Sexual risk behaviour and donor deferral in Europe

Area of Science:

• Transfusion Medicine
• Epidemiology
• Public Health Policy

Background:

• The permanent deferral of men who have sex with men (MSM) from blood donation is a contentious global policy.
• This policy aims to mitigate the risk of transfusion-transmitted infections, as male homosexual contact is considered high-risk.
• Current European Union legislation differentiates deferral periods based on sexual behavior, despite potential similar risks in heterosexual contact.

Purpose of the Study:

• To evaluate epidemiological and behavioral data to differentiate risk categories within sexual behaviors.
• To assess the relevance of donor adherence to deferral policies for blood safety.
• To inform policy regarding blood donor selection criteria for high-risk sexual behaviors.

Main Methods:

• Review of epidemiological and behavioral data.
• Analysis of modeling studies on residual risk and infection spread.
• Evaluation of studies on adherence to blood donor selection criteria.

Main Results:

• Existing data confirm men who have sex with men (MSM) and commercial sex workers (CSW) are high-risk groups.
• Further risk stratification beyond these groups lacks sufficient scientific evidence.
• Modeling studies indicate that high donor adherence to deferral policies is crucial for blood safety.
• A significant percentage of MSM donate blood despite permanent deferral policies.

Conclusions:

• Donor adherence to deferral policies is a critical factor in maintaining blood safety.
• Enhanced donor understanding and adherence may be more impactful than permanent deferral for certain high-risk groups.
• Policy adjustments should consider the balance between risk reduction and donor pool inclusivity, emphasizing adherence.