Boston, Mass. – The rate of infectious disease (ID) markers, such as those for HIV and hepatitis B and C viruses (HBV and HCV), in donated blood is higher for men who have sex with men (MSM) relative to blood donors overall, according to an analysis of data from more than 8.4 million blood donations collected from January 2017 through September 2018 by the American Red Cross. However, the ID marker rates for reinstated (1.44%) and newly eligible (2.0%) MSM donors were similar to those of first-time male donors (1.52%). The findings were presented at the 2018 AABB Annual Meeting, held Oct. 13-16 in Boston.
“Progress has been made in changing the MSM deferral policy in the U.S.; however, it is still too early to know the impact of these changes,” said lead author Susan L. Stramer, PhD, vice president of scientific affairs at the American Red Cross Biomedical Services. “The number of donors newly eligible under the revised deferral policy is small. In addition, while the infectious disease marker rates for donations from reinstated MSM donors is higher than for overall donations, the rates in these reinstated donors is comparable to those of first-time male donors.”
Citing the higher rate of HIV/AIDS among MSM, a lifetime blood donation deferral for MSM was instituted in the United States during the HIV/AIDS epidemic of the 1980s. At that time, there were no screening methods for HIV. With blood donation screening tests in place and with growing evidence, countries around the world have since lifted lifetime donation bans in favor of time-based or behavioral deferrals for MSM.
In December 2015, the United States adopted a one-year deferral policy. MSM who have abstained from sexual contact with another man for at least one year and meet other donation criteria are currently eligible to donate blood. The American Red Cross began implementing the new policy in phases in December of 2016. Individuals who were indefinitely deferred (MSM-77) and otherwise eligible were reinstated as potential donors. In addition, deferred donors could request reinstatement. Newly eligible MSM-77 donors were recruited based on the revised policy, and their donation history was tracked. In addition, MSM who donated for the first time following the MSM policy change (MSM-1-year), but who were subsequently deferred, were also tracked.
Stramer and her colleagues assessed deferral rates for both MSM groups based on the identification of ID markers, including HIV, HBV, HCV and syphilis antibodies from January 2017 to September 2018. These rates were compared with overall donations and donations from first-time male donors in 2017.
A total of 22,690 MSM-77 donors were reinstated, accounting for 0.017% of all donations between January 2017 and September 2018. Of these, 696 (3.1%) returned to donate 1,427 blood donations. From these donations, 10 (1.44%) had reactive ID markers with or without ongoing MSM activity. Three of the 149 (2.0%) MSM-1-year donors also had reactive ID markers with or without ongoing MSM activity. In comparison, 0.4% of the 4,829,679 overall donations had reactive markers for ID in 2017; 1.52% of 459,327 first-time male donors had markers for ID over the same time. Differences between MSM-77 and MSM-1-year compared with first-time male donors were not significantly different.
The researchers concluded that despite the ID reactivity among MSM donors, the number of donations from reinstated MSM donors is too small to assess any meaningful impact on national blood collections.
“If no changes are observed as data accumulate, it would be appropriate to look at further changes to the MSM donation policy,” said Stramer. “Either in the form of a shorter deferral time period or evaluation of movement to a risk-based deferral.”
AABB is an international, not-for-profit association representing individuals and institutions involved in the fields of transfusion medicine and cellular therapies. The association is committed to improving health through the development and delivery of standards, accreditation and educational programs that focus on optimizing patient and donor care and safety. AABB membership includes physicians, nurses, scientists, researchers, administrators, medical technologists and other health care providers. AABB members are located in more than 80 countries and AABB accredits institutions in more than 50 countries.