Views and experiences of men who have sex with men on the ban on blood donation: A cross sectional survey with qualitative interviews

Department of Social and Environmental Health Research, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK.
BMJ (online) (Impact Factor: 17.45). 09/2011; 343(sep07 2):d5604. DOI: 10.1136/bmj.d5604
Source: PubMed


To explore compliance with the UK blood services' criterion that excludes men who have had penetrative sex with a man from donating blood, and to assess the possible effects of revising this policy.
A random location, cross sectional survey followed by qualitative interviews.
1028 of 32,373 men in the general population reporting any male sexual contact completed the survey. Additional questions were asked of a general population sample (n=3914). Thirty men who had had penetrative sex with a man participated in the qualitative interviews (19 who had complied with the blood services' exclusion criterion and 11 who had not complied). Main outcome measure Compliance with the blood services' lifetime exclusion criterion for men who have had penetrative sex with a man.
10.6% of men with experience of penetrative sex with a man reported having donated blood in Britain while ineligible under the exclusion criterion, and 2.5% had donated in the previous 12 months. Ineligible donation was less common among men who had had penetrative sex with a man recently (in previous 12 months) than among men for whom this last occurred longer ago. Reasons for non-compliance with the exclusion included self categorisation as low risk, discounting the sexual experience that barred donation, belief in the infallibility of blood screening, concerns about confidentiality, and misunderstanding or perceived inequity of the rule. Although blood donation was rarely viewed as a "right," potential donors were seen as entitled to a considered assessment of risk. A one year deferral since last male penetrative sex was considered by study participants to be generally feasible, equitable, and acceptable.
A minority of men who have sex with men who are ineligible to donate blood under the current donor exclusion in Britain have nevertheless done so in the past 12 months. Many of the reasons identified for non-compliance seem amenable to intervention. A clearly rationalised and communicated one year donor deferral is likely to be welcomed by most men who have sex with men.

Download full-text


Available from: Sally McManus
  • Source
    • "that they or their loved ones may be dependent on the blood of others ( Ferguson et al . , 2008 ; Sojka and Sojka , 2003 ) . Indeed , thinking beyond the binary categories of ' donor ' and ' recipient ' , it seems sensible that ' donors - as - potential - recipients ' would want others to be asked about risky behaviour . Indeed the study of MSM by Grenfell et al . ( 2011 ) notes ( with supporting evidence ) a wide - spread preference for individual assessment . However , the authors ignore the voices of their research participants and instead choose to ventriloquise the paradigmatic position , stating without statis - tics or quotation : " [ however respondents ] … acknowledged [ that ] more in - depth "
    [Show abstract] [Hide abstract]
    ABSTRACT: Blood screening is imperfect so Donor Health Check questionnaires (DHC) are used to defer those whose 'behaviour' suggests disproportionate risk of Blood Borne Infection (BBI). Taking the UK case, we compare deferment of three sub-populations with different HIV prevalence; Men-who-have-Sex-with-Men (4.7%), black-Africans (3.7%) and 'the-general-(heterosexual)-population' (c.0.09%) arguing that, with respect to STIs, DHC assesses risk based on broad population-level risk-groups not behaviour. This approach relies on an imaginative geography that distances heterosexual risk from the domestic population. Most DHCs knowingly commit the ecological fallacy allowing population-level statistics to obscure within-group diversity, inadequately identifying the risk posed by 'low-risk-groups'. The disjuncture between ontological risk phenomenon (diverse sexual practice) and the epistemological grid used to map risk (homogenised risk-groups) needs examination. Unpacking the category 'heterosexual' would both better differentiate risk within this group and change the relative-risk calculated for 'high-risk groups'. We call for piloting of practice-based questions and a mixed-method approach to DHCs to more accurately assess all potential donors.
    Full-text · Article · Dec 2013 · Health & Place
  • Source
    • "Consequently, if the donor population is known, or assumed, to have a higher rate of any disease transmissible via blood, then the value of blood sourced from that population is likely to be greatly decreased. This is controversial not least because the evidence base for some such exclusion criteria has been subject to criticism , as we have seen, for example, in relation to the exclusion of men who have sex with men from giving blood in blood services in many countries (Grenfell et al., 2011; Hurley, 2009). It has become evident that the social implications of exclusion as a blood donor may be highly problematic for those involved, especially if such policies are perceived to be unjust or not merited. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The clinical use of blood has a long history, but its apparent stability belies the complexity of contemporary practices in this field. In this article, we explore how the production, supply and deployment of blood products are socially mediated, drawing on theoretical perspectives from recent work on 'tissue economies'. We highlight the ways in which safety threats in the form of infections that might be transmitted through blood and plasma impact on this tissue economy and how these have led to a revaluation of donor bodies and restructuring of blood economies. Specifically, we consider these themes in relation to the management of recent threats to blood safety in the United Kingdom. We show that the tension between securing the supply of blood and its products and ensuring its safety may give rise to ethical concerns and reshape relations between donor and recipient bodies.
    Full-text · Article · Mar 2013 · Health

  • No preview · Article · Dec 2011 · Transfusion Medicine
Show more