Blood donation practices and perceptions among men who have sex with men in China: A nationwide mixed-methods study

In China, current blood donation eligibility criteria classify men who have sex with men (MSM) as ineligible to donate blood. We aimed to examine perceptions, attitudes, and blood donation behaviors among MSM in China.

We conducted a nationwide multicenter cross-sectional survey followed by qualitative interviews from April to July 2024. Survey data included sociodemographic characteristics, sexual behaviors, and awareness, attitudes, and experiences related to blood donation eligibility criteria. Multivariable modified Poisson regression was used to identify the correlates of prior blood donation and attitudes toward the eligibility criteria. Interviews explored motivations for blood donation and perceptions of the eligibility criteria.

A total of 2725 MSM participated in the survey. 1255 (46%) were unaware that MSM were prohibited from donating blood in China, and 887 (33%) reported having previously donated blood. After all participants were introduced to the current eligibility criteria, 442 (16%) supported the criteria, and 934 (34%) opposed them. Prior blood donation was associated with positive attitudes toward blood donation and perceptions of the eligibility criteria. Qualitative interviews (n = 16) indicated that motivations for blood donation included contributing to society and securing priority access to blood products, while reliance on self-reported sexual behaviors was perceived to limit effective implementation of the criteria.

Blood donation was common among MSM in China despite limited awareness of current eligibility criteria. These findings highlight the need for further research on how existing eligibility criteria are communicated, understood, and implemented in practice while maintaining blood safety as a primary consideration.