Frequently Asked Questions

Are all LGBT people barred from giving blood for one year after sexual activity?

No. The deferral does not relate to someone’s sexual identity, but to their practice. If anyone, whatever they define as, is a man who has had sex with a man, he is asked to defer donating blood until 12 months after his last sex with another man. This deferral is in line with other deferrals of particular populations which are, as a group, at heightened risk of acquiring a range of sexually transmitted infections (STIs).

Isn’t it discrimination to have a different rule for gay men from heterosexuals or lesbians?

The different rule for gay men, or rather for any man who has had sex with another man in the last year, is not based on homophobia – if it was, other LGBT people would also be barred. It is based on the incontrovertible evidence that men who have sex with men in the UK are at far greater risk than any other population, per sexual encounter, of acquiring a variety of infections such as syphilis, Hepatitis B and C and, most of all, HIV.

THT would like to see the same regulations for all – but we will only get those regulations when we have managed to reduce the risks of STI transmission during gay sex to the same level as that faced by most heterosexuals.

A range of other deferral times exist for injecting drug users, people who have been paid for sex and for people who have had sex in some other areas of the world where HIV and other blood borne infections are more prevalent. Again, this is based on activities that may have put them at risk. However, not all these groups were included in the review and THT would like to see all group deferrals examined in the same way that this recent review has been conducted.

The Blood Service has to look at the balance of probabilities and assess statistical risk. They have a quantity of blood they need to collect and seek to take that blood from people who are at the lowest possible risk of having HIV or other blood-borne infections. They aim to reduce the risk as far as possible for people receiving that blood based on the best evidence available to them. They do not claim to be able to entirely eliminate the risk of HIV infected blood entering their supplies but the exclusions they have put in place aim to significantly decrease that risk.

But HIV isn’t a ‘gay disease’ anymore, is it?

HIV has never been a ‘gay disease’; anyone can contract it.

However, statistically in the UK men who have sex with men remain significantly more at risk of contracting HIV than their heterosexual counterparts and indeed are more at risk of contracting the virus today than at any time since the onset of the epidemic 30 years ago.

Certain behaviours make it more likely that someone will contract HIV in the UK, including anal and (less frequently) oral sex between men. More than one in ten gay men in London (one in seven on the gay scene itself) are now living with HIV, and one in 25 gay men in the rest of the country. These figures make it statistically far more likely that sex between two men will be where one partner has HIV and the other does not than sex between a man and a woman. Additionally, about one in four gay men who have HIV don’t yet know it, because they remain untested.

It is unhelpful to play down the devastating impact that HIV has had on gay communities in the UK and the very great, and disproportionate, HIV vulnerability that gay men still face. We consistently call for investment in initiatives that improve the sexual health of gay men in the UK. While HIV is not a ‘gay disease’ it is a huge issue for gay men.

But aren’t more heterosexual people diagnosed each year with HIV in the UK than gay men?

Health Protection Agency statistics show that there were 6,630 new HIV diagnoses in the UK in 2009. Fifty four percent (3,560) of these new diagnoses were among people who probably acquired HIV through heterosexual sex. However, of all of those heterosexual diagnoses, 68% of them were probably infected outside the UK, where a likely country of infection was reported.

In contrast, around 80% of the MSM who were diagnosed with HIV in 2009 probably acquired HIV within the UK. That means that MSM account for over two thirds of UK acquired HIV infections diagnosed in 2009, and diagnoses amongst MSM continue to remain high. This makes MSM the group at by far the highest risk of new HIV infection in the UK today.

Although there are more heterosexual people living with HIV in the UK, the fact that the vast majority of them probably acquired HIV overseas has important implications for the way donated blood is screened for HIV. The best available evidence currently shows that heterosexual infection is statistically more likely to have taken place outside the UK, and that the majority of these people are not recently infected and are therefore outside the “window period”. This means that their HIV infection will be more likely to show up using the current screening methods available to the National Blood Service.

How is it fair that a gay man with one sexual partner in the last year is deferred, while a heterosexual man can have 300 sexual partners and isn’t?

