Christopher Karas said he felt “powerless” and “worthless” when he first found out he could not donate blood at a clinic in Brampton, Ont. back in 2016 because of restrictions on men who have sex with other men.
That experience prompted Karas, who is gay, to file a complaint with the Canadian Human Rights Commission (CHRC) that same year. Fast forward to 2021, a federal court judge is expected to hear the case next week.
“Our blood system should not only be safe, but should also be an equitable system which is accessible to all of us,” Karas, 25, told Global News.
Canada’s blood donation eligibility continues to remain a contentious issue, with critics and opposition members pressing the government to deliver on its long-standing promise of reversing the rule.
Under the current policy, a man who has had sex with a man must wait three months after his last sexual encounter before donating blood due to the supposed risk of spreading HIV.
As part of a 2015 campaign promise, the Liberal party has vowed to end the ban on blood donations from gay men, which it considers discriminatory. At the same time, Ottawa is attempting to block Karas’ legal challenge in federal court.
Condemning the rule last week, New Democrat Leader Jagmeet Singh said it “makes absolutely no sense and has no basis in science.”
“Why does the prime minister continue to campaign to remove the blood ban yet right now is defending the blood ban in court?” Singh asked during question period in the House of Commons on May 13.
Deputy Prime Minister Chrystia Freeland responded, saying, “Our government absolutely shares those concerns, at the same time we respect the independence of Canadian institutions, especially when it comes to medical and scientific issues.”
In 2019, Health Canada approved Canadian Blood Services’ (CBS) request to reduce the blood donation waiting period for men who have sex with men from one year to three months. Non-profit CBS operates as Canada’s blood authority and is independent from the Canadian government, but it is ultimately up to the feds to authorize changes in donation practices.
The deferral period has been shortened three times over the past eight years. Prior to 2013, there was a lifetime ban.
But advocates say the focus should not be on identity or the timeline but on people’s behaviour — regardless of their background or sexual orientation.
“It’s unreasonable to say stop having sex for three months to donate blood,” said OmiSoore Dryden, associate professor in the Department of Community Health and Epidemiology at Dalhousie University.
“They don’t say that for heterosexual people who have many partners. They actually don’t ask heterosexual people how many partners they’ve had in the last three months and whether or not they used any kind of safer sex practices,” said Dryden, who is Black and identifies as a lesbian.
In a recent letter dated May 11 to Health Minister Patty Hajdu, Dryden said CBS should be held accountable for asking “racially stigmatizing questions” relating to Africa that were in effect for almost 20 years before being removed from the donor questionnaire in 2018.
“Canadian Blood Services and Héma-Québec should ask all donors the same questions, and those questions should be based on specific high-risk sexual behaviours, not who you love or what your gender identity is,” said Unifor, a Canadian private-sector union which has been campaigning for an end to the blood ban since 2018, in a statement on its website.
'Too broad'
Canadian Blood Services tests all donated blood for diseases, including HIV, before the blood is used in a transfusion.
According to the most recent data from Health Canada, gay, bisexual and other men who have sex with men represented 49.5 per cent of all new HIV infections in 2018, despite representing approximately three-to-four per cent of the Canadian adult male population.
For any changes to the donor eligibility criteria to be approved by Health Canada, CBS says it has to provide evidence that the changes are safe.
“Canadian Blood Services is proactively engaged in the evidence-based evolution of this donor deferral policy,” the agency told Global News in an emailed statement.
“We know it’s important. Canadian Blood Services’ end goal is to implement behaviour-based screening for all donors rather than a waiting period for men who have sex with men,” CBS said.
A spokesperson for Hajdu said the health ministry continues to encourage CBS and Héma-Québec, Quebec’s blood operator, to move toward a behaviour-based model.
“We eagerly await a request from Canadian Blood Services and Héma-Québec to eliminate the ban, so that this discriminatory policy can come to an end,” Aisling MacKnight told Global News in an emailed statement.
Most recently, in mid-May, CBS made a submission to Health Canada for a pilot project to establish alternative screening and collection processes that would enable men who have sex with men to donate source plasma. Health Canada aims to review the submission within 90 days.
According to Unifor, the current policy ignores scientific innovation in HIV and hepatitis C testing since the 1980s, that anyone can engage in high-risk sexual behaviours and that people exposed through heterosexual sex are most likely to be unaware of their HIV infection.
Some worldwide examples point in favour of eliminating the ban.
Italy dropped its ban in 2001, moving instead to a person-by-person risk assessment, and has not seen a significant increase in transfusion-related HIV transmission since the shift.
Portugal followed suit in 2010, as did Mexico in 2012. Instead of a ban, they’ve adopted risk-based deferrals with questions targeting high-risk sexual exposure.
Canada’s eligibility criteria is “too broad,” said Nathan Lachowsky, associate professor at the School of Public Health and Social Policy at the University of Victoria. It needs to focus on the specific risk practices that lead to someone acquiring HIV, he said.
“The current policy excludes all men for any kind of sex from donating blood and what we do know from decades of research is that that is too broad,” he told Global News.
More than 90 per cent of men who have sex with men would donate blood if they were eligible, according to a 2019 poll by Community-Based Research Centre (CBRC).
In partnership with Héma-Québec, and with funding from Health Canada, CBS is supporting 19 research projects investigating various aspects of blood and plasma donors’ eligibility criteria and screening process.
Lachowsky believes there is enough data to be able to implement a change in policy now.
“This is a voluntary blood system, and so we need people to feel excited and invited to donate blood.”
— With files from Global News’ Sean Previl