They had been waiting for it for years. Homosexual men will no longer have to justify a four-month abstinence period to access blood donation. The Ministry of Health announced, Tuesday, January 11, the publication of an order on Wednesday establishing identical selection criteria for all donors, regardless of their sexual orientation. It will take effect on March 16.
The stake of this text, qualified as“Major societal development” by the Director General of Health, Jérôme Salomon, is to remove all discrimination, a principle enshrined in law since the promulgation of the bioethics law in August 2021. The new questionnaire, which must be completed before each donation, will only identify “Individual practices at risk” like multipartnership or drug use.
“If equal access to donations is guaranteed, this is a major step forward, estimates Lucile Jomat, president of the association SOS Homophobie. But we are waiting to see the formulation of the new questions before fully affirming it. ” We must, in fact, wait another two months for this decree to apply. A necessary time, according to the ministry, to allow all the actors to appropriate the new provisions and to avoid any discrimination related to a misunderstanding of the text.
Another criterion linked to treatments
Equal access to blood donation has been a battle waged for many years by LGBT associations. Indeed, men who have sex with men were excluded in 1983, at the start of the AIDS epidemic. It was only in 2016 that homosexual men were able to be donors again, provided they had no sexual relations during the twelve months preceding the donation. Four years later, the period of abstinence had been reduced to four months, including for couples in a stable relationship. In the case of heterosexual people, this period only applies in the case of recent relations with several partners.
This difference in treatment has so far been justified by an increased risk linked to the prevalence of HIV infection in homosexual men. But in recent decades, that number has dropped dramatically, and so has the risk of transmitting HIV through transfusion. In 1990, it was estimated that one in 310,000 donations could be found to be HIV positive and not detected. Today, this probability is forty times lower according to the government. ” The reality is that there has been no new estimate of this residual risk., warns Fabrice Pilorgé, director of advocacy for the Aids association for the fight against AIDS, which was consulted during the drafting of the text. In the absence of sufficient data, it is believed that other questions should have been introduced, in particular on sexual practices, to reduce this risk and guarantee the safety of recipients. »Additional monitoring measures should be put in place to monitor the consequences of this decree, but none has yet been explained.
At the same time as the opening of blood donation to homosexual men, the government announced a new selection criterion. People taking pre- or post-exposure HIV treatment (PrEP or PEP) will have to wait four months after the last dose of the medicine before they can donate blood. These powerful antivirals can interfere with the detection of HIV in blood bags. But this is not the only explanation. “These people are generally linked to risky practices, specifies Cathy Bliem, director general of the French Blood Establishment (EFS). This indirect question sheds light on them. ” For Lucile Jomat, this new criterion can be a source of discrimination: “If this criterion was justified only by the medical aspect, why not. But associating those who take PrEP and PEP, mostly homosexual men, with risky practices, it remains stigmatizing. “
The Covid-19 pandemic has had an impact on blood donation and the tension is permanent between the number of bags available and the need for blood products. On January 11, the EFS estimated its stock at 77,000 red blood cell concentrates. For Cathy Bliem, “It takes 100,000 to be [à l’aise] “.