| Definitions | Individual risk is based on the donor’s sexual behaviour, including new partners and number of partners.
Partner risk is based on sexual contact with a partner who may, at a population level, be at higher risk of acquiring infection, as described in this entry.
Sexual contact is defined as oral, vaginal or anal sex.
Anal sex is defined as penile-anal intercourse only. It does not apply to oro-anal sex or the use of sex toys.
Chemsex is sex while using stimulant drugs taken for the specific purpose of enhancing sexual experience and reducing inhibitions. Chemsex does not refer to sex after using alcohol or recreational drugs for other purposes, nor the use of drugs such as Viagra or Cialis to treat erectile dysfunction. |
| Obligatory | Information must be provided so that individuals at risk do not donate. The reasons for donor self-exclusion must be understood.
1. You must not donate if:
You think you need a test for HIV/AIDS, HTLV or hepatitis.
2. You must never donate if:
a) You are HIV positive or receiving treatment for HIV.
b) You are HTLV positive.
c) You are a hepatitis B carrier.
d) You are a hepatitis C carrier.
e) You have ever been diagnosed with syphilis, even if treated.
f) You have ever injected or been injected with drugs; even a long time ago or only once. This includes bodybuilding drugs, injected tanning agents and injected chemsex drugs. You may be able to give if a doctor prescribed the drugs. Please ask.
3. You must not donate for at least three months if:
You are working as a sex worker. You may be accepted for donation if it is longer than three months since you last received money or drugs for anal, vaginal or oral sex.
4. Individual risk criteria
a) You must not donate for at least three months if you have taken part in chemsex activity, including the use of stimulant drugs. This risk applies for all sexual contact.
b) You must not donate if you have been diagnosed with gonorrhoea, until at least three months after completion of treatment and discharge from further follow up.
c) You must not donate if in the last three months,
- you have had more than one sexual partner, AND
- you have had anal sex with any of your partners.
d) You must not donate if in the last three months, you have had anal sex with a new sexual partner. For the purpose of donor selection, a new partner is someone that you have not had sex with before or a previous partner with whom you have restarted a sexual relationship.
If you are in a sexual relationship with one partner only, you can donate once it is three months from the date of first sexual contact, even if you are having anal sex.
5. Partner risk criteria
You must not donate for at least three months after sexual contact with a partner who is, or you think may be:
a) HIV or HTLV positive.
b) A hepatitis B carrier.
c) A hepatitis C carrier.
d) A partner who has ever received money or drugs for sex.
e) A partner who has ever injected, or been injected with, drugs: even a long time ago or only once. This includes bodybuilding drugs, injected tanning agents and injected chemsex drugs. You may be able to give if a doctor prescribed the drugs. Please ask.
6. You must not donate for at least three months if:
a) You have taken Pre-Exposure Prophlyaxis (PrEP) / Truvada® by mouth to prevent HIV.
b) You have taken or been prescribed Post-Exposure Prophylaxis (PEP) to prevent HIV.
If the underlying reason for taking PrEP or PEP warrants a longer deferral period, this should be applied.
7. You must not donate for at least two years if:
You have received PrEP as an injection to prevent HIV e.g. cabotegravir (Apretude®).
If the underlying reason for taking PrEP or PEP warrants a longer deferral period, this should be applied.
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| Additional Information | The FAIR (For the Assessment of Individualised Risk) study considered changes to the donor selection policy to allow a more individualised risk-based approach to donor selection policy. In their 2020 report, the FAIR group specifically looked at the guidelines which applied to men who have sex with men (MSM) and recommended an approach based on assessment of a donor’s recent sexual behaviour and experience. This approach has been agreed by SaBTO and has now been implemented by the UK Transfusion Services.
Changes to donor selection criteria mean that donors who were previously excluded because of their sexuality and/or gender can now be accepted, if they meet the individual risk criteria outlined in FAIR (see section 5, above). These rules must be applied equally to all donors.
FAIR identified several factors associated with a higher risk of blood borne infections. These include the recent diagnosis of a bacterial sexually transmitted disease and the following sexual behaviours:
- new or multiple sexual partners
- anal sex
- participation in chemsex activity
Drugs used for chemsex include methamphetamine, mephedrone and GHB/GBL, but other drugs may be used (e.g. ketamine, poppers, cocaine). Chemsex is a high risk activity because it usually involves multiple sexual partners, sometimes for extended periods of time. The drugs involved also reduce inhibition leading to riskier sexual activity.
Infection with some sexually transmitted diseases, particularly gonorrhoea or syphilis, is associated with a higher risk of acquiring blood borne infections. Donors who have had gonorrhoea can give three months after completing treatment. Donors who have had syphilis are permanently deferred as their blood will still react in screening tests, even if they have been successfully treated.
Some partner risk criteria still apply to donors who have a partner in a population group at higher risk of infection. For affected donors, these risk criteria should be applied even if the donor is eligible under individual risk criteria. These risks are being reviewed and will be updated as further evidence is available.
The drugs used in both Pre- and Post-Exposure Prophylaxis for HIV (PrEP and PEP) may interfere with the routine HIV screening tests carried out on all blood donations. For this reason, donors who have taken oral PrEP or PEP in the previous three months, or received injectable PrEP in the previous two years, should not donate. This applies even if they are otherwise eligible under individual risk criteria.
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