Why we ask men who have sex with men not to give blood

A guide for donors

Securing the safety of the national blood supply is our number one priority. We follow strict rules and regulations when collecting and processing blood to make sure we supply the safest possible blood.

We use two main strategies to keep blood donation as safe as possible.

1. Selecting ‘safe’ donors
2. Testing every donation

Selecting ‘safe’ donors means that we have to ask some people not to donate their blood. This includes all men who have had sex with other men.

Principles of selecting donors

There are over 450 rules guiding donor selection and there are many groups of people who we ask not to donate either for a short period or forever.

Some people in these groups may have a very low risk of blood-borne infections and their blood would probably be safe to give to patients, but it is safest to ask everyone within the groups that have been identified, not to give blood.

This request can be disappointing and frustrating to some people who wish to donate blood. Our decisions are based on information and research about the effects our policies will have on ensuring the safest blood supply possible, not out of a desire to discriminate against any particular group.

The aims of selecting donors are to:

1. select donors whose blood, as far as we can tell, is most unlikely to transmit any infection
2. collect enough blood to meet patients’ needs.
3. make sure that donors themselves come to no harm through giving blood.

We have to balance these three aims while also keeping the selection process clear and simple.

Why do we ask men who have sex with men not to give blood?

We ask men who have sex with men not to give blood because men who have sex with men, as a group, are known to be at an increased risk of acquiring HIV and a number of other sexually transmitted infections (STIs), many of which are carried in the blood.

It is specific behaviours, rather than being a man who has sex with men, which places men who have sex with men at increased risk of HIV infection.Safer sex will keep most men who have sex with men free from infection,however research shows that allowing men who have sex with men as a group to donate blood would increase the risk of HIV infected blood entering the blood supply.

Testing does not detect all infections

We test all blood donations for HIV, hepatitis B and C , syphilis and HTLV. However, no testing process can be ‘perfect’. We may miss infected donations because of the ‘window period’ between getting an infection and the test showing a positive result. There is also always a small risk of mistakes being made in the laboratory.

Selecting donors that are already in a low-risk group for these infections means that we will reduce the number of infected donations that could be missed by testing.

How the rule improves the safety of blood transfusions

Many men who have sex with men have not given blood since the AIDS epidemic began, and this has prevented many HIV infections being transmitted through transfusion. Also, the number of hepatitis B infections transmitted by blood transfusion fell considerably after this rule was introduced.

Abolishing the rule for men who have sex with men would increase the risk of HIV infected donations entering the blood supply in England by about five times , and changing the rule to allow men who have sex with men to donate one year after they last had sex with another man would increase the risk by 60%. (Reference: Soldan, K.; Sinka, K. Vox Sanguinis, Volume 84, Number 4, May 2003 , pp. 265-273(9)).

Keeping our rules simple

The rule about men who have sex with men is clear and simple. You can decide whether it applies to you without the need to discuss your personal life with our staff. The rule is based on an impartial assessment of available evidence. We ask that you observe it for the sake of blood safety.

Further information

People who are asked not to donate blood are entitled to a clear explanation as to why. If you would like more information than is contained in this leaflet, please see our contacts list.