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BMC Public Health
Published in: BMC Public Health 1/2019

Open Access 01-12-2019 | Human Immunodeficiency Virus | Research article

Gay and bisexual men’s views on reforming blood donation policy in Canada: a qualitative study

Authors: Daniel Grace, Mark Gaspar, David Lessard, Benjamin Klassen, David J. Brennan, Barry D. Adam, Jody Jollimore, Nathan J. Lachowsky, Trevor A. Hart

Published in: BMC Public Health | Issue 1/2019

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Abstract

Background

Researchers and activists have long called for changes to blood donation policies to end what is frequently framed as unjustified bans or deferral periods for men who have sex with men (MSM). Since 2016, in Canada, a man had to be abstinent from all sexual contact (anal or oral sex) with other men for at least 12 months in order to be an eligible blood donor. As of June 3, 2019, this deferral period was reduced to 3 months.

Methods

To better understand the acceptance of existing deferral policies and possible future policy, we conducted 47 in-depth interviews with a demographically diverse sample of gay, bisexual, queer, and other men who have sex with men (GBM) in Canada’s three largest cities: Vancouver, (n = 17), Toronto (n = 15), and Montreal (n = 15). Interviews were coded in NVivo 11 following an inductive thematic analysis. We focus on men’s preferred policy directions and their opinions about a policy change proposed by Canada’s blood operators: a 3-month deferral for all sexual activity between men. We interviewed GBM approximately one-year before this new deferral policy was approved by Health Canada.

Results

Most participants were opposed to any deferral period in relation to MSM-specific sexual activity. A fair and safe policy was one that was the “same for everyone” and included screening for several risk factors during the blood donation process with no categorical exclusion of all sexually active MSM. Participants believed that multiple “gender blind” and HIV testing-related strategies could be integrated into the blood donation process. These preferences for a move away from MSM-specific exclusions aligned with their opinions concerning the possible change to a 3-month MSM deferral, for which participants shared three overarching perspectives: (1) step in the right direction; (2) ambivalence and uncertainty; and (3) not an improvement.

Conclusion

A predominant assertion was that a change from a 12-month to a 3-month deferral period would not resolve the fundamental issues of fairness and equity affecting blood screening practices for GBM in Canada. Many participants believed that blood donation policy should be based on more up-to-date scientific evidence concerning risk factor assessment and HIV testing.
Appendix
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Footnotes
1
For accuracy, we refer to the target population of the current deferral policy as being for men who have sex with men (MSM), but reference the participants we interviewed as GBM to signify the diverse ways in which they identified themselves. MSM is an epidemiological category with policy relevance, but everyday people are more likely to refer to themselves and communities through common monikers or identities like gay, bisexual, and queer [42].
 
2
We use the term “gender-blind” screening here to align with the language commonly used in blood donation policy debates in Canada. However, we want to acknowledge that it is somewhat inaccurate to refer to such a policy as being based on gender, when really the emphasis here in on the sex of potential donors (biological males having sex with biological males).
 
3
For example, when describing “Geographic Deferrals” CBS explains that “[d]onor screening procedures are exclusionary, but the exclusion is based on risk factors. It has nothing to do with race or ethnicity” [1]. We believe further intersectional research and collaboration with community groups and other researchers in this field is necessary to help elucidate the multiple experiences of perceived discrimination that may persist despite further MSM-specific policy reform efforts.
 
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Metadata
Title
Gay and bisexual men’s views on reforming blood donation policy in Canada: a qualitative study
Authors
Daniel Grace
Mark Gaspar
David Lessard
Benjamin Klassen
David J. Brennan
Barry D. Adam
Jody Jollimore
Nathan J. Lachowsky
Trevor A. Hart
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-019-7123-4

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