M Germain1, R S Remis, G Delage. 1. Microbiology and Epidemiology, Héma-Québec, Montréal, Canada. Marc.Germain@Hema-Quebec.qc.ca
Abstract
BACKGROUND: It has been suggested that men who have had sex with men (MSM) should become eligible to donate blood if they recently abstained from male-to-male sex. STUDY DESIGN AND METHODS: The impact of a 12-month deferral policy for MSM on the risk of introducing contaminated units in the blood supply and the benefit of obtaining additional donations were estimated. Considered were the prevalence of HIV among MSM, the window period of infection, the rate of laboratory testing errors, and the occurrence of other system failures. This was compared with the risk and benefit that currently results from accepting female donors who have had sex with MSM. RESULTS: The revised policy for MSM would potentially result in one HIV-contaminated unit for every 136,000 additional donations (95% CI, 1 in 69,000 to 1 in 268,000), for an overall increase in HIV risk estimated at 8 percent. The number of donations would increase by 1.3 percent (95% CI, 0.9%-1.7%). The risk-benefit ratio of currently accepting female partners of MSM is approximately five times lower. CONCLUSION: The risk increment of accepting 12-month abstinent MSM would be very small but not zero. From a risk-benefit perspective, the current deferral policy for MSM is more efficient compared to an analogous hypothetical criterion for female partners of MSM.
BACKGROUND: It has been suggested that men who have had sex with men (MSM) should become eligible to donate blood if they recently abstained from male-to-male sex. STUDY DESIGN AND METHODS: The impact of a 12-month deferral policy for MSM on the risk of introducing contaminated units in the blood supply and the benefit of obtaining additional donations were estimated. Considered were the prevalence of HIV among MSM, the window period of infection, the rate of laboratory testing errors, and the occurrence of other system failures. This was compared with the risk and benefit that currently results from accepting female donors who have had sex with MSM. RESULTS: The revised policy for MSM would potentially result in one HIV-contaminated unit for every 136,000 additional donations (95% CI, 1 in 69,000 to 1 in 268,000), for an overall increase in HIV risk estimated at 8 percent. The number of donations would increase by 1.3 percent (95% CI, 0.9%-1.7%). The risk-benefit ratio of currently accepting female partners of MSM is approximately five times lower. CONCLUSION: The risk increment of accepting 12-month abstinent MSM would be very small but not zero. From a risk-benefit perspective, the current deferral policy for MSM is more efficient compared to an analogous hypothetical criterion for female partners of MSM.