Helen McEntee (Meath East, Fine Gael) | Oireachtas source

I thank the Senator for raising this issue. I am responding on behalf of the Minister, Deputy Harris. While I might not be able to give the Senator all the responses he needs, I will certainly relay his views to the Minister.

The remit of the Irish Blood Transfusion Service, IBTS, is to provide a safe, reliable and robust blood service to the health system. It keeps all its deferral policies under constant review to ensure the ongoing safety of the blood supply. It is in this context that, on 16 January 2017, the permanent exclusion of men who have sex with men from donating blood was changed to a 12-month deferral from their most recent sexual contact with another man. While this one-year deferral protects against the risk of transmission of HIV, issues could arise in regard to an emerging infection. In this regard, those who have had a sexually transmitted infection such as chlamydia or genital herpes are deferred for five years after completion of treatment. Those who have had syphilis, gonorrhoea or other specified sexually transmitted infections are already permanently excluded from donating blood.

The general approach of the IBTS to blood donation is that adults are eligible to donate provided they fulfil the donation criteria. One of the fundamental criteria is that they must not have been involved in an activity or visited an area where they could be exposed to viruses that have been identified as risk factors that could compromise the ongoing safety of the blood supply. The IBTS has a range of operational options available to it to implement management measures to protect both the recipients and the donors of blood and blood products. All these measures are aimed at minimising, or acting on, identified risks.

The inclusion of Question No. 52 in the donor health and lifestyle questionnaire, which coincided with the change in the donor deferral policy for men who have sex with men, is one example of an extra precaution taken by the IBTS to protect recipients of blood and blood products. The question asks potential blood donors whether in the past five years they have taken medication to prevent HIV infection. The medication involved is pre-exposure prophylaxis, PrEP, or post-exposure prophylaxis, PEP. Persons who have taken PrEP or PEP to prevent HIV infection are also deferred for a five-year period. Studies of gay and bisexual men have shown that PrEP reduces the likelihood of HIV infection by more than 90% if used consistently. A common concern is that PrEP will also lead people to stop using condoms, putting them at risk of other sexually transmitted infections.

A study published in the United States in 2016 showed a sharp rise in sexually transmitted infections in men on PrEP and associated the use of PrEP with a greater likelihood of being diagnosed with a sexually transmitted infection. If the Senator has not been able to find any information bar this study, I will request that the Minister revert to him on this. Perhaps he could seek further clarification on the which study this actually is.

More broadly, the IBTS has protocols in place to minimise transfusion-transmitted infection of blood. This risk is at its highest when individuals donate blood during the five-day to 16-day period following exposure to a virus when there is no biological measure to detect infectivity. As a consequence, the IBTS temporarily or permanently defers from giving blood an average of one in five people who are ineligible to donate for a variety of reasons on the day they attend.