Since 1983, the U.S. FDA has issued exclusionary regulations for blood donations from men who have had sex with other men (MSM). In April 2020, FDA guidance reduced the 12-month deferral period for MSM to 3 months. The U.S. House of Representatives recently submitted a resolution expressing concern that the deferral time is discriminatory against MSM and should be based solely on an individual basis. Concurrently, a new study from Canada suggests that the transfusion community must remain vigilant as pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) become more prevalent to prevent new HIV infections. While the use of PrEP and PEP antiretroviral therapies are a welcome addition to fight HIV, they may increase the window period and interfere with HIV screening. Saeed et al. retrospectively evaluated over 1.1 million donations and identified a total of 89 potential donors who self-reported PrEP/PEP use in the past 4 months—nearly all of these donors (96%) were deferred. Had potential donors not been directly asked about PrEP/PEP use, at least half would not have been deferred for another reason. While donor health questionnaires in Canada, the U.S., Australia, and the United Kingdom have specific questions about PrEP/PEP use, many other countries are not as specific. As regulations continue to evolve, it will be important to continue to monitor the safety of the blood supply.
References:
- Saeed S, Goldman M, Uzicanin S, O’Brien SF. Evaluation of a pre-exposure prophylaxis (PrEP)/post-exposure prophylaxis (PEP) deferral policy among blood donors. Transfusion 2021
- Schiff, et al. Resolution submitted in The House of Representatives. Expressing the sense of the House of Representatives that blood donation policies in the United States should be equitable and based on science.
