Accès au don du sang des hommes ayant des relations sexuelles avec des hommes et impact sur le risque de transmission du VIH par transfusion : tour d’horizon international

Abstract: As far back as 1983, in many countries, men who have sex with men were permanently excluded from blood donation because of their high risk of HIV infection. Since the implementation of HIV screening of blood donations in 1985, there has been a remarkable improvement in the viral safety of the blood supply due to improvements in donor selection and continuous progress in screening assays, including nucleic acid amplification testing. Despite, these improvements and the strong pressure of certain associations of the civil society, only few countries reduced the deferral duration for men who have sex with men. Studies that have assessed the impact of a modification of the permanent deferral measure on the HIV residual risk showed that a reduction in the deferral duration generates an additional risk. Even if this risk is tiny, is it acceptable to expose the blood product recipients to an additional risk? Nevertheless, these studies do not take into account an important parameter that is the probable better compliance of men who have sex with men with a temporary exclusion. The most recent studies agree to conclude that an alternative to the permanent exclusion of all men who have sex with men could consist in authorizing the donation from 12-month abstinent men who have sex with men, as some countries did already. This measure would allow covering widely the window period for the men having recently taken risks or for those whose partners would have taken risks, under the essential condition of an improvement of the donor compliance. [Copyright &y& Elsevier]