“It really is stigmatising,” says Joe Staniszewski. He’s sitting on his couch, dogs curled up next to him. There’s a sense of sadness and frustration in his eyes. Having worked as a registered nurse, Staniszewski knows the importance of donated blood, and the life-saving ability it has.
“I would love to give blood,” he says, but he knows he can’t. Not because of any physical problems, and not because of his own beliefs, but because of who he is. Staniszewski identifies as queer, and because of his sexuality, he’s restricted from donating blood in Australia.
Despite practicing safe sex, and despite being in a monogamous relationship, Staniszewski’s sexuality is still described as “risky sexual behaviour”.
Blood donation is something many people take for granted in Australia, and this restriction is one most people outside the LGBTQIA+ community don’t even know about. Australia is one of a declining number of countries across the globe that places restrictions on gay and bisexual men who would like to donate, based on a perceived risk of HIV transmission. But with HIV rates declining over the past decade and more tools to prevent and fight HIV than ever before, many are questioning why such restrictions remain.
Most countries introduced these restrictions in the 1980s, where HIV/AIDS transmission was at its highest, as well as homophobia and paranoia about the ‘dangers’ of gay sex. But over the past decade, and especially the last few years, several countries have made the decision to repeal those restrictions, saying they’re unfair, and ineffective.
“It’s been a long time coming. The current approach was discriminatory and wrong,” said Canadian Prime Minister Justin Trudeau on April 30 this year, as his government made the step to end the restrictions placed on Gay and Bisexual men in blood donation.
While Canada has removed its restrictions, Australia still restricts gay and bisexual men from freely donating blood. Even tough, with the onset of the COVID-19 pandemic and natural disasters such as the recent NSW and Queensland flooding, the demand for blood donors has been high. Stocks are so low at the moment, due to high numbers of regular donors being sick with colds, flu and COVID-19, that the Red Cross is pleading for more people to donate.
According to the Red Cross, Australia needs more than 1.6 million donations every year to meet the demand for blood and blood products, but there are only around half a million active donors in the country. The Red Cross says although this does meet the demand, “however the need for blood is constant and we always need new donors”.
Perth Gay Social Club event coordinator Ian Odlum says the fact that certain groups are still being prevented from donating blood is frustrating and upsetting.“It frustrates me that a blanket approach has been put on,” he says. “People like myself who are very safe and take our sexual health very seriously would be willing to give blood but because that blanket rule is there, I’m not able to.”
Odlum says what makes it worse is knowing he could help, but he’s restricted from doing so.
“The frustration comes from when I hear them calling out for donations, because they’re low on donations and they’re low on blood supply. If I was able to, I would.”
Ian Odlum
Canada has become the 31st country to place no limits or restrictions on men who have sex with men wanting to donate blood on the basis of sexual identity. In recent years many countries have scrapped their restrictions in favour of screening donors for high-risk sexual activity regardless of gender or sexual identity.
This year alone, France, Greece, Lithuania, and Canada have removed their restrictions. Some countries, such as Germany and the Netherlands, have made the decision to allow those who are in safe, monogamous relationships to freely donate blood without a deferral period.
The TGA and Red Cross Australia both say Australia’s restrictions remain in place due to the “specific epidemiology” of HIV in Australia, but when comparing rates in Australia and Canada, the results are strikingly similar.
What are these restrictions?
Australia is one of 44 nations that continues to enforce restrictions for men who have sex with men (MSMs) when donating blood. In Australia, if an MSM would like to donate blood they are required to wait a minimum three-month period after having sexual contact with a man.
This is often referred to as a ‘deferral period’ and Australia is one of 21 nations worldwide that enforces a deferral period. These periods can range from three months, in Australia’s case, to five years.
These restrictions are enforced by the Therapeutic Goods Administration in Australia and despite many countries recently changing their laws, it seems there is little desire to make a similar shift here. The TGA say the restrictions are in place to “maintain the safety and integrity of the Australian blood supply”.
Similarly, a spokesperson for the Australian Red Cross says: “These rules are in place to protect both the donor’s health and wellbeing as well as the recipient of the blood. All our rules are based on medical and scientific evidence and are regularly reviewed to make sure we keep them up to date.”
Australia made some progress after it lowered the waiting period from 12 to three months in January 2021, but the fact the three-month deferral is still in place is frustrating for those in the LGBTQIA+ community.
Some people are calling into question the efficacy of these restrictions in Australia, especially given the state of HIV rates in 2022.
What are the rates of HIV in Australia?
According to the Kirby Institute at the University of NSW, in 2020, HIV notifications reached a low of 633 in Australia having declined by 37 per cent since 2016. In gay and bisexual men, HIV diagnoses have declined by more than 44 per cent in the same period.
It’s estimated that 29,020 people, or 0.1 per cent of the Australian population, are living with HIV, and 91 percent of those people are aware of their status and are receiving treatment.
In WA, the rates look even better.
WA Aids Council chief executive Lisa Dobrin says rates in WA have been steadily declining since 2014, and in that period, have never exceeded 100 transmissions a year.
“In 2021, 56 People were diagnosed with HIV in WA, which is the lowest since 2004. We’ve come a really long way in terms of transmission rates. That’s primarily due to improved testing, and more ways to prevent HIV.”
Dobrin says rates of HIV have decreased significantly within the WA gay and bisexual communities.
“In WA, heterosexual men are actually on an equal par with men who have sex with men. The trend over the last decade has HIV rates decreasing among gay and bisexual men and increasing amongst heterosexual or straight men,” she says.
