Statements & Reports

Questions and Answers MSM Policy Decision

1. Why did Canadian Blood Services review the deferral policy for men who have had sex with men (MSM)?
Canadian Blood Services indefinitely defers any male from donating blood if he answers yes to the question: "Have you had sex with a man, even one time since 1977?" Canadian Blood Services continually reviews its policies to ensure they are still in the best interest of Canadians. Since the policy was implemented, there have been improvements in testing as well as evolving science and technology. As a consequence, a number of blood operators have made changes to their MSM deferral policies. All of these factors prompted Canadian Blood Services to review its current policy and as is our long-term practice, involve stakeholders in that review.

2. How was the review conducted?
The process involved a literature review, analysis of surveillance data and assessment of international MSM policies. Next, the Board of Directors commissioned the McLaughlin Centre for Population Health at the University of Ottawa to undertake an independent risk assessment of the current policy.

We then launched a comprehensive consultation process to involve Canadians in the decision-making on this issue. Through the consultations, we gathered the insights, through facilitated sessions, of key stakeholder and high interest groups such as student associations, gay rights activists, healthcare professionals and patient advocates to provide to the Board of Directors.

3. What is the rationale behind Canadian Blood Services' current policy on MSM?
The basic premise for the deferral criteria is that the prevalence and incidence of HIV is much higher in males who have had sex with other males (MSM) than it is in individuals having exclusively heterosexual sex, according to 2005 statistics from the Public Health Agency of Canada. This deferral is part of our screening procedures that are designed to identify a variety of behaviours and circumstances known to increase risk to the safety of the blood supply. For instance, we also indefinitely defer individuals from giving blood that have spent more than three months in the United Kingdom or France between 1980 and 1996, due to the increased risk of potential exposure to vCJD.

4. How has the Board of Directors decided to proceed?
As evidence-based decision-makers, the Board of Directors is committed to making informed decisions. After careful review of all information, including the risk assessment and the results of the consultations, the Board has determined that further knowledge is needed before a decision could be made to change the policy. At this time, we will be maintaining the current policy while we work to close the gaps that were identified through the risk assessment and the consultations.

5. What are the gaps you are talking about and how long will it take to close them?
Although the areas of study have not been finalized, knowledge gaps were identified in the areas of emerging pathogens in specific populations and the risks and benefits of behavioural-based donor selection questions. In addition, Canadian Blood Services will monitor the experience of blood agencies which have modified or changed the MSM donor deferral policy.

6. What are other countries doing?
At the present time, United States FDA regulations, as well as Council of Europe Regulations, require the indefinite deferral of men who have sex with men even once since 1977. This includes the U.S., the U.K., France, Germany, Switzerland, Holland, Norway, Denmark, Sweden, Finland, Iceland and Hong Kong. There are a few countries that have shorter deferral periods; 1 year - Argentina, Australia, Japan, Hungary; 5 years - South Africa; 10 years - New Zealand. To our knowledge, Italy is the only country that has moved to a deferral based on specific activities.

7. What is the significance of the year 1977?
The year 1977 has been identified as the date when rapid spread of HIV began throughout first world countries such as the United States and Canada.