Skip to main content
Top
Published in: BMC Public Health 1/2022

Open Access 01-12-2022 | Human Immunodeficiency Virus | Research

A mixed methods investigation of the relationship between blood donor policy, interest in donation, and willingness to donate among gay, bisexual, and other men who have sex with men in Ontario, Canada

Authors: JP Armstrong, David J. Brennan, David Collict, Maya Kesler, Tsegaye Bekele, Rusty Souleymanov, Daniel Grace, Nathan J. Lachowsky, Trevor A. Hart, Barry D. Adam

Published in: BMC Public Health | Issue 1/2022

Login to get access

Abstract

Background

As of 2019, men who have sex with men (MSM) in Canada are ineligible to donate blood if they have had oral or anal sex with another man in the last 3 months. Deferral policies targeting MSM are largely interpreted as unjust by gay, bisexual, and other men who have sex with men (GBMSM) – shaping their desire to donate blood and engage with blood operators. This mixed methods study explores interest in blood donation among GBMSM as well as willingness (and eligibility) to donate under four different deferral policies.

Methods

We surveyed 447 GBMSM who were recruited from the Ontario-wide #iCruise study. Participants were asked whether they were interested in blood donation and if they were willing to donate under each of our four deferral policies. We also completed interviews with 31 of these GBMSM. Participants were asked to describe their feelings about blood donation, their views on our different deferral policies, the impact of a policy change, as well as other means of redress.

Results

Most participants (69%) indicated that they were interested in donating blood. Despite this, an interpretation of the MSM deferral policy as discriminatory was common among all participants. Our mixed methods findings indicate that, among those who were interested in blood donation, the adoption of one of the alternative policies presented in this study (specifically Policy 2 or Policy 3) would significantly increase the number of participants willing to donate and be viewed as “a step in the right direction.” However, many participants who were not interested in blood donation argued that a gender-neutral deferral policy would need to be implemented for them to donate. Participants recommended that blood operators consider efforts to repair relations with GBMSM beyond policy change, including pop-up clinics in predominantly queer areas and diversity sensitivity training for staff.

