JPAC Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee
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Tissues Safety Entry

Definition

Individual risk is based on the donor’s sexual behaviour, including new partners and the number of partners in the 3 months prior to donation.

Partner risk is based on sexual contact with a partner who may, at a population level, be at higher risk of acquiring infection, as described in this entry.

Sexual contact is defined as oral, vaginal or anal sex.

Anal sex is defined as penile-anal intercourse only. It does not apply to oro-anal sex or the use of sex toys.

Chemsex is sex while using stimulant drugs taken for the specific purpose of enhancing sexual experience and reducing inhibitions. Chemsex does not refer to sex after using alcohol or recreational drugs for other purposes, nor the use of drugs such as Viagra or Cialis to treat erectile dysfunction.

Obligatory

Information must be provided so that those at risk do not donate.

1. You must not donate if:
You think you need a test for HIV/AIDS, HTLV or hepatitis.
 

2. You must never donate if:
a) You are HIV positive
b) You are HTLV positive
c) You are a hepatitis B carrier
d) You are a hepatitis C carrier


3. You must not donate for at least 12 months:
After stopping habitual use of injected drugs of addiction.


4. You must not donate for at least three months if:
a) You have taken Pre-Exposure Prophlyaxis (PrEP) / Truvada for prevention of HIV
b) You have taken or been prescribed Post-Exposure Prophylaxis (PEP) for prevention of HIV.
If the underlying reason for taking PrEP or PEP warrants a longer deferral period, this should be applied. 


5. You must not donate for at least 3 months if:
a) You have received money or drugs for sex
b) You have injected, or been injected with, non-prescription drugs, even only once. This includes, for example, bodybuilding drugs or injectable tanning agents. You may be able to donate if a doctor prescribed the drugs. Please ask.
c) You have injected, been injected with, or used non-parenteral Chemsex drugs.


6.  Individual risk criteria (FAIR):  
You must not donate for at least 3 months if:
a) You have taken part in chemsex activity, including the use of stimulant drugs. This risk applies for all sexual contact.
b) You have been diagnosed with gonorrhoea. You must wait for at least three months after you have successfully completed treatment and been discharged from further follow up.
c) You have had more than one sexual partner in the last 3 months AND you have had anal sex with any of these partners.
d) You have had anal sex with a new sexual partner. For the purpose of donor selection, a new partner is someone that you have not had sex with before or a previous partner with whom you have restarted a sexual relationship in the last 3 months.

If you are in a sexual relationship with one partner only, you can donate once it is three months from the date of first sexual contact, even if you are having anal sex.


7. You must not donate for at least 3 months after sex (even if you used a condom or other protective) with:
A partner who is, or you think may be:
a) HIV or HTLV positive
b) A hepatitis B carrier
c) A hepatitis C carrier
d) A partner who has received money or drugs for sex
e) A partner who has injected, or been injected with non-prescription drugs. This includes, for example, bodybuilding drugs or injected tanning agents. You may be able to give if a doctor prescribed the drugs, please ask.

See if Relevant

Addiction and Drug Abuse
Hepatitis B
Hepatitis C
Hepatitis of Viral Origin
HIV
HTLV
Infection - General
Pre- or Post-Exposure Prophylaxis for HIV
Sexually Transmitted Disease
Syphilis

Additional Information

The FAIR (For the Assessment of Individualised Risk) report (2020) recommended changes to blood donor selection policy to allow a more individualised risk-based approach. This approach was approved by ministers in devolved administrations and has now been implemented by the UK Transfusion Services.

The FAIR III working group recommended that a similar approach could be applied to tissue and cell donors in principle, acknowledging that the current donor selection policies already permit an individual risk assessment approach for life saving tissues and cells.

FAIR identified several factors associated with a higher risk of blood borne infections. These include the recent diagnosis of a bacterial sexually transmitted disease and the following sexual behaviours:

  • new or multiple sexual partners
  • anal sex
  • participation in chemsex activity

Drugs used for chemsex include methamphetamine, mephedrone and GHB/GBL, but other drugs may be used (e.g. ketamine, poppers, cocaine). Chemsex is a high risk activity because it usually involves multiple sexual partners, sometimes for extended periods of time. The drugs involved also reduce inhibition leading to riskier sexual activity.

The drugs used in both Pre- and Post-Exposure Prophylaxis for HIV (PrEP and PEP) may interfere with the routine HIV screening tests carried out on all tissue and cell donors. For this reason, donors who have taken PrEP or PEP should not donate for three months, even if they are otherwise eligible under individual risk criteria.

The deferral periods specified above may be reduced by doing individual risk assessment if the risk of acquiring an infectious disease may be outweighed by the risk of delaying a lifesaving transplantation.

Reason for Change

The entry was revised to include individual risk assessment of recent sexual behaviour for all donors. The deferral for donors whose sexual partners have been sexually active in Sub-Saharan Africa has been removed. This supports implementation of recommendations from the FAIR III Report.

Update Information

This entry was last updated in
TDSG-DD Edition 203, Release 57