Blood donor selection policy: More people now able to give blood

Following the FAIR (For the Assessment of Individualised Risk) steering group’s recommendations and in line with the latest scientific evidence, blood donation has become more inclusive. More people could be eligible to donate blood based on their health, travel and sexual behaviour.

New guidance means we can now assess your eligibility to give blood based solely on your own individual experiences, making the process fairer for everyone.

What has changed?

The questions we ask before you give blood have changed:

• We have removed a question to ask if you or your partner has had sexual contact in Sub-Saharan Africa
• We will now ask all donors if they have had a new sexual partner, or multiple partners, in the last 3 months
• Anyone who has had anal sex with a new partner or multiple partners in the last three months will not be able to give blood at that time, regardless of their gender or their partner’s gender

What questions will I be asked?

You will have to complete a Donation Safety Check and will be asked whether, over the last three months, you have:

• Had sex with anyone who has had syphilis, hepatitis or anyone who is HIV positive?
• Been given money or drugs for sex?
• Had sex with anyone who has ever been given money or drugs for sex?
• Had sex with anyone who has ever injected drugs?
• Taken Pre-Exposure Prophylaxis (PrEP) / Truvada for prevention of HIV or taken or been prescribed Post-Exposure Prophylaxis (PEP) for prevention of HIV?
• Used drugs during sex (excluding erectile dysfunction drugs or cannabis)?

If you answered yes to any of the questions above, then you are unable to give blood right now.

If you answered no to all of the questions above, you may be able to give blood if you meet our other eligibility criteria.

In addition, you will also be asked whether, over the last three months, you have:

• Had sex with a new partner, or had sex with more than one partner?

If you answer yes to this question, you will then be asked if you had anal sex with any of your sexual partners.

• If you have, you will not be able to donate for three months.
• If you have not, you will be able to donate (subject to all other eligibility criteria).

You will no longer be asked if you or your partner has had sex in a part of the world where HIV is common.

Why have we made these changes?

The Advisory Committee on the Safety of Blood, Tissues and Organs - which advises UK health departments – has recommended changes to the criteria around who can give blood after examining the latest evidence relating to blood donation and sexual behaviour presented by the FAIR (For the Assessment of Individualised Risk) steering group.

Patient safety is the heart of everything we do. Switching to an individualised check is a fairer and as safe a way to spot infection.

The changes mean many gay, bi-men and men who have sex with men in a long-term relationship are now be able to donate blood at any time, as well as their partners. It also means donors are likely to not donate if they feel they are at higher risk.

The latest update will help the UK blood services to recruit more Black donors to meet the needs of patients in the future.

We will keep working with and listening to donors, LGBT+ donors, patients and representatives to make sure donation is a positive experience for them.

What do the changes mean for transgender blood donors?

Currently, donors are asked about their assigned sex at birth every time they come to donate. We need to know sex assigned at birth because some blood products are safe to manufacture from the blood of donors assigned male at birth but not from those assigned female at birth.

We recognise that many trans people may not consider this suitable, so we have plans to require the assigned sex at birth only once at registration and not at every session.

Find out more about donation if you are transgender.

The FAIR recommendations

Current deferral decisions are based on how donors answer our donor health check questionnaire. FAIR looked at how to improve this process to ensure a fair and safe screening system for everyone.

FAIR carried out a review to understand the highest risk sexual behaviours for acquiring blood-borne sexually transmitted infections (STIs). They also identified methods for asking donors about their sexual behaviour in a gender-neutral way.

The guidance for any new regulations will be set out by the Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee (JPAC).

What is the FAIR steering group?

The UK blood services (which includes NHS Blood and Transplant), Public Health England, Nottingham University and a range of stakeholders including LGBT+ groups are working together in the FAIR (For the Assessment of Individualised Risk) steering group.

The aim of the FAIR steering group has been to explore if a more individualised risk assessment approach to blood donor selection policy is possible whilst ensuring the safe supply of blood to patients.

FAIR membership includes representatives from the four UK blood services (NHS Blood and Transplant, Scotblood, the Welsh Blood Service and the Northern Ireland Blood Transfusion Service), Public Health England, Nottingham University, the National Aids Trust (NAT), Stonewall, Freedom to Donate, Terrence Higgins Trust (THT), and includes experts in epidemiology, virology and psychology and other key stakeholders.

The Government sets blood donation guidelines based on advice from a Department of Health and Social Care expert committee: The Standing Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO). In 2017, the UK (1) introduced a world-leading blood donation policy reducing the deferral for men who have sex with men (MSM), as well as other some other groups, to three months since last sexual contact. In many parts of the world the deferral for MSM is 12 months or longer and in some areas MSM are asked not to donate at all.

We appreciate that any deferral is disappointing if you want to save lives by giving blood. We want to give as many people as possible the opportunity to donate whilst continuing to ensure the safety of patients. 

*PrEP (pre-exposure prophylaxis) is a medicine that people can take to prevent getting HIV from sex or injection drug use.