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Hematology, Transfusion and Cell Therapy publishes original articles, review articles and case reports covering various areas in the field of hematology and hemotherapy. The journal was ly published, untilas Revista Brasileira de Hematologia e Hemoterapia. SRJ is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google rank; it provides a quantitative and qualitative measure of the journal's impact. SNIP measures contextual citation impact by wighting citations based on the total of citations in a subject field.
Reevaluation of the deferral from voluntary blood donation by men who have sex with men MSM is being discussed in several countries, motivated by the need to ensure a blood supply free from transfusion-transmissible infections e.
Policies being considered include: permanent exclusion for any male-male sexual encounter, temporary deferral 3 months, 12 months, 5 years from the last encounter, or specifying behaviors that differentiate MSM at high risk from those at low risk. Current Brazilian regulations defer MSM from blood donation for months after the last male-male sexual encounter. Broad epidemiological evidence indicates that many Italian man in Petrey seeking casual are at increased risk for HIV in the present era, and few data exist to distinguish which men are likely to be in the immunological window for detection of these infections.
A multicenter study developed in Brazil demonstrated that the history of male-male sex was the most strongly associated with being an HIV-positive blood donor. Meanwhile, the blanket deferral of MSM from blood donation has generated considerable controversy. Rejection of the deferral policies stems in part from perspectives defending human rights, promoting equality and citizenship, and alleging bias and discrimination. The objective of this report is to discuss the current situation of blood donation among MSM in Brazil.
We highlight the lack of evidence for a true risk profile for male-male sex in the context of blood donation upon which to base sound policy. We recommend research to establish effective and acceptable criteria for blood donation by MSM and other blood donors. A safe and stable supply of blood for transfusion is necessary in all societies to prevent morbidity and save lives. A safe supply of blood is maintained by recruiting altruistic volunteers, screening them for certain health conditions, and testing their blood for markers of transfusion-transmissible infections.
Policies regulating the recruitment and selection of blood donors have been put in place to minimize the risk of transfusion-transmissible infections. The Brazilian Ministry of Health ordinance 5 of September 28, annex IVrequires trained health professionals to evaluate specific criteria that may pose a risk to blood donors and transfusion recipients.
These criteria exclude or temporarily defer potential donors with a wide range of conditions, including diabetes, tattoos or piercings, history of rape, sex work or partners of sex workers, persons with multiple casual partners, and men who have sex with men MSM. This last criterion, the deferral of MSM from blood donation, has been controversial. InBrazil changed the policy of permanent deferral for any male-male sexual behavior to the temporary deferral of 12 months from the last encounter.
This policy has been adopted and implemented by all Brazilian hemotherapy services since then. The policy of permanent or temporary deferral of MSM from blood donation is under discussion in many countries. Inthe World Health Organization WHO defined five of risk for HIV infection, regardless of local context, among which is the sexual practice of men with other men. The proportional distribution of cases, identified from to Juneshows a concentration in the Southeast and South regions, each ing for In addition, it is estimated that aboutpeople, out ofpeople living with HIV in Brazil, do not know that they are infected by the virus.
According to these organizations, the regulations aim at a collective interest in the maximum guarantee of transfusional quality and safety. A temporary deferral of MSM, as well as other groups at increased risk for HIV and other transfusion-transmissible infectious diseases, is held to be a strategy that contributes to the protection of blood recipients. Hence, the duration of deferral is therefore recommended to be Italian man in Petrey seeking casual enough to ensure a potential donor is not in the window period for a given infection. A case-control study investigating epidemiological profiles for blood donors testing positive for transfusion-transmissible infections was conducted at four large Brazilian blood banks in History of male-male sex was the factor most strongly associated with being an HIV-positive blood donor, followed by having had an HIV-positive sexual partner.
The study highlighted the need to improve awareness of the reasons for risk screening prior to blood donation since many cases, and some controls, revealed their risk behaviors at the time of the research study rather than at donation. Despite broad epidemiological and some blood donation contextual evidence that male-male sexual practices can be associated with an increased risk of infection for HIV, the temporary deferral of MSM for blood donation has generated heated discussion elsewhere. Compounding this double standard is the policy that heterosexual donors who have unprotected sex, including with multiple partners, are not deferred from blood donation and not required to be celibate for long periods of time.
