Assessing the effect of policy change on transfusion safety in Brazil: A three-and-a-half-year study after lifting the deferral for men who have sex with men.

BACKGROUND AND

OBJECTIVES

In July 2020, Brazil removed the long-standing restrictions on blood donation by men who have sex with men (MSM), shifting donor eligibility criteria towards individual behavioural risk assessment. We sought to establish the impact of this policy change on the safety of the blood supply.

MATERIALS AND

METHODS

This retrospective cross-sectional study evaluated the prevalence and incidence of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis among blood donors at Fundação Pró-Sangue/Hemocentro de São Paulo. Data were analysed across two periods: before (P1: January 2019-June 2020) and after (P2: July 2020-December 2023) the MSM policy change. Prevalence was assessed in first-time donors, and incidence was calculated among repeat donors. The chi-square testing was used for statistical comparisons (p < 0.05).

RESULTS

A total of 560,528 donations were included in the study. There were no significant differences in the prevalence per 100,000 donations of HIV (46.3 vs. 43.5; p = 0.77), HBV (33.3 vs. 27.7; p = 0.56) or HCV (94.1 vs. 72.6; p = 0.09) markers between P1 and P2. However, the prevalence of serological markers for syphilis increased significantly (745.7 vs. 1115.8; p < 0.0001) after the policy change. Donors with positive serological markers for syphilis in P2 were mostly younger and had higher education levels.

CONCLUSION

Lifting the MSM deferral policy in Brazil did not increase the prevalence or incidence of HIV, HBV or HCV markers among blood donors. The observed increase in the prevalence of serological markers for syphilis likely reflects broader population trends. These findings support risk-based donor screening as a safe and equitable approach to blood collection.