No more discrimination at the blood bank

No more discrimination at the blood bank

Societal impact of research

06-09-2023 · Interview

In today’s world, the societal impact of research findings seems more important than getting published in an academic journal like Nature or The Lancet. So, what impact has research conducted at UM had in recent years? This week: how a UM study put an end to discrimination against the gay community in blood donation.

In the early 1980s, blood banks like Sanquin in the Netherlands sounded the alarm. They noticed a new virus among patients with haemophilia, one that appeared to be circulating primarily among gay men. When HIV and AIDS were identified, men who have sex with men were banned from donating blood.

The Netherlands lifted this ban in 2015. Since then, gay and bisexual men have been allowed to donate blood under certain rules. They still have to answer a set of screening questions about their sexual activity. When was the last time you had anal sex? Was it within the last four months? If so, you’re not allowed to donate blood.

This might seem like a good thing, says Professor of Applied Social Psychology Kai Jonas, but the gay community doesn’t experience it that way. “Gay men are essentially asked to bare it all – to disclose what they do in bed, who they do it with, and how long they’ve been doing it. Straight people don’t have to do that, even though they are able to contract AIDS just as any gay person is.” It’s unacceptable, say LGBTI+ rights groups like COC Netherlands.

Blood supply

Jonas set out to remedy the situation. First, he interviewed men who have sex with men to find out how they would prefer for blood bank staff to communicate with them, how to have a respectful conversation about sexual activity, and their preferred language use. “Things go wrong right away if blood bank staff start off by referring to homosexuality as a ‘condition’. It’s offensive. And yes, it still happens.” Based on these interviews, Sanquin revised the language used in screening questions.

Next, Jonas conducted focus groups with gay men, Sanquin staff, and LGBT+ rights groups to determine the attitudes and preferences of all parties involved. His goal was to propose a new, non-discriminatory approach. Interestingly, there was quite a bit of resistance among Sanquin staff. “The organisation already knew that things had to change, but some employees – nurses and doctors – struggle with it. They were trained to maintain the safety of the blood supply and identify potential risks among gay donors. They will have to adopt a new way of working. It isn’t easy for some.”

Dominant

Jonas concluded that the new, preferred approach aligns with the British model of donor risk assessment. “Staff no longer ask donors about their sexual orientation, but only about high-risk behaviour. And they don’t just ask potentially high-risk donors, but all donors. In other words, a straight, over-65 woman from a rural town – let’s call her Frederieke from Meppel – would also be asked when she last had anal sex. One might wonder if this will deter older adults from donating blood.”

Asking straight people about high-risk behaviour arguably makes more sense in the UK than in the Netherlands. “In the UK, straight people – especially those with a migration background – are at higher risk of HIV infection.”

Is the British model the best fit for the Netherlands, then? Yes and no, says the UM researcher. “Yes, as it looks like this model is becoming internationally dominant. All countries, including the Netherlands, may eventually use the same risk assessment approach, which will make exchanging blood even easier.”

But Jonas also has some reservations about the approach. “The odds of Frederieke from Meppel having recently had anal sex with a new partner are quite low. Our recommendation was not to be too direct, but to build up to the potentially more intimidating questions. That’s what Sanquin is going to do.”

Iceland

In any case, Jonas’s research – partly funded but not commissioned by Sanquin – will put an end to discrimination in blood donation in the Netherlands. As of January 2024, gay and straight donors will be treated equally by the Dutch blood bank. Germany also introduced blood equality just this week.

Jonas has held Sanquin in high regard ever since his study, he says. In some countries, including Austria, equal treatment for donors was hotly debated. In Iceland, men who have sex with men are not allowed to donate blood at all.

Photo: Ellen Oosterhof

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