Conference Coverage

Still too early to determine impact of 1-year deferral for MSM blood donors


 

AT AABB2017

– It’s still too early to assess the impact of new guidelines for blood donation by men who have had sex with men, Brian S. Custer, PhD, MPH, of Blood Systems Research Institute, San Francisco, said at the annual meeting of the American Association of Blood Banks.

In 2015, the U.S. Food and Drug Administration lifted its lifetime ban on blood donations by men who have sex with men (MSM) and changed it to a 1-year deferral policy. Based on this new guidance, many U.S. blood centers moved from an indefinite deferral for any man who reported having had sex with a man since 1977 to a 1-year deferral from last sexual contact with a man.

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“The implementation of the 1-year policy has been in place for over a year now,” said Dr. Custer. “The rates for MSM deferral have declined, as expected. A small proportion have been reinstated and have donated multiple times and repeat donors have had negative infectious markers.”

In their study, Dr. Custer and his colleagues assessed the impact of the change in policy on donors and whether there was any early evidence of a change in risk to blood recipients.

At their center, the 1-year deferral was implemented on Aug. 29, 2016. On the health questionnaire that potential donors must complete, males are now asked two questions – one regarding sexual contact with men in the previous 12 months, and another about sex with men since 1977.

The rates of deferral were evaluated in two 7-month periods before and after the policy change (September 2015-March 2016 and September 2016-March 2017). They also looked at donor requests to be reinstated in lieu of the new policy, along with infectious disease marker test results in accepted donors.

In 272,306 interviews conducted before the policy change, 408 men responded yes to having sex with men since 1977 and 370 were deferred.

For the 252,395 interviews conducted after the policy change, 245 men answered yes to having sexual contact with men in the previous 12 months, and 245 were deferred.

Some of the men who reported having sex with men before the policy change were evaluated and accepted as donors. Overall, the donor acceptance rate was 9.3% during the period before the policy change, and 64.2% for the period after the policy change.

“Only 67 men requested to be reinstated and have been reinstated, and 39 returned to donate. There have been 59 successful donations to date,” said Dr. Custer.

Some of the reinstated donors were deferred for reasons similar to those for deferral of donors who are not men who have sex with men. Although it is still too early to draw any conclusions, Dr. Custer noted that they are being cautious, because infectious markers still are running a little higher among male donors with a history of having sex with men and donors without such a history.

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