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Wednesday 08 April 2009

The UK's gay blood battle

Posted in: Features, HIV
By Craig Young - 4th December 2008

Longtime gay equality campaigner Peter Tatchell has crossed swords with the a leading HIV prevention agency over the UK's continued ban on blood donations from gay men.

Their battle mirrors New Zealand's situation, where the NZ AIDS Foundation supports the NZ Blood Service's proposed five-year ban on men who have had sex with men, but LGBT networks like Rainbow Wellington say our current blood donor rules lead to discrimination on the basis of sexual orientation.'s researcher and blogger Craig Young overviews the British blood debate:

In the October 2008 issue of Attitude magazine, there's an excellent couple of articles about the ethics of continuing to ban gay men from blood donations, which take opposing sides.

Yes, argues Will Nutland of the UK AIDS prevention group Terrence Higgins Trust, the ban should remain in place. The UK National Blood Service and its counterparts elsewhere across the world need access to risk-free transfusable blood of recent donation date. Gay men still constitute the majority of HIV/AIDS seroconversions, and even the most monogamous of us may find that our partner doesn't share our definition of 'exclusive' relationship, and may even have been having unprotected sex with someone on the side.

Nutland does accept that to be effective, transfusion exclusion parameters need to be coherent and evidence-based, and may require adjustment. For example, what if a straight woman or man holidays in Africa and has unprotected sex with a positive heterosexual partner? Shouldn't they also be banned from giving blood? In the United Kingdom, they are, but only for single-year periods.

He also acknowledges that while screening and heat treatment may significantly remove HIV/AIDS infection risk, they aren't perfect. According to the UK Health Protection Agency, full abandonment of the ban may exacerbate risk of exposure by an unacceptable 500 percent, while even a partial relaxation would lead to sixty percent risk rise. However, THT advocates new evidence-based research to test the continued reliability of current exclusion parameters.

No, says Johann Hari, the blood ban discriminates against altruistic gay men, who want to do something about the appalling shortage of donor blood within the United Kingdom, where more than a third of national blood supplies may constitute a risk to patients because they have been stored for longer than a fortnight, and are now stale and unreliable. Why is unprotected, multiple partner straight sex viewed as less likely to spread HIV than protected, monogamous gay sex? For that matter, what if the unprotected straight sex is with members of high-prevalence ethnic minority groups?

Are blanket bans defensible? Rather than population groups, shouldn't the focus be on risky practices? Of course barebackers need to be excluded, he acknowledges, but should constant safe sex practitioners be similarly treated? Shouldn't altruistic, conscientious and responsible gay men be allowed to give blood, he concludes.

UK LGBT equality campaigner Peter Tatchell
In PinkNews and the Guardian, UK LGBT/human rights campaigner Peter Tatchell agreed. He argued that the ban was based on unsubstantiated prejudice that depicted all gay men as irresponsible liars who never behaved ethically, and should therefore be barred from contributing blood forever. He criticised the Terrence Higgins Trust for kowtowing to this subjective, bias-based policy, especially when other HIV/AIDS prevention organisations abroad had asserted that a blanket ban lacked evidence-based epidemiological and haemotological proof. Interestingly, Tatchell cited New Zealand, which only has a five year blanket ban on men who had sex with men giving blood.

Again, the Terrence Higgins Trust defended its stance, however. As did Will Nutland THT Head of Policy Lisa Power said that while gay men excluded from contributing blood concluded that the NBS policy was homophobic, other countries had different criteria for blanket bans that were based on different evaluations of what constituted risk. Britons were forbidden to donate blood in the United States due to the past BSE/mad cow disease epidemic in the United Kingdom, for example. THT supported the NBS ban for as long as it was regularly reviewed on contemporary evidence-based criteria, she reaffirmed.

Other UK HIV/AIDS prevention organisations were more skeptical of the reasoning behind the ban, however. The National AIDS Trust said that they were campaigning for an active and ongoing review. CEO Deborah Jack noted that NAT had concerns about the reliability of the National Blood Service's HIV test. They noted that similar blanket bans had been abolished in South Africa, Spain and Italy.

In response, the National Blood Service replied that while conscientious safe sex did reduce HIV risk, it didn't reduce it altogether, and that even condoms could be improperly used, or contain faults that might allow HIV/AIDS to infect negative gay men. They noted that celibate gay men and lesbians per se were not excluded from blood donation, and argued that they were actively considering new blood testing technology and methods.

The debate continues...


Links to some source articles are provided below, and a previous article showing the local situation is also linked:

Will Nutland and Johann Hari: Is the Blood Ban Homophobic? Attitude 171: October 2008: 70-73

Peter Tatchell attacks Terrence Higgins Trust over gay blood ban: PinkNews: 02.12.08:

THT rejects Tatchell criticism and reveals work with blood service: Pink News: 02.12.08:

Craig Young - 4th December 2008