CHS position on donor deferrals
After studying submissions from Canadian Blood Services and Héma-Québec, Health Canada has announced its decision to reduce the MSM (men who have had sex with other men) deferral from five years without MSM activities to one year. As in 2012-13, when the five-year deferral was considered and ultimately approved, Health Canada and the blood establishments undertook extensive consultations with patient organizations whose members bear the entire risk from transfusion-transmitted pathogens.
Australia, since 2000, the United Kingdom, since 2012, and New Zealand, since 2014, have adopted one-year deferrals for MSM. The United States will introduce a one-year deferral in 2016.
Given that rates of sexually transmitted diseases transmitted by blood and blood products (e.g. HIV, HCV, HBV, syphilis) are exponentially higher in the MSM population than in the general male population;
Given that window periods for these infections can be as long as two months;
Given that there is no research in the world at this time that demonstrates that a strictly behaviour-based questionnaire can replace a time deferral and maintain the current level of safety;
Given that Canadian Courts have ruled that time-based MSM deferral criteria are not discriminatory, are allowable based on health and safety considerations, but must be proportionate to comparable risks;
Be it moved that a time-based deferral should be maintained.
Given that a one-year deferral covers the window periods and includes an added margin of safety;
Given that no increase in HIV, HCV, HBV and syphilis rates were observed in Canadian donors between 2013 and 2015 after the lifetime deferral was reduced to five years;
Given that no increase in HIV, HCV, HBV and syphilis rates in donors were observed in Australia and the United Kingdom when the lifetime deferral was reduced to one year;
Given that new sexually-transmitted, blood-borne pathogens for which there are no tests are extremely likely to emerge first in a population of men who have had recent MSM activities before they emerge in a population of men who report no MSM activities in the last year and who show normal rates for HIV, HCV, HBV and syphilis;
Be it moved that the Canadian Hemophilia Society support the change to a one-year deferral for MSM.
Adopted unanimously by the Board of Directors of the Canadian Hemophilia Society, November 29, 2015
N.B. This policy replaces the previous CHS policy adopted in September 2012.
Current policy - November 29, 2015
Previous policy - September 29, 2012