Conclusion

We argue that the most impactful policy shift would be the implementation of an individual risk-based deferral policy that is applied to all donors regardless of sexual orientation or gender identity. However, given MSM’s historical exclusion from blood donations, blood operators should pair this policy shift with community relationship-building efforts.
Literature
2.
go back to reference Wainberg MA, Shuldiner T, Dahl K, Gilmore N. Reconsidering the lifetime deferral of blood donation by men who have sex with men. Can Med Assoc J. 2010;182(12):1321–4.CrossRef Wainberg MA, Shuldiner T, Dahl K, Gilmore N. Reconsidering the lifetime deferral of blood donation by men who have sex with men. Can Med Assoc J. 2010;182(12):1321–4.CrossRef
4.
go back to reference Goldman M, Shih A W-Y, O’Brien SF, Devine D. Donor deferral policies for men who have sex with men: past, present and future. Vox Sang. 2018;113(2):95–103.CrossRef Goldman M, Shih A W-Y, O’Brien SF, Devine D. Donor deferral policies for men who have sex with men: past, present and future. Vox Sang. 2018;113(2):95–103.CrossRef
5.
go back to reference Skelly AN, Kolla L, Tamburro MK, Bar KJ. Science over stigma: the need for evidence-based blood donation policies for men who have sex with men in the USA. Lancet Haemat. 2020;7(11):779–82.CrossRef Skelly AN, Kolla L, Tamburro MK, Bar KJ. Science over stigma: the need for evidence-based blood donation policies for men who have sex with men in the USA. Lancet Haemat. 2020;7(11):779–82.CrossRef
7.
go back to reference Valentine, K. Blood donation in Australia: altruism and exclusion. In: Charbonneau J, Smith A, editors. Giving blood: the institutional making of altruism. New York Routledge; 2016. p. 183–189. Valentine, K. Blood donation in Australia: altruism and exclusion. In: Charbonneau J, Smith A, editors. Giving blood: the institutional making of altruism. New York Routledge; 2016. p. 183–189.
8.
go back to reference Caruso J, Germain M, Godin G, Myhal G, Pronovost F, Morin M, et al. ‘One step closer’: Acceptability of a programme of plasma donation for fractionation from men who have sex with men. Vox Sang. 2019;114(7):675–86.CrossRef Caruso J, Germain M, Godin G, Myhal G, Pronovost F, Morin M, et al. ‘One step closer’: Acceptability of a programme of plasma donation for fractionation from men who have sex with men. Vox Sang. 2019;114(7):675–86.CrossRef
10.
go back to reference Grace D, Gaspar M, Klassen B, Lessard D, Brennan DJ, Lachowsky NJ, et al. It’s in me to give: Canadian gay, bisexual, and queer men’s willingness to donate blood if eligible despite feelings of policy discrimination. Qual Health Res. 2020;30(14):2234–47.CrossRef Grace D, Gaspar M, Klassen B, Lessard D, Brennan DJ, Lachowsky NJ, et al. It’s in me to give: Canadian gay, bisexual, and queer men’s willingness to donate blood if eligible despite feelings of policy discrimination. Qual Health Res. 2020;30(14):2234–47.CrossRef
11.
go back to reference O’Brien SF, Goldman M, Robillard P, Osmond L, Myhal G, Roy É. Donor screening question alternatives to men who have sex with men time deferral: Potential impact on donor deferral and discomfort. Transfusion. 2021;61(1):94–101.CrossRef O’Brien SF, Goldman M, Robillard P, Osmond L, Myhal G, Roy É. Donor screening question alternatives to men who have sex with men time deferral: Potential impact on donor deferral and discomfort. Transfusion. 2021;61(1):94–101.CrossRef
12.
go back to reference Grace D, Gaspar M, Lessard D, Klassen B, Brennan DJ, Adam BD, et al. Gay and bisexual men’s views on reforming blood donation policy in Canada: a qualitative study. BMC Public Health. 2019;19(1):772.CrossRef Grace D, Gaspar M, Lessard D, Klassen B, Brennan DJ, Adam BD, et al. Gay and bisexual men’s views on reforming blood donation policy in Canada: a qualitative study. BMC Public Health. 2019;19(1):772.CrossRef
13.
go back to reference Zahner GJ. We Need Blood and I Am Not Allowed to Help. JAMA Intern Med. 2020;180(12):1571–2.CrossRef Zahner GJ. We Need Blood and I Am Not Allowed to Help. JAMA Intern Med. 2020;180(12):1571–2.CrossRef
