The New Zealand Blood Service (NZBS) has changed its blood donation criteria so it is now less restrictive for men who have sex with other men, and other groups who faced specific rules.
Many people were previously not able to donate blood after engaging in certain activities and were 'deferred'. This included most gay, bisexual, and other men who have sex with men, given New Zealand's HIV epidemic.
You can now donate blood if you're a man and haven't had any oral or anal sex with another man in the last three months, regardless of whether a condom was used or not. The previous duration was 12 months.
Additionally, people who previously lived in a country with a high prevalence of HIV infections and those who are sex workers can now donate blood after a three-month deferral period. These both also previously had a 12-month duration.
A new criterion has been added for first-time donors where a person must wait three months following the last time they took medication for an HIV infection. This requirement is for people on both pre or post-exposure prophylaxis (PEP or PrEP).
These new changes take effect on December 14.
People cannot donate blood if:
- they're living with HIV, even if they're on antiviral treatment and have an undetectable viral load
- they have hepatitis B or hepatitis C, even if they've had successful treatment
- they've ever injected drugs not prescribed by a doctor or health professional.
NZBS says the behavioural donor eligibility criteria was previously reviewed by an independent expert panel in 2014, who suggested the rules should be looked at again when there was more information that could influence a decision.
It believes there is now enough information from donor services around the world, including from countries that NZBS benchmarks its rules against. These donor behaviour changes bring New Zealand's criteria in line with the United Kingdom, Canada, and the United States.
New Zealand AIDS Foundation Fellow Dr Peter Saxton says deferrals can "understandably seem unfair, or discriminatory", especially for people who personally believe they don't present a risk.
"Studies internationally show that many MSM [men who have sex with men] are interested in donating blood. MSM often view donating blood as altruistic and an act of citizenship," he wrote in a paper outlining the ongoing use of behaviour donation criteria in New Zealand.
"Since certain blood-borne viruses like HIV are more common among MSM than in other groups, others acknowledge that deferral is a blunt but pragmatic way to minimise risks to blood safety, based on current technology."
He says the priority in blood safety policy is that those who receive blood must be kept safe, and any rule changes shouldn't increase the risk to these "vulnerable" people.
"Often they need it urgently, have little or no choice, and if the transfusion has HIV it will almost certainly result in infection to them. The NZBS therefore has legal and ethical obligations to recipients, namely to prevent harm by ensuring blood is free from infectious pathogens."
Dr Saxton says men who have sex with other men aren't the only group that face deferrals, and that in New Zealand, around one-in-five first-time prospective donors are deferred for a range of reasons. This includes people who have recently been tattooed, those who are about to take part in hazardous jobs or activities such as flying or rock climbing, and people who have a higher probability of recent undiagnosed infections, such as HIV.
"In New Zealand, it reflects the high concentration of HIV among gay men, and heterosexual people from some parts of sub-Saharan Africa and South-East Asia. It also reflects the relative rarity of HIV among heterosexual people in New Zealand who are not already deferred," he says.
Dr Saxton stressed the information he wrote relates only to cis-gendered people - a person whose gender identity matches their sex assigned at birth. He says NZBS has a separate programme that gives consistent and appropriate donation criteria for trans and non-binary people.