London School of Hygiene & Tropical Medicine

Publishing in the BMJ, the research group led by Kaye Wellings explored adherence to the ban and further investigated reasons for non-compliance, concluding that a move to a deferral period of one year is likely to be accepted by most men who have sex with men. The results of the study were used to inform the Advisory Committee on the Safety of Blood, Tissues and Organs (SabTO) recommendations.

In the 1980s, blood services in many countries introduced a lifetime ban on blood donations by men who had ever had oral or anal sex with a man, while most other groups at increased risk of HIV infection are allowed to donate blood after a year's deferral since the last risky activity. In more recent years, several countries have introduced shorter deferral periods since last sex with a man, for example, six months in South Africa; 12 months in Australia, Sweden and Japan; and five years in New Zealand. This, along with advances in blood screening techniques and knowledge of HIV, has prompted calls for the UK to revise its blood donor policy.

LSHTM researcher Pippa Grenfell, lead author of the study said: "This is the first time that research into the views of people affected by the policy, and the wider public, has fed directly into a decision regarding the rules on who can and can't give blood. A one-year deferral is likely to be better accepted than the current lifetime ban and improving communication of the deferral criteria is likely to enable better adherence to a revised rule."

Between April 2009 and June 2010, the group surveyed 1,028 men in Britain reporting any male sexual contact and conducted 30 in-depth interviews with men who had and had not ever donated blood ineligibly. Many men considered the lifetime ban to be unfair, discriminatory and lacking a clear rationale whereas a one-year deferral rule was generally seen as feasible and acceptable. 10.6% of men reported donating blood since having penetrative sex with a man, 2.5% in the past 12 months. Reasons for not complying included self categorisation as low risk, confidentiality concerns, and a misunderstanding or perceived inequity of the rule. Others had discounted the experience that barred them from donating blood, highlighting the need to extend health information beyond men who identify as gay and bisexual.

The authors said: "Our research reveals that a small but important minority of men ineligible to donate blood under current UK rules have nevertheless done so in the past 12 months. However, many of the reasons identified for non-compliance appear amenable to intervention." They conclude: "Should such a revision be made, improvements to communication and confidentiality, and a clear explanation of the rationale will be essential. Careful monitoring of its effects will also be needed."

The full article can be viewed on the BMJ website, reference: BMJ 2011; 343:d5604