Rodney Croome | Time to change outdated blood donation rules

From this week, people with new tattoos can donate a week after being inked, not four months as was the case.

But gay men, and bisexual men and transgender women who have sex with men, must still be sexually abstinent for three months before we can donate.

The traditional rationale for this abstinence period is that men who have sex with men (MSM) are more likely to be newly infected with HIV.

There can be a window period between when someone is infected and when they begin producing anti-bodies that can be detected in blood tests.

The three-month abstinence period is meant to screen out MSM who are in this window period.

But research from around the world now conclusively shows that, as rates of new HIV infection among gay men decline, the chance of a gay man donating within this window period is so low as to be statistically meaningless.

This is why a growing number of countries are dropping their gay blood bans and adopting a new screening system that asks all donors, gay and straight, cis and trans, about individual sexual risk.

These countries include the UK, the US, the Netherlands, Canada, Germany, France, Israel, Greece, Italy, Spain, Argentina, Poland, Hungary ... the list grows longer every day.

In the UK, US, Canada and a number of other countries, all donors are asked if they have had anal sex with new or multiple partners in the last three months. If they say "yes" they're deferred for three months, and if "no" they can donate.

The reason for the rapid adoption of individual risk assessment is that it is the most rational approach: it focuses on the activity that actually causes risk, it screens out at-risk heterosexuals as well as at-risk gay men, it doesn't compromise safety, it treats all donors equally, it opens up a new source of safe blood for those in need.

Estimates by the Let Us Give campaign suggest the amount of safe, new blood that will flow from lifting the gay ban and adopting individual risk assessment will be substantial.

About 4.5 per cent of the population are men who have sex with men according to census data from the UK and Canada, which we would expect to be mirrored in Australia.

If Australian MSM donate as at the same rate as other Australians (3.5 per cent) there would be over 54,000 new donations if the gay blood ban was lifted.

That far outstrips the 10,000 extra donations Lifeblood says will come from lifting tattoo restrictions.

The benefits of greater equity in blood donation will also be substantial.

No longer will gay men have to dip out of workplace blood drives, feel guilty we're not pulling our weight during emergencies requiring extra blood, be told we can't help a close relative who needs our rare blood type, or feel like we are some kind of threat to public health.

However, Lifeblood isn't convinced.

It says individual risk assessment could reduce the blood supply by screening out those heterosexuals having risky anal sex.

A Canadian Blood Service survey of all its collection centres found only 0.7 per cent of existing heterosexual donors would be deferred from giving blood under an individual assessment regime, a figure compensated for by new gay donors.

It's hard to imagine the sexual habits of heterosexual Australians would be substantially different to those of their Canadian counterparts.

But, instead of heeding this research and following countries such as Canada, Lifeblood has opted for the "plasma pathway"; allowing gay men to give blood plasma, but not whole blood.

This will benefit the plasma supply and it will allow MSM on HIV prophylaxis drugs like PrEP to donate.

But only allowing gay plasma donation raises more problems than it solves.

Obviously, it doesn't solve the problem of regular shortages of whole blood.

It also doesn't solve the problem of inequity in blood donation.

A longitudinal Canadian study found that many gay and bisexual men felt a plasma-only policy would ultimately make them "second-class donors" by creating a two-tier system.

Instead of removing discrimination, plasma-only donation simply served to highlight it. As one participant in the study explained it would result in an us-versus-them system.

In short, plasma-only donation is to blood donation what civil unions were to marriage equality, a poor and unsustainable substitute.

This was one of the reasons Canada and Israel both abandoned their trials of plasma-only donation for gay men and moved on to whole blood donation.

In Australia, the plasma-only option has been approved by the Therapeutic Goods Administration and now goes to the nation's health ministers and the private, blood product business, CSL, for approval.

Let Us Give is lobbying health ministers, asking them to press Lifeblood on why it doesn't want to tap a new source of whole blood by allowing safe gay men to donate.

We are also asking why a private company has a role in making public health decisions.

We are realistic that the plasma-only option is likely to pass, but this will not stop our campaign for equity in blood donation.

We firmly believe Australia can have a blood supply that is both safe for blood recipients and fair for blood donors.

We will not rest until gay and bisexual men, and trans women, are allowed to donate whole blood to our fellow Australians in need.