Homosexual and bisexual men in Germany will be able to donate blood more easily in the future. This Monday, a corresponding renewal of the so-called “Guideline for the collection of blood and blood components and for the use of blood products” of the German Medical Association will come into force. According to a spokesman, whether the new regulation will be applied in practice from September 4 depends on how quickly the blood donation services switch to a new questionnaire.
According to the spokesman, the changes were made in agreement with the Paul Ehrlich Institute and with the participation of the Federal Ministry of Health and the Robert Koch Institute. Among other things, gay associations had rated the previous practice as discriminatory.
What is changing with the new policy?
In order to prevent discrimination, the risk assessment of blood donations will in future be independent of sexual orientation and gender identity. Therefore, those interested in donating are no longer asked about their sexual orientation, but about the number of sexual partners and sexual practice, as Johannes Oldenburg, doctor and member of the scientific advisory board of the German Medical Association, explains.
In the future, heterosexual people will also have to provide specific information about their sexual practice. They also specifically ask about anal sex.
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There are no special exclusion criteria for men who have sex with men (MSM). In addition, there is no provision for deferring trans people who have sex with frequently changing partners. In addition, the previous age limits will no longer apply in the future. In future, people over the age of 60 can also be approved as first-time donors.
Who is not allowed to donate blood in the future?
Anyone who “has exhibited sexual behavior within the last four months that poses a significantly increased risk of transmission of serious infectious diseases that can be transmitted by blood” will be deferred. This includes sex with a total of more than two people and sex with a new person if anal intercourse was practiced. The aim of the risk analysis is to prevent the transmission of an infection to the recipient of a blood donation as far as possible.
Which blood donation rules have applied so far in relation to sexual behavior?
Regardless of sexual practice, it was still considered risky if a man had sex with a new man within the last four months. In the case of sexual intercourse between women and men, on the other hand, only those who had “frequently changing partners” were deferred for four months.
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What is the trigger for the change?
In March, Parliament decided to eliminate “an unacceptable, medically unnecessary discrimination” against homosexual men in blood donations, as Health Minister Karl Lauterbach (SPD) called it. The law provided the German Medical Association with a corresponding amendment to the guideline.
The Transfusion Act stipulates that sexual orientation must not be taken into account when assessing the risk that leads to the exclusion or deferral of blood donations. However, an assessment should remain possible based on the “individual sexual behavior of the person willing to donate”.
Why have other criteria applied to homosexual and bisexual men so far?
According to the Robert Koch Institute, epidemiological data show that sex among men is associated with a particularly high risk of transmission of various infections. About two thirds of the annual new infections with HIV fell on MSM.
According to the RKI, 85 percent of all diseases were also attributed to sex between men in the case of syphilis diseases in which the route of infection is known (as of September 2021). Until 2017, MSM and trans people were not even allowed to donate blood.
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What are the precautions when donating blood?
According to the Federal Center for Health Education, 15,000 blood donations are needed every day for operations, to treat accident victims and to treat serious illnesses. In order to guarantee a safe supply, all blood donations are examined in the laboratory for specific infectious diseases, such as HIV, syphilis and hepatitis B, C and E.
According to transfusion physicians Oldenburg, the donation is also checked for an infection with the West Nile virus. However, the tests cannot provide absolute security, even if they are extremely sensitive. Very new infections in particular can only be detected in the blood after a certain period of time. Therefore, before making a donation, those interested in donating must fill out an extensive questionnaire about their health and have a doctor’s consultation.
Are blood products still safe with the new regulation?
“Nothing will change in terms of the safety of the blood products,” assured Oldenburg. This was also shown by field reports from other countries, which had already adjusted their catalog of questions accordingly. Even if in future there will no longer be explicit questions about sexual orientation, possible risks would be recorded just as well.
Potential recipients of blood donations also need not worry about the abolition of the age limit. “The quality of the blood is not affected by age.” The previous regulation was set up to protect donors because some older people had circulatory problems or high blood pressure.
What do those affected say about this?
The German Aidshilfe described the change in the law by the traffic light coalition in March as “great progress”. The extent to which discrimination will really be avoided in the future can only be assessed when the guideline is published on September 4th, spokesman Holger Wicht said on request. “It’s about avoiding discrimination while ensuring safety,” Wicht said.
The association had repeatedly described the previous regulation as discriminatory because it excluded gay men too generally and without sufficient justification.
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