The continued tale of the ‘bloody shame’ that could just be plain old common sense.

In response to my original post on this subject, a friend asks why I have so little faith in men who have sex with men (MSMs) telling the truth about their risk status when choosing whether or not to self-exclude from donating blood.

Every year around forty of the donations made in the UK and and Northern Ireland are confirmed to be HIV-positive.

On further investigation, around 50% of these donations can be shown to have come from men who have had sex with other men, but who have chosen to lie during pre-screening (and given that they are just the ones we can prove, the percentage is likely to be far higher).

Bearing in mind that the vast majority of MSMs do obey the the rules and do self-exclude themselves, that means that an incredibly small percentage of the 10% of men who are MSMs and are so convinced about their HIV-negative status that they simply choose to lie, still manage to account for more than half of the HIV-infected donations hitting the screening process.

The NBS have – thanks in no small part to the fact that the vast majority of MSMs are respecting the rules – been incredibly lucky that not a single one of those infected donations has ever made it through the inaccurate screening processes. Even without a relaxation in the rules, the laws of chance tell us that one of those window period donations will hit the system and will not be detected until it is too late.

Even with HIV management as it is today, one person becoming unintentionally infected through a donation is one too many; but one unit of donated blood that makes it through the screening process doesn’t just have the ability to infect one person. Donated units are more often than not batched and processed as blood products – so the one unit will probably infect many others units, meaning that hundreds of people are put at risk of infection.

Open donations up to even a relatively small percentage of men who have sex with men and the chances of a window period donation hitting the system become so high as to be not just a near certainty, but a regular occurrence .. at which point public confidence in the blood supply will be totally destroyed.

As to my lack of faith – that has more to do with men actually understanding the risk they may have put themselves at. There is for example a common misconception that unprotected oral sex is safe; but the Health Protection Agency estimates that upwards of 15% of new HIV infections occur through oral sex. Oral sex simply isn’t safe sex – it is SAFER sex – and I defy you to find more than a handful of MSMs who would ever use barrier protection when engaging in oral sex.