Brennan David J, Armstrong Jp, Kesler Maya, Bekele Tsegaye, Lachowsky Nathan J, Grace Daniel, Hart Trevor A, Souleymanov Rusty, Adam Barry D
Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada.
Department of Sociology, York University, Toronto, Canada.
PLOS Glob Public Health. 2023 Jan 6;3(1):e0001380. doi: 10.1371/journal.pgph.0001380. eCollection 2023.
In Canada, gay, bisexual and other men who have sex with men (GBMSM) are a population that are willing to donate blood, if eligible, but have a history of ineligibility and deferrals due to concerns that their blood poses an increased risk of HIV entering the blood supply. Our objective was to examine the proportion of GBMSM who are willing and eligible to donate under the 12-month deferral policy (implemented in 2016) and the 3-month deferral policy (implemented in 2019). Data for this study comes from the #iCruise study, a mixed cohort study designed to examine sexual health outreach experiences through online services and mobile apps among GBMSM in Ontario. A total of 910 participants were recruited between July 2017 and January 2018. Eligibility criteria include identify as male (cisgender or transgender); at least 14 years old; having had sex with a man in the previous year or identifying as sexually/romantically attracted to other men or identifying as gay, bisexual, queer or two-spirit; and living or working in Ontario or having visited Ontario four or more times in the past year. Participants completed a baseline and a follow-up questionnaire. A subset of #iCruise participants (n = 447) further completed this questionnaire. Willingness and eligibility to donate blood were assessed under 12-month and 3-month deferral policies. Of the 447 GBMSM surveyed, 309 (69.1%) reported a general interest in donating blood. 109 (24.4%) GBMSM were willing, 75 (16.7%) were eligible, and 24 (5.4%) were both willing and eligible to donate blood under the 12-month deferral policy. Under the 3-month deferral policy, willingness and eligibility to donate blood increased significantly to 42.3% and 29.3%, respectively. The percent of GBMSM who were both willing and eligible to donate blood also increased significantly to 12.3% under the 3-month deferral policy. The increase in willingness to donate blood varied by age, ethnicity, and geographic residence of participants whereas the increase in eligibility to donate blood varied by education level of participants. Under the 3-month deferral policy, GBMSM who were 50 years or older, identified as bisexual or other, had a lower education level, and who were not 'out' to others were more likely to be eligible to donate. GBMSM who reported a general interest in donating blood were more likely to be willing to donate blood under both deferral policies. The most common reason for not being interested in donating blood was the MSM deferral policy itself; many participants interpreted the policy as discriminatory for 'singling out' GBMSM or self-assed themselves as ineligible. Among study participants, both willingness and eligibility to donate blood was significantly higher under the 3-month deferral policy. The results suggest that a time-based reduction to a 3-month deferral policy is impactful but limited. Future research should measure GBMSM's willingness and eligibility under the individual risk-based assessment (to be implemented in 2022).
在加拿大,男同性恋者、双性恋者以及其他与男性发生性行为的男性(GBMSM)群体如果符合条件是愿意献血的,但由于担心他们的血液会增加艾滋病毒进入血液供应的风险,他们有不具备献血资格和被推迟献血的历史。我们的目标是调查在12个月推迟献血政策(2016年实施)和3个月推迟献血政策(2019年实施)下,愿意且符合献血条件的GBMSM的比例。本研究的数据来自#iCruise研究,这是一项混合队列研究,旨在通过在线服务和移动应用程序调查安大略省GBMSM的性健康外展经历。2017年7月至2018年1月期间共招募了910名参与者。入选标准包括:自我认同为男性(顺性别或跨性别);至少14岁;在过去一年与男性发生过性行为,或自我认同在性方面/情感方面被其他男性吸引,或自我认同为男同性恋者、双性恋者、酷儿或双灵族;居住或工作在安大略省,或在过去一年访问安大略省四次或更多次。参与者完成了一份基线问卷和一份后续问卷。#iCruise研究的一个子集(n = 447)进一步完成了这份问卷。根据12个月和3个月推迟献血政策评估献血意愿和资格。在接受调查的447名GBMSM中,309名(69.1%)表示普遍有献血兴趣。在12个月推迟献血政策下,109名(24.4%)GBMSM愿意献血,75名(16.7%)符合献血条件,24名(5.4%)既愿意又符合献血条件。在3个月推迟献血政策下,献血意愿和资格分别显著提高到42.3%和29.3%。在3个月推迟献血政策下,既愿意又符合献血条件的GBMSM的比例也显著提高到12.3%。献血意愿的增加因参与者的年龄、种族和地理居住地区而异,而献血资格的增加因参与者的教育水平而异。在3个月推迟献血政策下,50岁及以上、自我认同为双性恋或其他、教育水平较低且未向他人公开身份的GBMSM更有可能符合献血条件。在两种推迟献血政策下,报告有普遍献血兴趣的GBMSM更有可能愿意献血。对献血不感兴趣的最常见原因是男男性行为者推迟献血政策本身;许多参与者将该政策解读为对GBMSM的“区别对待”而具有歧视性,或自我评估认为自己不符合条件。在研究参与者中,在3个月推迟献血政策下,献血意愿和资格都显著更高。结果表明,将推迟献血政策时间缩短至3个月是有影响的,但也是有限的。未来的研究应该衡量GBMSM在基于个体风险的评估(将于2022年实施)下的献血意愿和资格。