Compliance with time-based deferrals for men who have sex with men

The deferral for men who have sex with men (MSM) was reduced from a permanent deferral for MSM if even one time since 1977 to progressively shorter time deferrals of 5 years and 1 year in Canada. We assessed compliance with these deferrals and the impact on safety at Canadian Blood Services.

Three anonymous online compliance surveys of male whole blood donors were carried out before and after implementation of successive changes. HIV rates and incidence were monitored from January 1, 2011, to August 14, 2018.

Participation rates in the consecutive surveys were 49.7% before implementation, 36.3% after 5 years and 36.3% after 1 year. There was no difference before versus after implementation in male donors with MSM history in the past year (0.21%, 0.19%, 0.24%; p = 0.70). The percentage of eligible MSM donors increased (0.13%, 0.66%, 1.21%; p < 0.0001), with approximately 2500 eligible MSM donors with the 1-year deferral in place. HIV rates were less than 0.6 per 100,000 donations and unchanged after each policy change (p = 0.14 for trend). Incidence remained unchanged at 0.22 per 100,000 person-years before implementation, 0.54 per 100,000 after 5-year deferral, and no incident cases after 1-year deferral (p = 0.55).

Progressively shorter time deferrals had no impact on noncompliance of MSM with a male partner in the past year. Contrary to modeling predictions, shorter time deferrals had no impact on HIV rates or incidence. There was a modest increase in eligible MSM in the donor pool after each shorter time deferral. These results support the safety of reducing deferral periods for MSM.