It’s important to look at how statistical modelling is done. A straight man with 300 sexual partners would be a statistical anomaly (i.e. very unusual). The projections are based on research about what happens across populations and the truth is that men who have sex with men are far more likely to contract HIV during the course of their regular sex life than men who have sex with women.

Anomalies do exist but it is still reasonable to run statistical projections and assessments of risk based on general epidemiological data rather than individual cases when looking at the integrity of the blood supply. It’s these assessments which determine what questions the Blood Service asks of people seeking to make a donation.

But aren’t these statistical models based on assumptions about what men who have sex with men actually do?

Yes, they are. However, not all assumptions are wrong and epidemiologists and statisticians have to make assumptions as they are unable to look at behaviours on an individual level when assessing risk across populations.

Epidemiology and statistical projecting are not exact sciences; however, we believe that the assumptions made in the most recent review were based on the best available research into behaviour and high risk activity at the time.

It is unfortunate that generalisations have to be made and that people have to be categorised and grouped, but we accept that in this instance it is not done in a judgemental or discriminatory fashion, but is necessary in order for sensible decisions about safeguarding the blood supply to be made.

Shouldn’t people be allowed to assess their own risk when they answer questions before giving blood?

In an ideal world they would. However, we know that many people living with HIV did not believe that they were at risk of contracting HIV prior to their diagnosis. People aren’t always good at assessing their own risk.

Around a quarter of MSM with HIV today in the UK don’t yet know they have it. 20% of those in this group who were diagnosed with HIV last year presented so late with the virus that they were already seriously unwell. These people were unaware they had HIV, even though they may have begun to show symptoms, and came forward for testing so late that their long term health may be damaged as a result. They did not always consider that their activities may have put them at risk of contracting HIV, though clearly that was the case.

Even people in long term relationships that they believe to be monogamous can acquire the virus if their partner is not honest with them about the sex they are having outside of that relationship. THT sees a significant number of men who have become infected in this way. It passes no judgement on these men to say that they are at higher risk of unintentionally donating blood containing HIV.

Penetrative sex is never completely risk free and even though using a condom greatly reduces the risk of contracting HIV, accidents do happen and sometimes people remove a condom mid-act without telling their partner. Administering a questionnaire about recent sexual behaviour to every donor, as some have suggested, would not uncover these risks as the person in question may be completely unaware of them.

Can’t they test the blood before passing it on?

There is no available test that completely removes the ‘window period’ where someone has HIV in their blood which won’t show up in tests. It is true that “fourth generation” or RNA testing, which has been the standard test since 2007, can give a quicker result than before, but whether the window period lasts for one week or 12 weeks, it still exists and still presents a risk. However, changes in science and technology are part of what the review has taken into account.
Not all blood products can be heat treated to kill off viruses that they may contain. It is also important to remember that blood is still pooled and one donation is usually shared amongst several recipients. It should also be remembered that the recipients are unlikely to know that they are at risk until after they have potentially infected others.

The Blood Service freely admits that no test is perfect and that mistakes, however rare, can be made in the laboratory. Taking blood from populations who are at low risk of having HIV reduces the number of infected donations that could be missed by testing which is why selection takes place before donations are given. Since 2003, there have been no new HIV diagnoses resulting from UK blood donations (Aidsmap).

What has THT been doing about this?

THT, alongside NAT, GMFA and Stonewall, worked with the National Blood Service and SABTO on the review, which we had called for, and which has been taking place over the past two years. Our Chief Executive sat on the committee examining the evidence along with other community representatives and patients who use the NBS. We have been actively involved in making recommendations for the future, which the Minister has now decided on. We have also been involved in ensuring that research was done into gay men’s understanding of the regulations and their decision-making based on various options, so that social research went alongside the scientific evidence.

THT encourages everyone to abide by the new regulations and calls on all gay men and other men who have sex with men to work with us to reduce the risks of blood-borne viruses within gay sex to a level whereby the regulations can again be changed.

Go back to THT's blood donation policy page.