Upliftment by SANBS of MSM policy, just what the doctor ordered.

2014-05-28 20:39

“Thus, the law is a reflection of each of our individual values, writ onto the larger canvas that we, for convenience if not literal correctness, call society.  We are the law in a very real sense.  We are part of its creation and it reflects who we are.” - Ivan Hoffman[1]

The concept of blood “donor deferral” is a simple one, and is defined as, “The non acceptance of a potential donor based on lifestyle criteria or prior exposures to pathogens”.[2]

The adoption of blood donor deferral policy arose from the need to prevent the transmission of HIV/AIDS, and other diseases, through blood transfusion at a time when medical and technological advancement could not adequately detect HIV/AIDS and other transfusion transmissible infections adequately in a blood donor.

In essence blood donor deferral policy is applicable to groups of individuals, identifiable by a higher risk of HIV, and other transfusion transmissible infections. This included inter alia, users of intravenous drugs and men who have had sex with other the men (MSM).

The historical adoption of MSM blood donor deferral policy in countries across the world, resulted in the interplay between two conflicting factors viz. the need to ensure safety of the general population from transfusion transmissible infections on the one hand, and the stigma associated with the marginalization of a sector of society where a higher risk of infection existed, on the basis of sexual orientation, on the other.

The South African National Blood Service introduced the MSM blood donor deferral policy in 2006, which was met with twofold criticism. Firstly, the policy was viewed as discriminatory against the MSM community in that it sidelined a sector of society on the basis of sexual orientation. Secondly, the policy was criticized on the basis of non applicability within the South African context, where the rate of HIV/AIDS is higher amongst the heterosexual community in comparison to their homosexual counterparts.

In terms of the above policy, gay men were precluded from donating blood, unless they had been celibate for a period of six months or longer.

According to SANBS, “It was not a ban per se, but it was the criteria, which has now been changed.”

Due to certain medical and technological advancements in the detection of HIV/AIDS and other transfusion transmissible infections, in recent years, a global policy shift in respect of blood donor deferral policy has occurred.

In terms of the new policy, adopted by SANBS earlier this month, partners in monogamous relationships (both heterosexual and homosexual) exceeding a period of six months may donate blood. However, individuals with new sexual partners or multiple sexual partners (both heterosexual and homosexual), are disqualified from donating blood for a period of six months.

This new policy based on the sexual activity of an individual, and the number of sexual partners an individual may have, in comparison to policy based on sexual orientation is far more logical than its predecessor.

Whilst previous policy was aimed preventing the transmission of HIV/AIDS and other transfusion transmissible infections, it was impractical in the South African context where HIV/AIDS is higher amongst the heterosexual population, and served no purpose aside from perpetuation of the stereotype that the MSM community is at a higher risk of HIV or in fact diseased.

Whilst medical and technological advancement in relation to the detection of HIV/AIDS and other transfusion transmissible infections in blood donors may warrant a change in policy, it is undoubtedly a raised political and social awareness of LGBTI equality which has precipitated the aforementioned advancements into substantial policy change and the creation of equitable social outcomes.

In all likelihood, the blood donor deferral policy introduced by SANBS would not have withstood constitutional challenge.

The amendment of MSM policy by SANBS is welcomed, and is not only reflective of medical and technological advancement in the detection of HIV/AIDS, but is symbolic of a raised social and political consciousness and a shift in the societal attitude toward the MSM community in particular, and the LGBTI cause in general.

[1] http://www.ivanhoffman.com/thelaw.html

[2] <a href="http://medical-dictionary.thefreedictionary.com/donor+deferral">donor deferral</a>

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