On April 28th, 2022, Canadian Blood Services announced the end of the blood ban for men who have sex with men. This announcement comes after years of work by advocates and while it may be considered a step forward, the new measures presented still perpetuate stigma.
“Canadian Blood Services will introduce new criteria no later than Sept. 30, 2022 that will ask all donors, regardless of gender or sexual orientation, if they’ve had new and/or multiple sexual partners in the last three months. If they answer yes to either, they would be asked if they’ve had anal sex with any of these partners. If they have, they will be required to wait three months from when they last had anal sex to donate. If they have not and meet all other eligibility criteria, they will be able to donate. ”https://www.blood.ca/en/blood/am-i-eligible-donate-blood/men-who-have-sex-men#:~:text=Canadian%20Blood%20Services%20will%20introduce,in%20the%20last%20three%20months.
Essentially, the new measures will stop discriminating solely based on sexual orientation, but will continue to stigmatise what Canadian Blood Services (CBS) have identified as “higher-risk behaviour”, regardless of safer sex pratices. This means that they will continue stigmatising gbMSM communities as well as restricting other populations who practice anal sex.
The new measures perpetuate continued stigma against key populations, particularly as the restriction requires individuals to wait four months after taking PrEP or PEP or three months after having anal intercourse with new or multiple sexual partners; this is also contradictory to public health messaging which promotes the use of PrEP and PEP. Safer sex practices are, on the one hand, promoted and valued, while on the other hand, anal sex is still being stigmatised as high risk and unsafe regardless of practices. This also stigmatizes non-monogamous people regardless of safer sex practices.
The risk assessment practice being promoted is counterintuitive and the screening questionnaires only highlight anal intercourse as being problematic, further adding to stigma and barriers for certain marginalised groups. Data trends have indicated a faster growing proportion of HIV infections who are not from the gbMSM community, concluding that this increase is not through anal intercourse.
Finally, this is a failure to explicitly apologise for the decades of discrimination and stigmatisation of gbMSM populations. The head of CBS only referred to repairing and building trust but offers no concrete strategies:
“While this eligibility change represents a significant step on our continual journey to build a more diverse, equitable and inclusive national transfusion and transplantation system, we still have considerable work to do to build trust and repair relationships with 2SLGBTQIA+ communities,” says Dr. Sher.https://www.blood.ca/en/about-us/media/newsroom/canadian-blood-services-remove-eligibility-criteria-specific-men-who-have
This draws on the history of systemic discrimination and racism against specific groups and how this will indirectly continue through this updated policy.
This is a step forward, but there is still work to be done to truly end stigma.