14.
go back to reference Brennan, DJ, Kesler, M, Lachowsky, NJ, Davies, A, Georgievski, G, Adam, B, et al. Sociodemographic and psychological predictors of seeking health information online among GB2M in Ontario: Findings from the #iCruise Project. International Journal of Sexual Health. 2021 Dec 16. https://doi.org/10.1080/19317611.2021.2000087. Brennan, DJ, Kesler, M, Lachowsky, NJ, Davies, A, Georgievski, G, Adam, B, et al. Sociodemographic and psychological predictors of seeking health information online among GB2M in Ontario: Findings from the #iCruise Project. International Journal of Sexual Health. 2021 Dec 16. https://​doi.​org/​10.​1080/​19317611.​2021.​2000087.
15.
go back to reference Baggaley RF, White RG, Boily M-C. Systematic review of orogenital HIV-1 transmission probabilities. Int J Epidemiol. 2008;37(6):1255–65.CrossRef Baggaley RF, White RG, Boily M-C. Systematic review of orogenital HIV-1 transmission probabilities. Int J Epidemiol. 2008;37(6):1255–65.CrossRef
16.
go back to reference Rothenberg RB, Scarlett M, del Rio C, Reznik D, O’Daniels C. Oral transmission of HIV. AIDS. 1998;12(16):2095–105.CrossRef Rothenberg RB, Scarlett M, del Rio C, Reznik D, O’Daniels C. Oral transmission of HIV. AIDS. 1998;12(16):2095–105.CrossRef
17.
go back to reference Vitinghoff E, Douglas J, Judon F, McKiman D, MacQueen K, Buchinder SP. Per-contact risk of human immunodificiency virus tramnsmision between male sexual partners. Am J Epidemiol. 1999;150(3):306–11.CrossRef Vitinghoff E, Douglas J, Judon F, McKiman D, MacQueen K, Buchinder SP. Per-contact risk of human immunodificiency virus tramnsmision between male sexual partners. Am J Epidemiol. 1999;150(3):306–11.CrossRef
18.
go back to reference del Romero J, Marincovich B, Castilla J, García S, Campo J, Hernando V, et al. Evaluating the risk of HIV transmission through unprotected orogenital sex. AIDS. 2002;16(9):1296–7.CrossRef del Romero J, Marincovich B, Castilla J, García S, Campo J, Hernando V, et al. Evaluating the risk of HIV transmission through unprotected orogenital sex. AIDS. 2002;16(9):1296–7.CrossRef
19.
go back to reference Patel P, Borkowf CB, Brooks JT, Lasry A, Lansky A, Mermin J. Estimating per-act HIV transmission risk: a systematic review. AIDS. 2014;28(10):1509–19.CrossRef Patel P, Borkowf CB, Brooks JT, Lasry A, Lansky A, Mermin J. Estimating per-act HIV transmission risk: a systematic review. AIDS. 2014;28(10):1509–19.CrossRef
20.
go back to reference Smith DK, Herbst JH, Xinjiang Z, Rose CE. Condom effectiveness for HIV prevention by consistency of use among men who have sex with men in the United States. J Acquir Immune Defic Syndr. 2015;68(3):337.CrossRef Smith DK, Herbst JH, Xinjiang Z, Rose CE. Condom effectiveness for HIV prevention by consistency of use among men who have sex with men in the United States. J Acquir Immune Defic Syndr. 2015;68(3):337.CrossRef
21.
go back to reference Jin F, Prestage GP, Imrie J, Kippax SC, Donovan B, Templeton DJ, et al. Anal sexually transmitted infections and risk of hiv infection in homosexual men. J Acquir Immune Defic Syndr. 2010;53(1):144–9.CrossRef Jin F, Prestage GP, Imrie J, Kippax SC, Donovan B, Templeton DJ, et al. Anal sexually transmitted infections and risk of hiv infection in homosexual men. J Acquir Immune Defic Syndr. 2010;53(1):144–9.CrossRef
22.
go back to reference Jin F, Jansson J, Law M, Prestage GP, Zablotska I, Imrie JCG, et al. Per-contact probability of HIV transmission in homosexual men in Sydney in the era of HAART. AIDS. 2010;24(6):907–13.CrossRef Jin F, Jansson J, Law M, Prestage GP, Zablotska I, Imrie JCG, et al. Per-contact probability of HIV transmission in homosexual men in Sydney in the era of HAART. AIDS. 2010;24(6):907–13.CrossRef
25.
go back to reference Berg BL, Lune H. Qualitative research methods for the social sciences. 8th ed. Boston: Pearson; 2012. Berg BL, Lune H. Qualitative research methods for the social sciences. 8th ed. Boston: Pearson; 2012.
