Proposal to change the deferral policy for MSM donors
The Blood Service is proposing to relax the deferral rule for men who have sex with men (MSM) so that a history of male-to-male sexual activity would no longer automatically disqualify a prospective blood donor. An official regulation to change the policy is being drafted at the moment.
Under the current rules, MSM donors must abstain from sex for a period of four months before being allowed to donate blood. The Blood Service is proposing to change this so that only sex with a new partner or several partners would trigger a deferral period. This would bring the deferral policy for MSM donors in line with that for heterosexual and women-who-have-sex-with-women (WSW) donors. MSM donors in monogamous relationships would be able to donate blood on the same terms as other male donors.
Finland’s rules for donor deferrals based on sexual activity were most recently relaxed in 2014 and in 2021. Revisiting the policy at regular intervals is prudent, as blood donor criteria are a sensitive topic and the rules are constantly evolving elsewhere in Europe as well.
The Blood Service believes that the risk to the safety of blood products from donors’ sexual activity can be controlled even if the criteria were changed. Lessons learned from other countries, scientific publications and extensive studies conducted in large European countries all support the rule change. Further backing for the new criteria comes from the Blood Service’s sensitive infection screening tests, statistics on donors’ infection rates, residual risk calculations and Finland’s existing deferral policy for donors with a new sexual partner.
The rule that male-to-male sexual activity automatically triggers a deferral period is widely considered unfair and even discriminatory. However, the policy has always been based on medical risk assessment and statistics on infectious diseases. Underlying the rule is the simple fact that the incidence of new HIV infections is considerably higher among men who have sex with men than among the rest of the population. Although all donated blood is carefully screened, laboratory tests cannot detect a recent infection. This is why extremely strict blood donor criteria have been in place globally, including in Finland.
Finland’s donor criteria are based on the Finnish Medicines Agency’s regulation, which sets out deferral periods for donors who have engaged in ‘high-risk behaviours’, including male-to-male sexual activity and paying for sex. Almost all European countries imposed a blanket ban preventing people who had paid for sex and men who had had sex with other men from donating blood in the 1990s, but most have switched from a lifetime ban to an activity-based fixed-term deferral in the last decade.
A recent risk assessment carried out by the Blood Service indicates that a new policy can be adopted in Finland without compromising safety, whereby a four-month deferral period would only be triggered by a new sexual partner or several partners, and whereby male-to-male sexual activity in itself would no longer be an obstacle to donating blood.
The Finnish Medicines Agency issued a consultation document detailing the proposal on 5.5.2023.