Paul's Internet Landfill/ 2019/ Blood Questionnaire and PrEP

Blood Questionnaire and PrEP

I gave blood again this afternoon, and I notice two changes to the questionnaire:

Looking at the CBS website, it looks like these changes took effect on June 3.

Also of note is that Togo and Cameroon are no longer permanent deferrals and that CBS is starting to acknowledge the existence of trans individuals. (I will note, however, that their computer registration system still classifies people as male or female. Sorry, nonbinaries.)

Overall I feel these changes are for the better, although in my darker moments I continue to question the motives of Canadian Blood Services in eliminating the prohibitions for gay men.

The new question about PrEP is particularly interesting. It appears to be an attempt to move eligibility restrictions away from identity (men who have sex with men) to behaviour (men who take PrEP because they are at higher risk for engaging in unsafer sex practices). But as usual this punishment has a perverse incentive, because a promiscuous gay man who is on PrEP is likely less of a risk than a man who is promiscuous but is not on PrEP. Currently the difference between these deferral periods is only a month, but as time goes on I expect Canadian Blood Services will try to eliminate the prohibition on men who have sex with men entirely. That could cause problems.

In addition, PrEP is not just for gay men. Promiscuous straight people might also take PrEP, and would be deferred in the same way. However, I am still uncomfortable with the idea that those who guard their health more closely (by getting regular AIDS screenings and/or by taking PrEP) are punished by the eligibility questionnaire over those who act irresponsibly.

The strange thing about the PrEP deferral is that it is only four months. That is shorter than the old deferral for any men who had sex with men, which was six months (down from a year, which was down from three years, which was down from a lifetime deferral). If CBS really considers PrEP a high-risk activity, shouldn't the deferral be longer?

Certainly CBS must be reeling from the menstruation-related changes they decided (or were forced to) implement. Men can donate every 56 days (8 weeks), but recently the deferral period for women was increased; they can now donate only every 84 days (12 weeks). That means married straight couples can no longer donate together. It also means women have a much more difficult time qualifying for the pins and swag that frequent blood donors receive. Overall this change sucks, and I feel it should be revisited. For example, why should this change affect menopausal women? What about women who eat lots of meat and have sufficient iron stores despite menstruating? It is weird that CBS is paying so much attention to gay men when there are a whole lot more women around who are prohibited from donating blood as frequently as they otherwise might.