Barriers and enablers to source plasma donation by gay, bisexual and other men who have sex with men under revised eligibility criteria: protocol for a multiple stakeholder feasibility study

Abstract

Background Blood donation policy in Canada for gay, bisexual and other men who have had sex with men (gbMSM) has changed progressively in the last decade from indefinite deferral to 3-month deferral from last male-to-male sex. Driven by safety data and overseen by the national regulator, more inclusive policies continue to redress the disparity in donation for gbMSM. At the same time, the need for source plasma to prepare fractionated blood products is growing worldwide. The collection and processing of source plasma ensures greater safety compared to whole blood donation with respect to transfusion-transmitted infection. This greater safety offers an opportunity to evolve policies for gbMSM from time-based to behaviour-based deferral using revised eligibility criteria. However, changing policies does not in itself necessarily guarantee that gbMSM will donate or that staff in donor clinics are ready to support them to do so. In anticipation of a move to behaviour-based donation screening for gbMSM in Canada, we aim to assess the acceptability of and perceived barriers and enablers to source plasma donation using revised screening criteria for gbMSM among key stakeholders to inform policy implementation strategies. Methods This mixed-methods feasibility study will involve gbMSM and donor centre staff to understand modifiable barriers to implementing more inclusive eligibility criteria. Key informant interviews and surveys will be rooted in the Theoretical Domains Framework to identify modifiable factors associated with source plasma donation motives in gbMSM and training needs in donation centre staff. We will use an integrated knowledge translation approach involving a partnership between researchers, the national blood operator and gbMSM, situating knowledge users as key research team members to ensure their perspectives inform all aspects of the research. Discussion Our integrated knowledge translation approach will provide a more comprehensive and collaborative understanding of blood operator and gbMSM needs while accelerating the implementation of study findings. Given the historical backdrop of the decades of exclusion of sexually active gbMSM from blood donation, this study has the potential not only to inform a process and policy for gbMSM to donate source plasma, a blood product, but also offers opportunities for new relationships between these knowledge users.

Stepping Stones or Second Class Donors?: a qualitative analysis of gay, bisexual, and queer men’s perspectives on plasma donation policy in Canada

“…Unsurprisingly, despite these targeted education resources, most participants had limited knowledge and understanding of plasma donation and were unsure of the extent to which plasma was needed. Our findings confirm Vesnaver et al's hypothesis that many GBM, as well as the general population, have likely not been educated or made knowledgeable about plasma donation, including differences between the blood and plasma donation process [32]. While our finding of low knowledge is not unexpected, it is significant given the dearth of empirical scholarship regarding GBM's views of plasma donation.…”

“…Future research could provide more comprehensive education on plasma donation in order to evaluate the extent to which the education of potential donors both increases willingness to donate plasma and addresses concerns about blood donation policy reform more broadly. Our research also complements ongoing stakeholder feasibility research into the multiple barriers and facilitators faced by GBM to donating plasma [32].…”

“…We focused our analysis on attitudes related to changes in plasma donor eligibility given that at the same time Canadian Blood Services was in the process of assembling a proposal for Health Canada related to plasma donation. As Vesnaver et al [32] put it, these policy activities represent an "effort to be more inclusive while maintaining the safety of the blood supply, including some [GBM] that are at low to no risk of HIV infection such as those in monogamous relationships. "…”

Source plasma deferral trends: A 3‐year analysis of 255 centers in the United States

“…In an effort to increase the number of available blood and plasma donors, the FDA lowered several of the deferral periods for donors in May 2020. Several areas of change most pertinent to SP centers was the decrease of the deferral for tattoo or piercing from 1 year to 3 months as well as the change in deferral for men who have sex with men (MSM) from 1 year after the last contact to 3 months 21,22 . At our plasma centers, these deferrals are 4 months due to European regulations, but it has impacted deferrals.…”

Title: Advances in blood donor policies in relation to gay, bisexual and other men who have sex with men (gbMSM) and transgender populations as donors: A scoping review.

“…Only two published studies speci cally examined gbMSM views on plasma donation (2,14). Given the direction that Canadian Blood Services is intending to take with the Fall 2021 Health Canada submission to allow sexually active gbMSM in long term monogamous relationships to donate blood and the worldwide shortage of plasma (34,35) to manufacture into puri ed plasma protein products, this dearth of plasma related research is concerning.…”