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Unacceptable blood

How blood donation regulations use stats to target queer men

The Engineering Undergraduate Society’s blood drive with Héma-Québec took place from September 15 to 17, and the restrictions placed on “men who have sex with men,” or MSM, from donating blood continued to incite controversies last week. During the blood drives both this year and last year, the McGill club Queer Engineer held a campaign to protest these Canadian regulations. This discrimination persists despite being founded in misconceptions and faulty science.

“Policy should be based on science, not stereotypes,” read the cards distributed near the blood drive by Queer Engineer this year. The cards had information and quotes criticizing the current policy, which states that a man who has had sex with another man in the last five years (as well as a woman who has had sex with an MSM in the last five years) cannot donate blood. The reasoning given by Health Canada for targeting MSM is mainly the fact that HIV is most easily transmitted via anal sex. However, the cards pointed out the fact that in order to donate blood, MSM are forced to abstain from having sex with other men for five years, while for women, both anal and unprotected sex have no restrictions or regulations. The cards also noted that the current policy is outdated and does not take into account the scientific advancements in testing accuracy since 1985.

“Policy should be based on science, not stereotypes.”

Many countries banned MSM from blood donations after the AIDS epidemic in the 1980s. To this day, the U.S. maintains the ban. Canada lifted its ban on blood donations from gay men in 2013, though there still is a five-year deferral time during which the donor cannot engage in sexual activities with other men. “Canada is the only major developed country that has a five-year deferral period,” noted a representative from Queer Engineer.

Blood donors must complete a questionnaire with about thirty questions, including what medications the donor has been taking, the countries the donor has been to, and whether the donor is an MSM or has had sex with an MSM. The Héma-Québec website says this last question is based on statistics which indicate that over 10 per cent of gay men have HIV, compared to less than 1 per cent of heterosexual people and lesbian women in Canada.

However, these statistics unnecessarily target gay men, and provide a warped perspective on the issue. For instance, the forms do not ask about condom use when having sex, even though individuals who do not use condoms have an 85 per cent higher chance of contracting HIV than consistent condom users, according to a study by the U.S. Department of Health and Human Services. It is questionable why Health Canada would ignore such important statistics, but focus on data that are specifically and irrationally targeting MSM. This negligence diminishes the credibility of the survey as an objective method aimed at decreasing the likelihood of a blood sample containing HIV.

Another reason often used to justify the policy is the existence of a “window period” early in HIV contraction, when current tests are unable to detect the infection: if contaminated blood is added to the donation pool unknowingly, it has the potential to affect all the people who receive blood from that pool. The window period depends on the method of testing, but generally the window for antibody testing lies anywhere from one to three months – certainly much shorter than the five year deferral period. The current, high-tech method of antigen testing, which detects the virus itself in a blood sample, greatly reduces the window period to as little as a few weeks. Most commonly, two different types of tests will be done on a sample, further reducing the chance of a false negative.

“I think that we need to think in the light of new tests out there, and the fact that we can do RNA tests, DNA tests. […] We then need to re-think these policies in 2015.”

“The best HIV tests out on the market have an accuracy [of] about 99 per cent. The older [antibody-based] tests have 98.5 per cent – about a 1 per cent rate of false negative,” Nitika Pant Pai, an associate professor of Epidemiology and Infectious Diseases at McGill, told The Daily. Pant Pai noted that in a low-prevalence country like Canada, the probability of infection from donated blood can be even less than in other areas where a larger portion of the population has HIV. The extent of the contamination “depends on how [the blood] is used and how much blood they collect,” Pant Pai said.

According to the U.S. Food and Drug Administration website, HIV testing errors are mostly attributed to the window period. “The thing with government is that it tries to prevent the possibility of [contamination] happening by banning it; that’s kind of like an all-members response,” Pant Pai said, explaining that while the policy is somewhat understandable, as eliminating even the slightest risk might be seen as “for the greater social good,” it is not a believably intelligent response.

Pant Pai highlighted the fact that people may not take precautions before donating blood, or they may lack the education and knowledge of possible consequences. In order to prevent the minuscule chance of spreading infection, it is important to educate the public on safe sex and regular testing for infection.

In addition, Pant Pai reminds us that it may be time to review our current regulations: “I think that we need to think in the light of new tests out there, and the fact that we can do RNA tests, DNA tests. […] We then need to re-think these policies in 2015.”

Effects of a discriminatory policy

“It’s prejudicial. It’s isolating. It’s taking something about a person, about a group of people who are marginalized, and just [imposing] administrative barriers, administrative marginalization,” said Justin Dauncey-Ripplinger, the administrative coordinator of Queer McGill, about the policy. A representative from Queer Engineer concurred, saying, the policy is discriminatory “since it’s only men who have sex with men, but apparently not men who have anal sex with women,” for example.

Dauncey-Ripplinger shared his personal struggles, saying, “At a high school blood drive, I remembered seeing a box asking, ‘Have you engaged in homosexual sex as a man?’ It instilled this doubt in my mind that I would be looked upon differently.”

Dauncey-Ripplinger disclosed that his fear, which stemmed from the categorization of sexual orientation he faced in his youth, continued to persist during his teenage years. He also remarked that he has felt discriminated against during his blood donation procedure: “[When I donate blood] immediately the tone of the discussion changes.”

“I can’t do [the blood donation] for a decision that is not the government’s responsibility to police.”

After the AIDS epidemic in the 1980s, many countries banned queer men from donating blood because it was believed the outbreak originated amongst the gay community in the U.S., though now it is known that HIV was contracted by humans from chimpanzees in West-Central Africa. In the eighties, little was known about AIDS in health institutions and people blamed homosexuality as the caused of the disease, leading to the ban.

Even so, countries have been slow to lift their bans on blood donations from queer men. The UK lifted its ban in 2011, and both it and Australia still require men to go one year without sex with another man before they can donate blood. While there have been some considerations to relax the restrictions since last year, many people are frustrated at the slow progress.

“Canada isn’t doing enough,” said Dauncey-Ripplinger. He claimed that the government implementing regulations that physically bar MSM contradicts the idea of Canada as an accepting country. In comparison to the U.S., he remarked that Canada has been in the forefront of lawmaking that ensures equality for sexual orientation and same-sex marriage, and it is disappointing to see that Canada has been unable to step away from such prejudiced “mental ideologies” as restricting MSM from fair blood donation practices.

Dauncey-Ripplinger hopes to see the regulations change soon: “I would like to be able to walk past the Héma-Québec truck right outside of McConnell Engineering […] and then [not] have to do a double take on myself, and be like, just kidding, I can’t do [the blood donation] for a decision that is not the government’s responsibility to police.”