Compliance with gender-neutral sexual behavior-based blood donor screening questions

In September 2022, Canadian Blood Services replaced the time-based deferral for gay and bisexual men who have sex with men (gbMSM) with sexual behavior-based questions. All donors who had sex with a new partner or >1 partner in the last 3 months and anal sex were deferred, permitting gbMSM with one regular partner to donate. We aimed to measure compliance with the new criteria post-implementation.

Pre-implementation 42,999; post-implementation 41,157 donors were invited to complete an anonymous online sexual risks survey. Results were weighted reflecting the donor base age, sex, and geography base. Frequencies and 95% confidence intervals were calculated.

In total, 13,159 donors participated pre-implementation (33% participation, 6532 females and 6627 males of whom 183 had ever had sex with another man (gbMSM)); post-implementation 11,217 donors (28% participation, 5253 females and 5964 males of whom 188 were gbMSM). Pre-implementation 9.3% (4.3%-14.2%) gbMSM had a new or >1 partner and anal sex in the last 3 months (all ineligible), similar to post-implementation when some were eligible (8.9%, 4.1%-13.8%, p > .05). There was no difference between pre- and post-implementation for non-gbMSM males (pre- 0.7%, 0.5%-1.0% vs. post-0.7%, 0.4-0.9) and females (pre- 0.8%, 0.6%-1.0% vs. post-0.6%, 0.4-0.8%) (p > .05). The estimated non-compliance of those with deferrable behavior was 87% (79%-93%). Most donors reported being comfortable with the new questions.

The majority of donors with deferrable sexual behaviors failed to disclose post-implementation. Donors may make a judgment about whether they need to disclose behaviors in screening.