“The mere fact that a man has or has had sexual relations with another man does not constitute ‘sexual conduct’, within the meaning of the directive, which justifies his permanent exclusion from donating blood”, concluded in 2014 the general counsel of the Court of Justice of the European Union Despite this ruling, seven years later, countries of the European Union such as Greece and Croatia do not allow men who have sex with men (MSM) to donate blood.

This ban on donating blood to MSM finds its origin in 1977 with the appearance of HIV (human immunodeficiency virus) that causes AIDS or acquired immunodeficiency syndrome, as people are considered to be at greater risk of carrying and transmitting the virus. But tests performed on donated blood have been able to detect the virus since 1985. With current tests that identify the HIV genome, the window period from when a person may have been exposed to HIV to when these tests can determine with certainty if you contracted the virus it is less than a week, although the window period varies from person to person and depends on the type of test used.

That is, there is a time after the onset of an infection during which donated blood could contain the virus and not be detected by tests, but the risk of receiving HIV-infected blood without it being detected by tests is one in two million. To prevent the virus from escaping the test, some countries set a specific temporary ban on MSM after their last sexual relationship with a man, even if they have a monogamous relationship and/or have had sex with a barrier that prevents HIV transmission, which does not apply to people who have heterosexual relationships even without having taken measures to prevent the transmission of the virus.

In addition, in Spain all the blood that is donated must be analyzed, not only to detect HIV but also other infectious agents such as syphilis, hepatitis B and hepatitis C. In fact, most countries have legislation for the safety and quality of blood transfusions. 99.8% of donated blood in high-income countries and 99.9% in upper-middle-income countries is tested for HIV, hepatitis B and C viruses, and hepatitis syphilis. according to the basic quality procedures, according to the World Health Organization (WHO).

Maldita.es has analyzed the current situation in the world and at least 33 countries limit or prohibit blood donation to MSM regardless of whether they have risky sexual practices or not.

There are countries that prohibit gay and bisexual men from donating blood. Some do it for life, like Turkey and Malaysia; others after a period since they had the last homosexual relationship even if it was safe sex, like France, where it is 4 months. Many of these bans also apply to women who have relationships with men who have had sex with another man, as is the case, for example, in Ireland, Estonia and Finland. In Lebanon and Trinidad and Tobago, men who have ever had sex with men cannot donate and women who have had sex with an MSM have a 12-month temporary ban. 

In Australia, where the ban was initially reduced from 5 years to 12 months after the last male homosexual intercourse, a scientific study found no increase in HIV transmission by donating blood. Nor was an increased incidence of HIV found among first-time blood donors in the United States after moving from a ban to a one-year ban on no sex between men in 2015. The same was true for the incidence of hepatitis B and C viruses.

In recent years many countries have eliminated or reduced this prohibition based on group membership and sexual orientation and not on an individual risk assessment as requested by institutions such as the American Red Cross and the Human Rights Campaign (HRC for its acronym in English). Sometimes, the end of discrimination against men who have sex with men comes from the constitutional courts and not from parliaments or governments, as occurred in Colombia and Georgia. In Greece, any man who has had a homosexual relationship since 1977 cannot be a blood donor, although in October 2021 the Minister of Health requested a review of that policy.

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