Scientists welcome new blood donation policy

Population health researchers are excited to have helped inform a policy change by the New Zealand Blood Service (NZBS).

From 4 May, every blood donor will be asked the same questions about their sexual history, whereas previously, men who have sex with men were excluded (deferred) if they had oral or anal intercourse in the previous three months.

“This is a much fairer system, because no longer will men be singled-out and asked sexuality-based questions about whether they’ve had sex with another man,” says researcher Tony Sriamporn in the School of Population Health at Waipapa Taumata Rau, University of Auckland.

This blanket ban meant men with low or no risk of HIV, such as men in monogamous same-sex relationships, were not allowed to donate.

In 2022, the Sex and Prevention of Transmission Study (SPOTS) recruited 3,253 gay and bisexual men, collected blood samples, and asked them about their HIV prevention behaviours and experience with blood donation.

SPOTS data showed that four out of five gay and bisexual men in New Zealand wanted to donate blood if the rules were changed and they were allowed to donate.

Importantly, the study found no participants with confirmed undiagnosed HIV.

“We knew the New Zealand Blood Service wanted to modernise but lacked New Zealand evidence to strengthen their case. Therefore, we are delighted that SPOTS participants have helped improve New Zealand’s blood donor policy,” says Sriamporn.

The University’s SPOTS study found a policy like the one just announced could triple the number of eligible gay and bisexual men donors from 13 percent to 41 percent or around 5,200 to 16,400 men.

“It’s a win for everyone as we always need more donors,” Sraimporn says. “We saw how recent events like Cyclone Vainau can disrupt collection services and quickly leave us short of blood."

New Zealand Blood Service chief medical officer Dr Sarah Morley says the organisation has long been committed to moving towards a behaviour-based approach when screening potential blood and plasma donors.

“The findings from the SPOTS research provided valuable New Zealand-specific evidence that strengthened the growing international evidence base,” Morley says.

“Together, this enabled our clinical team to complete a detailed review and risk assessment, confirming that introducing behaviour-based screening would not compromise the safety and quality of the blood we supply to patients.

“We’re looking forward to implementing these changes and to adopting a fairer, more consistent approach to assessing donor eligibility.”

Liz Gibbs, chief executive of The Burnett Foundation, also welcomes the move.
“We welcome this as an important step forward towards more equitable, behaviour-based donor screening,” Gibbs says.

“It reflects years of advocacy and the growing recognition that policy must evolve alongside science and community understanding.”

Associate Professor Peter Saxton from the University of Auckland’s School of Population Health says, “Sriamporn’s internationally recognised and published doctoral research offers insights into how an entire population could be introduced into the blood donor pool.

“It’s not every day that an entire population become eligible to donate blood. However, care must be taken in the next few steps to convert those good intentions into presenting for blood donation,” Saxton says.

“While many participants spoke about altruism, doing their civic duty, helping others, a significant minority felt alienated by the previous policy, and weren’t sure whether they would donate,” Saxton says.

“The challenge will be for the blood service rebuild relationships with the gay community, because this will ensure more eligible gay and bisexual men come forward.”

“This is wonderful news for the Rainbow community,” says Sriamporn, but noted that some members will remain frustrated.

“Future research could explore whether people taking pre-exposure prophylaxis (PrEP), preventive HIV medication, could safely donate plasma in NZ,” says Sriamporn.

Australia has introduced a ‘plasma pathway’, which has enabled a wider group of donors to donate plasma, including people who use PrEP.

“We’ll also be closely watching the recent rollout in Australia for how its ‘Plasma Pathway’, which does just that, performs in practice.” Find out more.

Nonetheless, the team supports cautious and safe introduction of a fairer and consistent behaviour-based sexual activity screening approach for all donors.

The Sex and Prevention of Transmission Study (SPOTS) has been led by Waipapa Taumata Rau, University of Auckland in partnership with the University of Otago and community organisations Burnett Foundation Aotearoa, Body Positive Inc, Te Whāriki Takapou and the NZ Blood Service.

The SPOTS study was funded by the Health Research Council of NZ and the Ministry of Health.