男同性恋和双性恋者对加拿大献血政策改革的看法：一项定性研究。
Gay and bisexual men's views on reforming blood donation policy in Canada: a qualitative study.
机构信息
Dalla Lana School of Public Health, University of Toronto, 155 College Street, 5th Floor, Room 556, Toronto, ON, M5T 3M7, Canada.
Dalla Lana School of Public Health, University of Toronto, 155 College Street, 5th Floor, Room 510, Toronto, ON, M5T 3M7, Canada.
出版信息
BMC Public Health. 2019 Jun 17;19(1):772. doi: 10.1186/s12889-019-7123-4.
BACKGROUND
Researchers and activists have long called for changes to blood donation policies to end what is frequently framed as unjustified bans or deferral periods for men who have sex with men (MSM). Since 2016, in Canada, a man had to be abstinent from all sexual contact (anal or oral sex) with other men for at least 12 months in order to be an eligible blood donor. As of June 3, 2019, this deferral period was reduced to 3 months.
METHODS
To better understand the acceptance of existing deferral policies and possible future policy, we conducted 47 in-depth interviews with a demographically diverse sample of gay, bisexual, queer, and other men who have sex with men (GBM) in Canada's three largest cities: Vancouver, (n = 17), Toronto (n = 15), and Montreal (n = 15). Interviews were coded in NVivo 11 following an inductive thematic analysis. We focus on men's preferred policy directions and their opinions about a policy change proposed by Canada's blood operators: a 3-month deferral for all sexual activity between men. We interviewed GBM approximately one-year before this new deferral policy was approved by Health Canada.
RESULTS
Most participants were opposed to any deferral period in relation to MSM-specific sexual activity. A fair and safe policy was one that was the "same for everyone" and included screening for several risk factors during the blood donation process with no categorical exclusion of all sexually active MSM. Participants believed that multiple "gender blind" and HIV testing-related strategies could be integrated into the blood donation process. These preferences for a move away from MSM-specific exclusions aligned with their opinions concerning the possible change to a 3-month MSM deferral, for which participants shared three overarching perspectives: (1) step in the right direction; (2) ambivalence and uncertainty; and (3) not an improvement.
CONCLUSION
A predominant assertion was that a change from a 12-month to a 3-month deferral period would not resolve the fundamental issues of fairness and equity affecting blood screening practices for GBM in Canada. Many participants believed that blood donation policy should be based on more up-to-date scientific evidence concerning risk factor assessment and HIV testing.
背景
研究人员和活动家长期以来一直呼吁修改献血政策，以结束人们经常认为不合理的对男男性行为者（MSM）的禁令或延期献血。自 2016 年以来，在加拿大，男性必须在 12 个月内完全避免与其他男性进行任何性接触（肛交或口交），才有资格献血。自 2019 年 6 月 3 日起，这一延期期限缩短至 3 个月。
方法
为了更好地了解对现有延期政策的接受程度和可能的未来政策，我们在加拿大三个最大的城市温哥华（n=17）、多伦多（n=15）和蒙特利尔（n=15）对不同背景的男同性恋、双性恋、酷儿和其他男男性行为者（GBM）进行了 47 次深入访谈。访谈采用 NVivo 11 进行编码，并采用归纳主题分析。我们关注的是男性对政策的偏好方向以及他们对加拿大血液运营商提出的一项政策变化的看法：即对所有男性间性行为进行 3 个月的延期。我们在加拿大卫生部批准这项新的延期政策之前大约一年对 GBM 进行了采访。
结果
大多数参与者反对与 MSM 特定性行为相关的任何延期。公平和安全的政策是对每个人都“一视同仁”的政策，包括在献血过程中对几个风险因素进行筛查，而不是对所有有过性行为的 MSM 进行一刀切的排除。参与者认为，有几种“性别中立”和与 HIV 检测相关的策略可以整合到献血过程中。这些对消除 MSM 特定排除的偏好与他们对 3 个月 MSM 延期的看法一致，参与者对这一可能的变化有三种总体看法：（1）朝着正确的方向迈出了一步；（2）矛盾和不确定；（3）没有改善。
结论
一个主要的观点是，将 12 个月的延期改为 3 个月的延期并不能解决影响加拿大 GBM 血液筛查实践的公平和公正的根本问题。许多参与者认为，献血政策应该基于更最新的科学证据，包括对风险因素评估和 HIV 检测的评估。
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