Canada’s new blood donor policy still excludes many gay and bi men, critics say

For Aaron Crowe, donating blood is a valuable way to contribute to society, having himself received blood donations.

But it remains banned from donating, even following a Health Canada decision last week that ended a blanket ban on blood donations from men and some transgender women who have had sex with men in the UK. course of the last three months.

This is because Crowe’s partner of six years is HIV positive and the Canadian Blood Services (CBS) continues to prohibit people from donating if they have had sex with someone who is HIV positive in the last 12 years. month. This is despite the fact that Crowe’s partner has an undetectable viral load from the drugs, and therefore cannot transmit the virus to him.

Crowe is just one of those who critics say will be a ‘significant’ number of individuals who will continue to be banned under the new blood donor policy, which is due to come into effect on 30 september.

Supporters say the new policy — championed as a long-overdue milestone by federal politicians including Prime Minister Justin Trudeau — will still effectively ban many men who have sex with men, while continuing to perpetuate stigma at about them and to people living with HIV.

“The initial coverage was really exciting because it looked like they were making meaningful changes to end discrimination against gay people and other people,” Crowe said in an interview, “but when you actually looked at how they were changing it, it looks like they are really laundering the same policy.

The new rules prohibit all individuals – regardless of their sexual orientation or gender identity – from donating if they have had anal sex with one or more new partners in the past three months.

All blood donations are tested for diseases such as HIV and hepatitis B and C. The blood agency says there is a window of about nine days after an HIV infection when a person can transmit the virus and is not detected by the test, hence the need for screening questions.

The agency said it used a three-month deferral period because the window for other pathogens like hepatitis B “is considerably longer”, and three months is the time frame used in the UK.

Critics point out that although everyone will now be asked about anal sex – which carries a higher risk of HIV transmission than other sexual practices – it is a sexual activity more commonly practiced among men with sex with men, and they will continue to be disproportionately excluded. except in a monogamous relationship.

“While Canadian Blood Services expects a real increase in donations – which we sometimes really need – this policy change does not appear to suggest, in our view, that will be the case,” said Dane Griffiths, Director. of the Gay Men’s Sexual Health Alliance.

“Once you really go through the details of who is being excluded… It will still make a lot of us ineligible to donate.”

The concern is that the new policy “will continue to prohibit a significant number of gay, bisexual and homosexual men from donating,” said attorney Gregory Ko, who represents Christopher Karas, who filed a lawsuit. of human rights against the blood donation system.

To allow more men to donate while maintaining a safe blood supply, CBS should ask about safe sex practices, advocates say, such as condom use. CBS says condoms can break.

CBS also bans people who take pre-exposure prophylaxis (PrEP) — ​​a drug that prevents the transmission of HIV. The agency said PrEP, which has become an increasingly popular safe sex practice in the LGBTQ community, affects the sensitivity of their tests, and it’s unclear whether PrEP can prevent HIV from showing up. in a blood transfusion.

Individuals must be off PrEP for four months before they can donate blood, a criteria put in place at the request of Health Canada in 2019, the Canadian Blood Services said.

“For most gay and bisexual men, especially those who use PrEP – those same people we encourage to use the tools at our disposal to reduce the impact of HIV in our community – they will not be eligible to do a gift,” Griffiths mentioned.

The head of the Canadian AIDS Society, consulted by Canadian Blood Services for years, said the government should have invested more in research into the impact of PrEP and testing.

“It’s very dishonest of Trudeau to take a stand with his comrades-in-arms, the gay caucus, and say, ‘Hey, we’ve done this now,'” the company’s executive director, Gary, said. Lacasse. “There has been too much harm, and it’s perpetuated even more now.”

CBS also continues to ban people like Crowe who have had sex with someone who is HIV-positive — regardless of their viral load status — in the past 12 months. In recent years, a number of organizations and governments, including Ottawa, have taken the position that an undetectable viral load means that HIV cannot be transmitted sexually.

“I continue to be a strong advocate for the message Undetectable=Untransmittable (U=U),” Canada’s Chief Public Health Officer Dr. Theresa Tam said in 2018. a principle firmly rooted in science.”

The CBS says U=U does not apply to blood transfusions, saying a small amount of virus could still be transmitted by an HIV-positive person donating blood. As for partners of HIV-positive people with an undetectable viral load, the agency said that due to confidentiality concerns, it “cannot ask donors for detailed information about their partners’ test results.” CBS says it plans to look into this issue of donors in the future.

A Dalhousie University professor who has spent years researching the blood donation system says Canadian Blood Services must be held accountable for failing to address homophobia and anti- black, and how the two crossed paths to stop black gay and bi men from donating — going so far as to say the agency needs new leadership.

An example was the presence for years of an online questionnaire for donors that asked people if they were born or had ever lived in Africa, accompanied by pictures of elephants and acacia trees – questions that have since been suppressed, said OmiSoore Dryden, the James R. Johnston Chair in Black Canadian Studies at Dalhousie Medical School.

“When you use these images of Africa to always be around vegetation, animals, dirt, you are perpetuating a particular racist stereotype about people who were born or lived in Africa,” she said. .

The questionnaire “described Africa as if it were one country…as if the whole African continent was riddled with AIDS, and these racist stereotypes were never appropriately addressed”.

CBS said the questions about Africa were “forced” on the agency by Health Canada due to concerns about new strains of HIV in some African countries that may have been less detectable in testing.

“We were able to convince Health Canada that our methods were adequate to detect these new strains, and the questions were removed entirely in April 2018,” the agency said. “We…recognize that some of our current and past donor selection issues have had a disproportionate impact on Black and other racialized Canadians.”

Dryden said it’s “a really juvenile understanding” to think that by simply removing or reframing the questions, “then the stigma is gone.”

Crowe says that by continuing to ban people like him from donating blood, CBS unnecessarily perpetuates the stigma around HIV, which he says prevents people from getting tested and getting the treatment they need.

Crowe’s partner, Randy Davis, has had an undetectable viral load from antiretroviral drugs almost since his diagnosis began seven years ago, and therefore did not transmit the virus to Crowe.

“There are a lot of couples who are in the situation that we are in, and they’re mostly on the LGBT spectrum, so I feel like the new rules are still very discriminatory towards LGBT people,” the consultant said. 53 year old software.

“One of the big issues in the ability to tackle the HIV epidemic is the fight against stigma, and that only further stigmatizes people living with HIV and people living with them.

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