New eligibility rules that will allow more men who have sex with men to donate blood, platelets and plasma come into effect this week, marking an historic move to make blood donation more inclusive while keeping blood just as safe.
Research from the University of Nottingham has helped to shape the new rule, which mean that from today (Monday) – World Blood Donor Day – the questions asked of everyone when they come to donate blood in England, Scotland and Wales will change. Eligibility will be based on individual circumstances surrounding health, travel and sexual behaviours evidenced to be at a higher risk of sexual infection.
Experts from the School of Psychology were part of the FAIR (For the Assessment of Individualised Risk) steering group, who have been working to enable a more individualised way of assessing safe blood donations.
Donors will no longer be asked if they are a man who has had sex with another man, removing the element of assessment that is based on the previous population-based risks.
Instead, any individual who attends to give blood - regardless of gender - will be asked if they have had sex and, if so, about recent sexual behaviours. Anyone who has had the same sexual partner for the last three months will be eligible to donate.
The changes to the re-named Donation Safety Check form* will affect blood, plasma and platelet donors. The process of giving blood will not change.
Professor Eamonn Ferguson, University of Nottingham led the behavioural research, he said: "I am very proud to be part of the FAIR project, which when the changes recommended by the project come into effect in June 2021 will mean that any individual who attends to give blood – regardless of gender or sexuality – will be assessed for eligibility against sexual behaviour risks and deferred if found to be at a higher risk of infection. This a major step forward to creating a fair and equitable blood donor system for all, while maintaining safety. We provided the behavioural science research evidence, based on surveys of donors and non-donors, and interviews with donor staff, donors, non-donors, men-who-have-sex-with-men and patients, to the FAIR project. This was triangulated with the epidemiological evidence to identify the best combination of questions to use for the policy change. This shows how bringing different scientific approaches (behavioural science and epidemiology) together is beneficial to support evidence-based policy changes."
Ella Poppitt, Chief Nurse for Blood Donation at NHS Blood and Transplant, said: "Patient safety is at the heart of everything we do. This change is about switching around how we assess the risk of exposure to a sexual infection, so it is more tailored to the individual.
"We screen all donations for evidence of significant infections, which goes hand-in-hand with donor selection to maintain the safety of blood sent to hospitals. All donors will now be asked about sexual behaviours which might have increased their risk of infection, particularly recently acquired infections. This means some donors might not be eligible on the day but may be in the future.
"Our priority is to make sure that donors are able to answer the pre-donation questions in a setting that makes them feel comfortable and safe and donation is something that continues to make people feel amazing. Our staff have been trained to make sure these more personal conversations are conducted with care and sensitivity and accurate information is captured.
"We are asking all blood, plasma and platelet donors to please consider the new questions alongside the existing health and travel questions before their appointment, and to re-schedule if they do not meet the changed criteria to donate right now.
"We want donation to be a positive experience and we are looking forward to welcoming donors as we move forward with these changes."
Under the changes people can donate if they have had the same sexual partner for the last three months, or if they have a new sexual partner with whom they have not had anal sex, and there is no known recent exposure to an STI or recent use of PrEP or PEP. This will mean more men who have sex with men will be eligible to donate.
Anyone who has had anal sex with a new partner or with multiple partners in the last three months will be not be able to give blood right now but may be eligible in the future. Donors who have been recently treated for gonorrhoea will be deferred. Anyone who has ever received treatment for syphilis will not be able to give blood.
The changes follow an evidence-based review into individualised criteria by the FAIR (For the Assessment of Individualised Risk) steering group led by NHS Blood and Transplant.
FAIR concluded on a new donor selection system which is fairer and will also maintain the UK's status as one of the safest blood supplies in the world. The findings were accepted in full by the government last December.
Data around the impact of the donor selection changes will be kept under review and assessed 12 months after implementation to determine if changes are needed. Feedback from donors, LGBT+ individuals, patients and representatives will be a key consideration in this review.
These changes come at a time when demand for blood is increasing. This year, as life and the NHS start to return to normal, patients need blood donors more than ever.
Become a blood donor. Register today and book and appointment by calling 0300 123 23 23, downloading the GiveBloodNHS app, or visiting www.blood.co.uk
If you have been deferred because of previous guidelines and would like to donate, please call NHS Blood and Transplant on 0300 123 23 23. One of our team can review the new guidelines with you and, if eligible, book your next appointment.
You can also donate plasma for antibody medicines that are used to save the lives of people with rare immune diseases - potential plasma donors should call 0300 123 23 23.