She puts this down to a better understanding of risk and sexual health amongst queer communities.
“Gay people, or anyone on the LGBTQIA+ continuum, generally, their sexual health and wellbeing is so much better in terms of testing, screening and prevention, because they have been seen as people who are most at risk from the early days, in the 80s, and 90s.”
Ian Odlum agrees.
“I don’t think that heterosexual couples, at least the ones that I have spoken to about sexual health, have taken it as seriously as my community does.”
Gay and bisexual men in Australia have access to more tools to prevent HIV transmission than ever before. Along with the widespread use of condoms to prevent transmission, gay and bisexual men also have access to a number of medications that can help them avoid HIV transmission.
This includes pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), both of which minimise the risk of transmission. PrEP can limit HIV transmission with more than 99 per cent effectiveness.
According to the Australian Federation of AIDS Organisations, nearly 50,000 Australians were taking PrEP regularly by the end of 2021. The preventative measures, along with increased testing and innovations such as self-tests now sold at pharmacies in Australia, have meant HIV transmission is comparatively low risk in Australia, particularly within the queer community.
For gay and bisexual men in Australia, HIV is no longer a daily fear. It’s something easily preventable, easily treatable, and has no reason to prevent them for living their lives.
Member for Southern River in the WA Legislative Assembly Terry Healy is a champion of blood donation in Australia. In 2016, Healy became the youngest ever Australian to donate blood 300 times and values the importance of the voluntary donation.
“I think that Australia as a community is a very generous and caring community and, in my experience, I think most people would love the opportunity to help someone else,” he says.
But Healy is all too aware of the restrictions placed on men who have sex with men, and the pain and disappointment this can cause. “I have been donating blood for more than 20 years and I bring my friends and colleagues to donate blood with me. And when Red Cross turns people away for no evidenced-based reason just because of 1980s fear, everyone is disappointed.”
How does the LGBTQIA+ community react?
People within the community are frustrated. They know that if given the opportunity, they’d give blood. But they’re prevented from doing so. They’re prevented from potentially saving a life.
Paul Benson is a Perth resident who was born in the late 1970s. He’s convinced that any ‘risk’ associated with gay sex is misconstrued.
He’s seen HIV become a part of our world, and has seen the rates decline to where they are now. He wants to donate blood. “I would donate blood if I could. The fact that I’m on social media, I’m constantly bombarded with requests from the Red Cross, asking for blood donations. There’s not nearly enough people doing it. But they will turn people away who present no risk.”
He looks dejected as he says the rules are a ‘relic’ and says in today’s world, the rules restricting him make little sense.
Benson says he understand why the restrictions might be in place but calls into question how necessary they are.
“I think the people who are writing these regulations are doing so with the very best of intentions and like all professionals I’m sure they are striving to remove any inherent bias they might have. But that doesn’t mean they don’t have it.”
In his Kelmscott studio, Host of the Queer Stories on the Swan Podcast Chris Tierney, who’s gay, says he’s sure these restrictions have no place in today’s world, especially considering the spread of HIV amongst heterosexuals in WA in 2022.
“If it’s spread to straight people, that’s a bit unfair. Why don’t they have the restrictions as well?”
Christopher Tierney
Tierney says restrictions around blood donation shouldn’t be based solely on sexual identity. When he says it, he seems absolutely sure, and shocked that we’ve got to this point.
He says men in the LGBTQIA+ community would be willing to donate blood “to help save a life.”
Joe Staniszewski calls into question the data the TGA and the Red Cross are using.
“I think these restrictions are unnecessary and based on very outdated data and also inaccurate data sources. When it comes to accepting blood donations from people that are not heterosexual, I find that it’s just using very old notions of HIV and other blood borne viruses and it really is stigmatising.”
But Staniszewski isn’t deterred. He knows there’s an opportunity for change.
What’s next?
Australia currently uses a “population statistical risk approach”, which identifies risk factors across the population. However, some nations like the UK and Canada have decided to move towards an “individual risk assessment” which would identify donor eligibility based on the sexual activity of the individual, regardless of their sexual identity.
The TGA says “Lifeblood are exploring other pathways to broaden donor eligibility,” but some are calling for the Red Cross to adopt an individual risk assessment, or an evidence-based approach. This would mean looking at all donors’ risk factors, not just disallowing gay and bisexual men because of who they are. Terry Healy says the option is there for the relevant authorities to change their approach, but that option has not been used.
“I understand Red Cross and the TGA had had the option to adopt an evidence-based approach to blood donation from gay and bisexual men for many years, but have so far declined to take on that evidence-based approach,” he says.
Healy says it’s time Australia adopts an approach that examines individual risk factors, instead of making blanket decisions based on sexuality.
“Instead of screening donors for the gender of their sexual partner, we should screen them for the safety of their sexual activity.”
Terry Healy MLA
“It does not matter whether a person is gay or straight. If a person engages in activity that puts them at high risk, they should not be allowed to donate. If a person is at low risk, they should be able to donate.”
In removing its restrictions, the Canadian government spent seven years and more than $5 million on research and scientific evidence that showed an individual risk approach not only would ensure the “safety of the blood supply”, but also put an end to “discriminatory practices.”
Many are calling for Australia to do the same. Paul Benson says removing the restrictions is the right move for Australia.
“We’re told that these restrictions Australia has are for everybody’s safety. And yet, when these restrictions have been removed elsewhere, the sky hasn’t fallen in.”