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Is Lifeblood's plasma pathway best way forward for LGBTQ+ donors?

The Australian Red Cross Lifeblood service is working towards removing barriers for gay men, bisexual men, and some trans folks and non-binary people who have sex with men to donate plasma in Australia.

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The proposed changes would remove questions about sexual activity from plasma donor assessments, though it would retain the three-month abstinence period for gay and bi men and many transgender people for whole blood donation.

Equality campaign Let Us Give questioned the move, urging instead for a move towards individual risk assessments to allow more LGBTQ+ people to give whole blood.

“Countries like Israel, Canada and France trialled plasma donation for gay men, but then quickly abandoned that approach in favour of whole blood donation,” Let Us Give spokesperson Dr Sharon Dane said earlier this week.

“In the Israeli, Canadian and French trials, plasma from gay donors was quarantined and frozen for three to four months so the donor could return and be tested for HIV. For a variety of reasons, many donors could not return in that timeframe and their plasma had to be dumped.”

Responding to the media statement from Let Us Give and Dr Dane, a spokesperson for Lifeblood told OUTinPerth these pathways are not being proposed by their organisation.

“We would not require the donor to return within a specific timeframe for re-testing. Those countries only collect very small volumes of plasma, which impacts their decisions,” the spokesperson said.

“In Australia more than half of the donations needed by Australian patients are plasma. The need for plasma – the lifesaving “golden” part of blood – is at a record high and the need is expected to keep growing. There are a growing number of patients relying on plasma donations for the treatment of cancer, immune disorders, haemophilia, trauma, and kidney disease, and plasma is now the most needed type of blood donation in Australia.”

“Plasma donations undergo further processing that reduces the risk of an infection being passed to a patient. These additional processing steps include, for example, viral filters as precision sieves to remove viruses and other methods to inactivate or kill viruses.”

“This additional processing technology is currently not able to be performed on red cells. Lifeblood is committed to looking at options for other changes for blood donations in the future as evidence becomes available. It’s important to say that for any changes, we must maintain the present very high safety threshold of Australia’s blood supply.”

Lifeblood argue the proposed plasma pathway potentially provides the most donors, as opposed to individual risk assessments.

“The plasma pathway potentially means that anyone impacted by this rule would be able to donate. Individual assessment still restrict people from donating blood, including people across the whole population (many who are currently eligible to donate) who have anal sex with a new sexual partner and those who have multiple sexual partners,” the spokesperson continued.

“Donors on PrEP are also still unable to donate. The main risk within the heterosexual community for newly acquired HIV is sexual activity with someone from a country with high rates of HIV, and we use this question to screen out those new cases.”

Lifeblood also responded to concerns raised by Let Us Give over The Australian Red Cross’ callouts for blood donation. While Let Us Give hope more access to blood donation would help alleviate Australia’s low blood supplies, Lifeblood say they do not change the rules in response to requests for donation.

“Only 3 per cent of the population donate, and there are more than 9 million Australians eligible who are able to respond. Any changes to blood rules take time, because they impact the lives of vulnerable patients in hospitals. They are part of ongoing work to ensure as many people as possible have the opportunity to donate,” the spokesperson said.

“One of the strategies employed to address shortages is to ask donors to give the type of donation that is most needed on the day, whether this be a blood donation or plasma. The plasma initiative will allow us to grow our overall donor panel and by doing so helps us to meet the demand for both plasma and blood donations.”

Let Us Give continue push for safe whole blood donation

Speaking to OUTinPerth, Let Us Give’s Dr Sharon Dane clarifies that the advocacy campaign believes allowing plasma donation for gay and bi men, trans women and non-binary people is a step forward, but there’s more work to be done.

“Unfortunately, it doesn’t address the current shortage of whole blood, which would be alleviated by allowing all donors to be assessed for their individual risk regardless of the gender of their sexual partner,” Dr Dane said.

Conservative estimates of how many Australian gay men would give blood if the current ban was lifted show there would be an extra 25,500 litres of safe blood available each year to help Australians in need. Lifeblood should be reviewing the current ban based on this figure alone.”

Dr Dane also argues that removing the current bans on some LGBTQ+ folks in favour of individual risk assessment only ensures safe blood donations from all Australians.

”The other reason for removing the current bans and adopting individual risk assessment is there continues to be new infections among heterosexual people,” Dr Dane said.

The latest figures from the Australia Federation of AIDS Organisations and The Kirby Institute show 24% of new HIV cases in 2020 were attributed to heterosexual sex, while new HIV diagnoses among gay and bisexual men has fallen by 44% over the last five years.

“To ensure the blood supply is as safe as possible, the Red Cross Lifeblood Service should to be willing to ask all donors about their sexual risk, not just men who have sex with men.”

“We are also interested to know what questions Lifeblood intends to ask gay plasma donors in order to better respond to its proposed new policy”.

“If Lifeblood’s fear is about asking all donors about their sexual risk it has a duty to explain what research there is to substantiate this fear.”

Leigh Andrew Hill


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