What viruses will I be tested for during the donation process?
It is possible for certain viral infections to be transmitted to a patient during the transplant process via the stem cells. This can be a significant risk to the patient as they will have a very low immune system during the process. As a result, we test all donors for the following infections that can be sexually transmitted:
- HIV
- Hepatitis B
- Hepatitis C
- Syphilis
- HTLV 1/2
Why am I asked about whether I have any new sexual partners?
Sexually transmitted infections have different “window periods”. This is the time between exposure to the virus and the blood tests becoming positive. This means that if you have had any new partners within the past 1-3 months it is possible that you have acquired an infection that our tests would not detect. We may still be able to proceed with the donation, but we may ask you further questions about these encounters and we may need to inform the patients’ team.
Why am I asked about whether I have had multiple sexual partners or sex under the influence of drugs in the past 3 months?
The FAIR (For the Assessment of Individualised Risk) steering group reviewed the guidelines for assessing risk of sexually transmitted infections in blood donors. Following this review the steering group made recommendations in line with the latest scientific evidence to make blood donation more inclusive.
We have incorporated these guidelines into our sexual health assessment for stem cell donation. This means that we can now assess eligibility to donate based solely on your own individual experiences, making the process fairer for everyone.
A review of the literature and observed data in donors and the wider population identified the following behaviours as having increased risk of acquiring blood borne infections through sex: a bacterial sexually transmitted infection (STI) in the last 12 months, sex under the influence of drugs (except alcohol, cannabis and Viagra) multiple or new sexual partners.
This is why these questions are used for all donors to screen individuals for their risk of acquiring blood borne viruses. Donors who answer “yes” to these questions will then be asked whether the sexual activity included anal sex.
Why am I asked if I had anal sex?
Anal sex has a higher risk of spreading sexually transmitted infections than many other types of sexual activity. This is because the lining of the anus is thin and can easily be damaged, which makes it more vulnerable to infection.
When would my sexual activity mean that I cannot donate?
Donors who answer “yes” to the question about any recent new partners or multiple sexual partners in the past 3 months will then be asked about anal sex. If these encounters involved anal sex, we would have to defer the donation by 3 months as per our guidelines. If the sexual activity was assessed as low risk (i.e. not involving anal sex) we will need to inform the patients team however they will usually proceed with the donation, or they may ask for repeat blood tests prior to the transplant. In some cases, donations to research (instead of patients) can proceed outside of these guidelines.
Why am I asked if I used barrier contraception?
Barrier contraception, such as condoms, reduce the risk of infections being transmitted. This can be reassuring for the transplant centre when deciding about the risk to the patient of any possible infection if you have a new partner within the window periods for the tests.
Moreover, donors cannot proceed with donation if they are pregnant, so we ask all those of child-bearing potential to use contraception during the donation process. We may ask you to use barrier contraception if you usually use the rhythm method as contraception.
Why am I asked about whether I have taken PrEP?
Pre exposure prophylaxis (PrEP) is a medication taken to prevent HIV transmission. It is very effective however while the medication is being taken it can interact with the way that HIV testing is performed in the laboratory which can lead to confusing results. This can impact on the donation process as we need to have clear HIV results for the patients transplant team. It is important for us to discuss this with donors who have taken PrEP before so that they are aware to inform us if they are likely to take this again during the donation process.
The donor coordinator will ask you what type of PrEP you have taken and when, as different types impact on the blood results for different amounts of time. We would never ask you to stop taking PrEP as your safety is the priority. If this is not something you take regularly any longer and the last time is outside the window of impacting the blood results this will not impact on the donation, but we do ask you to inform us if this is required during the process.
Why am I asked about whether I have ever had any sexually transmitted infections?
Some sexually transmitted infections such as chlamydia and gonorrhoea can be easily treated with antibiotics. However, other infections such as syphilis or hepatitis B can remain dormant in the body even after treatment. This can pose a risk for a patient who has a poor immune system, so it is important for us to inform the patient’s transplant centre about this if you have been treated for any sexually transmitted infection in the past.