Legislative Assembly for the ACT: 2018 Week 04 Hansard (Wednesday, 11 April 2018) . . Page.. 1302 ..
donations from paid donors—often vulnerable people—rather than altruistic donors. It is an issue which was highlighted in the recent Four Corners program “Blood business”.
While reviewing restrictions on local donations is unlikely to solve this issue by itself, it could help to increase Australian donation numbers and reduce the cost to the National Blood Authority, which spends an astounding half a billion dollars annually to procure the shortfall in local blood products from overseas.
There is no doubt that the Therapeutic Goods Administration have an important role in ensuring that blood donation practices are evidence based and that our blood supply is safe. However, they also have a role in ensuring that their policies remain up to date with the latest evidence and technology. The initial ban on blood donation by men who have sex with men was established in 1985 in Australia during the height of the AIDS epidemic. Men who had sex with men were more at risk as a population group of HIV/AIDS infection, so restrictions then put on them donating blood were arguably justified at the time, as little was medically known during the crisis.
In 2000 the outright ban was replaced with a “deferral period” that mandated a period of abstinence for men who have sex with men of 12 months to account for the “window period” between which HIV/AIDS is contracted and the point that it becomes detectable via antibodies in a blood test. This one-year deferral period is still effectively a ban for many gay men. This motion highlights that things have changed dramatically in the past 18 years.
All donated blood is now tested for sexually transmitted diseases. Two tests are used for HIV/AIDS—a nucleic acid test, which has a short 5.6-day window, and a serology test, which has a 22-day window. This means that it is much easier to detect HIV/AIDS than it has been in the past, and it is much more quickly tested. The availability of rapid testing also means that gay men are much more aware of their HIV status than has been possible in the past.
In addition HIV is now a preventable disease. There are many good drugs that can dramatically reduce the viral load in blood to undetectable levels, in some cases, thereby reducing the risk of transmission, particularly through the use of pre-exposure prophylaxis—PrEP—which, as an HIV prevention measure, has reduced and will reduce the risk for people with exposure to HIV.
The New South Wales trial of PrEP is a good example. It began two years ago and has shown a reduction in HIV diagnoses by almost a quarter. The ACT has been part of the trial since March last year, funded by the ACT government. It currently has 315 participants and it will continue until June next year. It is also fantastic that the federal Minister for Health has added PrEP to the pharmaceutical benefits scheme. It starts this month and it will reduce the cost of this drug which we expect to be used much more widely in the future. Part of the requirements of taking PrEP is that participants must take a blood test every three months; which keeps users informed of their HIV status, as well as the government and community health organisations.