndSTIs/1011HIVUK2010Report/ (Accessed 9/2/11) (Web)
Royal College of Nursing (2008) The case for allowing MSM to donate blood, London: RCN. Available at:
(Accessed 3/2/11) (Web)