Following the FDA’s 2023 removal of previous donor eligibility restrictions affecting sexually active gay and bisexual men, Individual Donor Assessment (IDA) was adopted as a science-based approach to donor screening that focuses on individual behaviors rather than sexual orientation or gender identity.
NYBCe has long supported updates to donor eligibility policies based on evolving science, and we welcome this shift to a more inclusive screening process that applies the same questions and criteria to all donors.
Donor eligibility is no longer based on sexual orientation or gender identity. All donors are asked the same gender-neutral questions and assessed using the same evidence-based criteria.
Under these guidelines, all donors are asked whether they have had new or multiple sexual partners in the past three months:
FDA determined, based on its review of currently available scientific data, that the IDA changes would not compromise the safety or adequacy of the United States blood supply. Evidence from the ADVANCE Study, the Transfusion – Transmissible Infections Monitoring System, and other data assessed by the FDA supported making this change.
Yes, every donation is tested for an array of infections that could potentially be transmitted by blood transfusion, but no test is perfect. Testing has a limitation called the “window period,” which is the time between when an infection is acquired and when it can reliably be detected. Screening questions protect patients in the rare event a recent infection is not detected by testing. These questions are asked of all donors, are kept confidential, and combined with testing to maintain a safe blood supply.
Statistically, anal sex has a significantly higher chance of HIV transmission per sex act than vaginal or oral sex. This does not account for individuals’ safe sex practices, such as condom use, but is based on an evidence-based approach to overall risk.
Condom use, while an excellent sexual health practice, isn’t an evidence-based method of screening donors because condoms are not always effective and can break or slip.
Pre-exposure prophylaxis (PrEP) and or post-exposure prophylaxis (PEP) are important, highly effective medications used for HIV prevention. In people taking PrEP or very early HIV infection may be harder to detect.
Donors who have used oral PrEP or PEP are asked to wait three months, and donors who have used injectable PrEP are asked to wait two yearsdue to how long the medication remains in the body.
NOTE: We do not recommend stopping the use of PrEP or PEP as prescribed by your healthcare provider in order to be eligible to donate blood.
“Undetectable equals untransmissible” only applies to sexual transmission of HIV. Unfortunately, this does not apply to the risk for transfusion-transmission. Even blood donated by those who have an undetectable viral load could potentially put a patient at risk for HIV following a blood transfusion.
The risk of transmission is much higher with a unit of blood due to the large volume of a blood transfusion and the much higher total amount of virus present.
The new Donor History Questionnaire is gender-neutral and poses questions to all donors regardless of gender or sexual orientation. Transgender individuals are welcome to donate blood.
Currently, computer system limitations prevent us from providing gender selections other than male and female. Work is underway to improve the registration process to make it fully inclusive for trans and non-binary donors while still ensuring their safety.
No. The blood community’s goal is to be as inclusive as possible while maintaining the highest level of safety for the blood supply. Donor eligibility undergoes frequent revisions resulting in changes based on current scientific evidence.
For additional details about the FDA’s guidance, visit the FDA website.
