It’s been nearly a decade since I last donated blood. It was in my high school gymnasium and, at the time, it was a great way to skip a quiz happening in my grade 11 biology class. The nurse, who resembled a Claymation bird from Chicken Run, tried multiple times to hit a vein to begin drawing blood. When she eventually hit red gold, I did my duty and left that day with a bottle of orange drink, a foil-wrapped package of cookies, and a rapidly growing bruise on my inner elbow.
This is not a point of pride for me but, ironically, it is a point that Calgary Pride week has me thinking about. My last experience donating comes to mind more this week than any other of the year. I haven’t been able to donate blood since then; I don’t have tattoos or use intravenous drugs, and I haven’t spent more than three months in the United Kingdom between 1980 and 1996. Instead, I had sex. With a man.
All the behaviours above disqualify people (at least temporarily) from donating blood. As a man who has sex with men — or MSM — I have been unable to donate blood since that last time in grade 11. Even as an MSM in a seven-year strong monogamous and HIV-negative-seroconcordant (meaning we are both HIV-negative) relationship, changes in recent years from an indefinite deferral for all MSM to a one-year deferral period still prevent me and my partner from donating blood. Our sex drives haven’t quite plateaued to a once-in-12-months schedule.
The Community-Based Research Centre for Gay Men’s Health (CBRC) is hoping to end the gay blood ban with its SexNow Survey. This Pride season — June through to September, for those out of the know — the CBRC made the rounds with their SexNow Survey at Pride festivals across Canada with Calgary Pride as its final leg. The in-person survey that will be conducted at the Calgary Pride grounds on Prince’s Island Park on Sunday, September 2.
SexNow, which began as a pencil and paper survey in 2000, asks MSM about what is going on in their lives in regard to issues around sex, sexuality, substance use, mental health and relationships. SexNow also works to discuss issues around HIV and how it pertains to blood donation. It includes the option to participate in a dried blood spot test where masculine identifying individuals interested in sex with other masculine identifying individuals can provide blood samples for research purposes. With the survey, the CBRC hopes the samples they have collected across Canada will provide the research-based evidence that will help Health Canada and Canadian Blood Services update what the CBRC considers to be a discriminatory policy that doesn’t align with the current research.
“We know from years of epidemiologic research that, compared with other men, gay, bisexual and other men that have sex with men are around 75 times more likely to acquire HIV,” says Dr. Nathan Lachowsky, the lead investigator with the SexNow Survey and Research Director at CBRC. “But, what we also know from those years and years of research, is that not every gay man has the same odds of getting HIV.”
He says the current policy sends the message that the blood of these men is more risky or “less than” the blood of other people.
The history of these policies dates back well before the CBRC was formed in 1999. An outright deferral on men who had sex with men even once since 1977 was embedded into Health Canada regulations in the ’80s when the Canadian Red Cross, then solely responsible for Canada’s blood supply, followed the United States’ lead. Coincidentally, in 1992 — the year I was born — blood products became regulated by the national blood system regulator, Health Canada, and the criterion was “grandfathered” into existing regulations. If I were more skeptical, I might think that Health Canada never really wanted my blood.
Changes have been made in the past 26 years, but they are also slow to come. It wasn’t until 2013, that this indefinite deferral was updated to a five-year deferral for sexual contact with another man and, in 2016, updated once more to a 12-month deferral period. Lachowksy says CBRC has been working with CBS in regard to the current policy and both groups were involved in organizing getting researchers together in January 2017 to talk about the issue at hand. He says the federal government, who ran on a platform to change the policy around MSM and blood donation, even provided funding through CBS for the SexNow Survey project this year. But, Lachowsky says, a blanket ban of any kind on sex between men isn’t evidence-based and that a more nuanced approach to blood donation screening is needed.
“What we want to do is use the survey to help create better evidence to inform a policy that is based on the best possible evidence we have around who is really at risk for acquiring and passing HIV,” Lachowsky says. “Ultimately, what we’re trying to do with the survey is to develop the evidence around a new system that works for a new generation that thinks differently about gender, sex, and sexuality. We want to create a sustainable blood donor screening process that works for the future. All of these things in terms of sex and gender and sexuality have been changing rapidly in society and the system needs to keep pace if you want to stay relevant to new donors.”
A decade ago, I actually fibbed when I donated blood. As a short and featherweight teenager, I didn’t meet the weight requirements CBS outlined, but this was a lie that would not potentially affect the blood supply I was donating too. Any problems and an extra juice box would have fixed them. I can’t in good conscience lie about my current barrier to blood donation. Full disclosure, I was also awful at science and ultimately rely on the knowledge of scientists and researchers to justify something as important as my eligibility to donate blood which is why, until my blood is valued based on my behaviours and not the risk-factor that is tied to my sexuality, my blood is a gift that I cannot give.
By Fraser Tripp