These authors believe that the deferral is a bias based on the ideology that all male—male sex is risky, rather than focusing on the true risk factors for transmission. In fact, there is a scarcity of studies investigating the impact of MSM exclusion and deferral policies on blood safety, including the recruitment and retention of low-risk volunteers and the effectiveness of screening questions and criteria.
For example, according to Haire et al. Accordingly, reducing the deferral period to 3 months would not increase the risk to recipient health and may have the social benefit of increasing inclusion. Needed studies at the intersection of blood donation and risk among MSM can follow two paths.
The first focuses on blood donors, making an assessment of potential deferral criteria and the impact of asking specific questions on sexual practices to persons presenting to donate. The second focuses on MSM in the community, to evaluate attitudes, perceptions, opinions, and intentions to donate, given the current or new policies on blood donation.
There is therefore a Italian man in Petrey seeking casual of evidence on the epidemiological profile of MSM who may or may not seek to donate blood, including their intentions toward donation and their attitudes and understanding of the month deferral period adopted in Brazil.
Recently, the discussion on blood donation by MSM has been brought to Brazilian courts. According to the Attorney General's Office and lesbian, gay, bisexual and transgender advocacy groups, the deferral policy is unconstitutional and raises questions on fundamental rights of these marginalized populations. In addition, they emphasize that the restrictions are based on the immutable gender and sexual orientation of the individuals and not on risk behavior.
According to a press release in October by the Federal Supreme Court Ministry rapporteur, Edson Fachin, the policy violates the rights of MSM and the foundation of respect for diversity and human dignity of those who wish to donate blood. According to the Brazilian Ministry of Health, the current month MSM celibacy deferral policies for blood donation should be considered as a technical issue and therefore should not be treated as a matter of constitutionality.
In a letter, ed by 26 blood centers directors to the STF at the end ofthe precautionary principle should continue to be valid while further studies are carried out in Brazil. We argue that further studies are necessary to provide scientific evidence regarding blood donation by MSM. These studies should focus on the adequacy of the deferral period versus the impact on blood safety and stability of supply in Brazil. Approaches for improved donor selection are important and urgently necessary, as well as studies regarding non-compliance with the deferral period, epidemiological and risk profile of MSM and studies regarding the impact of MSM exclusion and deferral policies on blood safety.
In summary, studies to understand the impact of blood donation by MSM in Brazil must be conducted in the country with the engagement of MSM communities, taking into consideration the cultural diversity in our nation. The authors declare no conflicts of interest. Hematology, Transfusion and Cell Therapy. ISSN: Open Access Option. article Next article. Issue 2. s April - June More article options. Blood donation deferral policies among men who have sex with men in Brazil.
Download PDF. Miriane Lucindo Zucoloto a. Corresponding author. This item has received.
Under a Creative Commons. Article information. We recommend research to establish effective and acceptable criteria for blood donation by MSM and other blood donors. Men who have sex with men. Full Text. Introduction A safe and stable supply of blood for transfusion is necessary in all societies to prevent morbidity and save lives. The controversy over the month deferral policy for MSM in blood donation Despite broad epidemiological and some blood donation contextual evidence that male-male sexual practices can be associated with an increased risk of infection for HIV, the temporary deferral of MSM for blood donation has generated heated discussion elsewhere.
Conflicts of interest The authors declare no conflicts of interest. Tanaka, A. Offergeld, C. Kamp, M. Heiden, R. Norda, M. Sexual risk behavior and donor deferral in Europe. Vox Sang,pp.
Sacks, R. Goldstein, R. The U. N Engl J Med,pp. Levy, L. Olmer, Y. Livnat, A. Yanko, E. Attitudes, perceptions and knowledge among men who have sex with men towards the blood donation deferral policy in Israel. Berkman, L. Ban the Ban: a scientific and cultural analysis of the FDA's ban on blood donations from men who have sex with men. Columb Med Rev, 1pp.
Buck, T. Dieltjens, V. Compernolle, P. Is having sex with other men a risk factor for transfusion-transmissible infections in male blood donors in Western countries?. Hughes, N. Sheon, B. Siedle-Khan, B. Transfusion, 55pp. Lucky, C. Seed, D. Waller, J.Italian man in Petrey seeking casual
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