Before the introduction of testing for human immunodeficiency virus (HIV) in the mid-1980s, thousands of Canadians were infected through tainted blood products. Being solely responsible for Canada’s blood supply at that time, the Canadian Red Cross Society introduced a donor eligibility criterion that excluded all men who have had sex with a man even once since 1977. This criterion was embedded into Health Canada regulations in 1992.
At Canadian Blood Services, we periodically review our donor eligibility criteria, including those related to men who have sex with men. In 2019, Health Canada approved Canadian Blood Services’ and Héma-Québec’s applications to reduce the men who have sex with men waiting period from one year to three months. In other words, as long as they meet all other donor eligibility criteria, a man is now eligible to donate blood if it has been at least three months since he last had sex with a man. We believe this is an important step toward being as minimally restrictive as possible while also maintaining the safety of the blood supply.
This change was made after extensive review of scientific and epidemiologic evidence. Equally important was the consultation with high-interest groups, including patient groups representing heavy users of blood and blood products as well as members of lesbian, gay, bisexual, trans and queer community groups.
Canadian Blood Services is exploring the possibility of moving toward behaviour-based screening.
Our aim is to identify a long-term solution that prioritizes patient safety while minimizing the societal impact on certain groups of people. We established a working group, which includes representation from patient advocacy groups, as well as LGBTQ community organizations, to serve as a forum for ongoing discussion and consultation as we develop further changes in eligibility criteria. We have also committed to research funding, as described below.
A two-day meeting was held in January 2017 with national and international stakeholders to identify research priorities for closing knowledge gaps that impact donor eligibility for men who have sex with men.
Since then, and among other regular contact points, we have held face-to-face consultation meetings in Vancouver and in Toronto.
Our guiding principles for all stakeholder engagement are to:
Build supportive and constructive relationships with stakeholders.
Engage stakeholders proactively and explore expectations.
Inform good decision-making with evidence from different sources.
Foster transparency in decision-making while respecting privacy and partnerships.
Facilitating blood research
Canadian Blood Services continues to explore the possibility of moving toward a behaviour-based screening criteria.
In partnership with Héma-Québec and with funding from Health Canada, we are supporting 15 research projects investigating various aspects of blood and plasma donors’ eligibility criteria and screening process. The goal of this unique research funding program is to generate adequate evidence to inform alternative screening approaches for donors, which could evolve thecurrent eligibility criteria for men who have sex with men.
Canadian Blood Services is a world leader in discovery research and applied development related to blood and blood products: your donation could help us build the future of transfusion medicine. Make an appointment to donate blood for research.
There is no international consensus on an optimal blood donation waiting period for men who have sex with men, since the patterns, causes and effects of HIV infection differ by country. Currently many large blood suppliers such as the United States, Australia and the Netherlands have implemented a one-year waiting period for men who have sex with men. In 2014, Australia’s health regulator denied a proposal to further reduce their one-year waiting period to six months. Canada and the United Kingdom, excluding Northern Ireland, have implemented a three-month waiting period for men since last sexual contact with a male partner.
Three-month waiting period
Men who have sex with men account for the largest proportion of new HIV infections reported in Canada. A three-month waiting period was implemented in 2019 as the next incremental step toward more inclusive blood donor criteria. Our goal is to maintain the safety of the blood supply while being as minimally restrictive as possible.
All changes made to the donor eligibility criteria for men who have sex with men have been based on scientific evidence, are acceptable to patient groups and were approved by Health Canada.
We use antibody testing and nucleic acid amplification testing (NAT) to test blood for HIV. Introduced in 2001 and since upgraded, NAT greatly reduces the length of time HIV can go undetected in a person infected with the virus. However, there is still an approximately nine day period shortly after infection when an individual may transmit HIV but the virus is not detected by our tests. That’s why we use screening questions before a donation is made as part of a multi-tiered safety system to protect patients. Learn more here.
Stem cells and organ donation
Regulations for organ and stem cell donations are different than those for blood donation. For more information, visit our Frequently Asked Questions (FAQ) on the topic.