The FAIR (For the Assessment of Individualised Risk) steering group, which was set up at the beginning of 2019 at the request of the Department of Health and Social Care exploring whether some gay and bisexual men might be able to donate blood without a deferral, is still hoping to report its findings before the end of 2020 in spite of the coronavirus pandemic.
The steering group includes representatives from NHS Blood and Transplant (NHSBT), Scottish National Blood Transfusion Service, the Welsh Blood Service, the Northern Ireland Blood Transfusion Service, Public Health England (PHE), the University of Nottingham, National Aids Trust (NAT), Stonewall, Freedom to Donate, Terrence Higgins Trust (THT), patient and donor representatives, and experts in epidemiology, virology and psychology.
Currently a man who has had sex with a man is deferred from donating blood for three months, and so the FAIR work is exploring whether there is sufficient evidence to change the current blood donor selection policy.
The current three month deferral uses ‘population based risk’ and the FAIR work could lead to the use of a more individualised assessment of risk, whilst still maintaining the safety of the blood supply. The change might enable some men who have sex with men but who are deferred under the current policy, to give blood.
Dr Su Brailsford, the chair of FAIR, who holds senior roles at both NHSBT and PHE, said: ‘We are all committed to equality, diversity and inclusion and we are pleased to be working collaboratively with other organisations on this important issue.
‘We need a donor selection system that is safe and can also cope with large numbers of people. We need to understand which questions are most relevant to assessing risk and whether there are some questions which might put people off donating.
‘This work takes time and we need to make sure everything we do is based on good evidence with patient safety as the number one priority.
‘We appreciate that any deferral is disappointing if you want to save lives by giving blood and recognise that people want to be considered as individuals as much as possible. We want to give as many people as possible the opportunity to donate whilst continuing to ensure the safety of both the blood supply and those patients who receive blood.’
Debbie Laycock, Head of Policy at THT, said: ‘As a member of the FAIR steering group, we are pleased that the important work of this group is progressing and that its recommendations will be released this year.
‘We have long campaigned for a blood donation system that better reflects the realities of sexually transmitted infections. That’s why we welcomed the reduction in the deferral period to three months for those who are gay and bisexual men, and we will continue to support this work around exploring an individual risk assessment.’
FAIR is taking a collaborative, evidence led approach. This has included conducting focus groups with gay and bisexual men. Existing public health data and research is being examined to scope how best to identify individuals at high and low risk of infections. Thousands of current and potential new blood donors are being surveyed to examine how people would respond to possible new and more detailed questions about their sexual behaviours. A mixture of workshops, focus groups and interviews are being held with groups such as blood donation session staff, current blood donors and potential new donors.
Currently all blood donors are asked a series of questions on travel, health, tattoos, sexual behaviour and more, to help assess how safe it is for them to donate, and how safe it is for someone to receive their blood. A central part of FAIR’s work is considering which new questions could successfully be added to identify donors, including men who have sex with men, at lower risk of acquiring certain infections that can be transmitted through blood.
A Stonewall spokesperson added: ‘We’re very pleased to be working with NHSBT and other partners on this vital project exploring ways to stop the blanket restriction against gay and bi men looking to donate blood. Working towards introducing a system of individualised risk assessment is a crucial part of allowing people who want to save lives to safely donate blood.’
FAIR aims to submit a report to the Advisory Committee on the SaBTO by the end of 2020.
NHSBT’s LGBT+ Network has a page outlining the guidance on blood, organ, stem cell and tissue donation if you are LGBT+: www.nhsbt.nhs.uk/lgbtdonation
More info on THT: www.tht.org.uk
More info on Stonewall: www.stonewall.org.uk
More info on National AIDS Trust: www.nat.org.uk