Daniel Grace1, Mark Gaspar2, Benjamin Klassen3, David Lessard4, Praney Anand2, David J Brennan5, Nathan Lachowsky3,6, Barry D Adam7, Joseph Cox8, Gilles Lambert8, Jody Jollimore3, Trevor A Hart2,9. 1. Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada. Daniel.Grace@utoronto.ca. 2. Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada. 3. Community-Based Research Centre, 1007-808 Nelson Street, Vancouver, BC, V6Z 2H2, Canada. 4. Centre for Health Outcomes Research, McGill University Health Centre, 5252 de Maisonneuve West, Montréal, QC, H4A 3S5, Canada. 5. Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St W, Toronto, ON, M5S 1V4, Canada. 6. School of Public Health & Social Policy, Faculty of Human & Social Development, University of Victoria, P.O. Box 1700, STN CSC, Victoria, BC, V8W 2Y2, Canada. 7. Department of Sociology, Anthropology, and Criminology, University of Windsor, 401 Sunset Ave, Windsor, ON, N9B 3P4, Canada. 8. Direction de santé publique de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 1560 Sherbrooke St E, Montreal, QC, H2L 4M1, Canada. 9. Department of Psychology, HIV Prevention Lab, Ryerson University, 350 Victoria St, Toronto, ON, M5B 2K3, Canada.
Abstract
BACKGROUND: Men who have sex with men (MSM) are not eligible to donate blood or plasma in Canada if they have had sex with another man in the last 3 months. This time-based deferment has reduced since 2013; from an initial lifetime ban, to five-years, one-year, and now three-months. Our previous research revealed that gay, bisexual, queer, and other MSM (GBM) supported making blood donation policies gender-neutral and behaviour-based. In this analysis, we explored the willingness of Canadian GBM to donate plasma, even if they were not eligible to donate blood. METHODS: We conducted in-depth interviews with 39 HIV-negative GBM in Vancouver (n = 15), Toronto (n = 13), and Montreal (n = 11), recruited from a large respondent-driven sampling study called Engage. Men received some basic information on plasma donation prior to answering questions. Transcripts were coded in NVivo following inductive thematic analysis. RESULTS: Many GBM expressed a general willingness to donate plasma if they became eligible; like with whole blood donation, GBM conveyed a strong desire to help others in need. However, this willingness was complicated by the fact that most participants had limited knowledge of plasma donation and were unsure of its medical importance. Participants' perspectives on a policy that enabled MSM to donate plasma varied, with some viewing this change as a "stepping stone" to a reformed blood donation policy and others regarding it as insufficient and constructing GBM as "second-class" donors. When discussing plasma, many men reflected on the legacy of blood donor policy-related discrimination. Our data reveal a significant plasma policy disjuncture-a gulf between the critical importance of plasma donation from the perspective of Canada's blood operators and patients and the feelings of many GBM who understood this form of donation as less important. CONCLUSIONS: Plasma donor policies must be considered in relation to MSM blood donation policies to understand how donor eligibility practices are made meaningful by GBM in the context of historical disenfranchisement. Successful establishment of a MSM plasma donor policy will require extensive education, explicit communication of how this new policy contributes to continued/stepwise reform of blood donor policies, and considerable reconciliation with diverse GBM communities.
BACKGROUND:Men who have sex with men (MSM) are not eligible to donate blood or plasma in Canada if they have had sex with another man in the last 3 months. This time-based deferment has reduced since 2013; from an initial lifetime ban, to five-years, one-year, and now three-months. Our previous research revealed that gay, bisexual, queer, and other MSM (GBM) supported making blood donation policies gender-neutral and behaviour-based. In this analysis, we explored the willingness of Canadian GBM to donate plasma, even if they were not eligible to donate blood. METHODS: We conducted in-depth interviews with 39 HIV-negative GBM in Vancouver (n = 15), Toronto (n = 13), and Montreal (n = 11), recruited from a large respondent-driven sampling study called Engage. Men received some basic information on plasma donation prior to answering questions. Transcripts were coded in NVivo following inductive thematic analysis. RESULTS: Many GBM expressed a general willingness to donate plasma if they became eligible; like with whole blood donation, GBM conveyed a strong desire to help others in need. However, this willingness was complicated by the fact that most participants had limited knowledge of plasma donation and were unsure of its medical importance. Participants' perspectives on a policy that enabled MSM to donate plasma varied, with some viewing this change as a "stepping stone" to a reformed blood donation policy and others regarding it as insufficient and constructing GBM as "second-class" donors. When discussing plasma, many men reflected on the legacy of blood donor policy-related discrimination. Our data reveal a significant plasma policy disjuncture-a gulf between the critical importance of plasma donation from the perspective of Canada's blood operators and patients and the feelings of many GBM who understood this form of donation as less important. CONCLUSIONS: Plasma donor policies must be considered in relation to MSM blood donation policies to understand how donor eligibility practices are made meaningful by GBM in the context of historical disenfranchisement. Successful establishment of a MSM plasma donor policy will require extensive education, explicit communication of how this new policy contributes to continued/stepwise reform of blood donor policies, and considerable reconciliation with diverse GBM communities.
Entities:
Keywords:
Blood donation; Canada; Discrimination; Gay, bisexual, queer and other men who have sex with men; HIV/AIDS; Plasma donation; Policy; Qualitative
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