26.
go back to reference Adam BD, Globerman J, Elliott R, Corriveau P, English K, Rourke S. HIV Positive People’s Perspectives on Canadian Criminal Law and Non-Disclosure. Canadian Journal of Law and Society. 2016;31(1):1–23.CrossRef Adam BD, Globerman J, Elliott R, Corriveau P, English K, Rourke S. HIV Positive People’s Perspectives on Canadian Criminal Law and Non-Disclosure. Canadian Journal of Law and Society. 2016;31(1):1–23.CrossRef
27.
go back to reference Sanders SA, Yarber WL, Kaufman EL, Crosby RA, Graham CA, Milhausen RR. Condom use errors and problems: a global view. Sexual health. 2012;9(1):81–95.CrossRef Sanders SA, Yarber WL, Kaufman EL, Crosby RA, Graham CA, Milhausen RR. Condom use errors and problems: a global view. Sexual health. 2012;9(1):81–95.CrossRef
29.
go back to reference Schreiber GB, Schlumpf KS, Glynn SA, Wright DJ, Tu Y, King MR, et al. Convenience, the bane of our existence, and other barriers to donating. Transfusion. 2006;46(4):545–53.CrossRef Schreiber GB, Schlumpf KS, Glynn SA, Wright DJ, Tu Y, King MR, et al. Convenience, the bane of our existence, and other barriers to donating. Transfusion. 2006;46(4):545–53.CrossRef
30.
go back to reference Guglielmetti Mugion R, Pasca MG, Di Di PL, Renzi MF. Promoting the propensity for blood donation through the understanding of its determinants. BMC Health Serv Res. 2021;21(1):127.CrossRef Guglielmetti Mugion R, Pasca MG, Di Di PL, Renzi MF. Promoting the propensity for blood donation through the understanding of its determinants. BMC Health Serv Res. 2021;21(1):127.CrossRef
31.
go back to reference Haire B, Whitford K, Kaldor JM. Blood donor deferral for men who have sex with men: still room to move. Transfusion. 2018;58(3):816–22.CrossRef Haire B, Whitford K, Kaldor JM. Blood donor deferral for men who have sex with men: still room to move. Transfusion. 2018;58(3):816–22.CrossRef
32.
go back to reference Grace D, Gaspar M, Klassen B, Lessard D, Anand P, Brennan DJ, et al. Stepping Stones or Second Class Donors?: a qualitative analysis of gay, bisexual, and queer men’s perspectives on plasma donation policy in Canada. BMC Public Health. 2021;21(1):444.CrossRef Grace D, Gaspar M, Klassen B, Lessard D, Anand P, Brennan DJ, et al. Stepping Stones or Second Class Donors?: a qualitative analysis of gay, bisexual, and queer men’s perspectives on plasma donation policy in Canada. BMC Public Health. 2021;21(1):444.CrossRef
33.
go back to reference Haire BG, Kaldor JM. Prevalence of Transfusion-transmissible Infections, Not “Infection Pressure”, Should Dictate Suitability to Donate Blood. Clin Infect Dis. 2019;68(6):1009–10.CrossRef Haire BG, Kaldor JM. Prevalence of Transfusion-transmissible Infections, Not “Infection Pressure”, Should Dictate Suitability to Donate Blood. Clin Infect Dis. 2019;68(6):1009–10.CrossRef
34.
go back to reference Rodger AJ, Cambiano V, Bruun T, Vernazza P, Collins S, van Lunzen J, et al. Sexual Activity Without Condoms and Risk of HIV Transmission in Serodifferent Couples When the HIV-Positive Partner Is Using Suppressive Antiretroviral Therapy. JAMA. 2016;316(2):171–81.CrossRef Rodger AJ, Cambiano V, Bruun T, Vernazza P, Collins S, van Lunzen J, et al. Sexual Activity Without Condoms and Risk of HIV Transmission in Serodifferent Couples When the HIV-Positive Partner Is Using Suppressive Antiretroviral Therapy. JAMA. 2016;316(2):171–81.CrossRef
Metadata
Title
A mixed methods investigation of the relationship between blood donor policy, interest in donation, and willingness to donate among gay, bisexual, and other men who have sex with men in Ontario, Canada
Authors
JP Armstrong
David J. Brennan
David Collict
Maya Kesler
Tsegaye Bekele
Rusty Souleymanov
Daniel Grace
Nathan J. Lachowsky
Trevor A. Hart
Barry D. Adam
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2022
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-022-13229-2

Other articles of this Issue 1/2022

BMC Public Health 1/2022 Go to the issue