Regulating the Risk of Blood-borne Related Infections: Men Who Have Sex with Men Deferral Policy
Bibliographic record
Abstract
In Canada, from 1989 to 2013, a man who had had sex with another man (MSM), even once since 1977, was categorically excluded from the blood donor pool. Although the LGBTTQ community and student groups argued that this exclusion, based solely on sexual orientation, was discriminatory and promoted homophobic attitudes, the painful legacy of the tainted blood scandal and the desire to maintain public trust in the blood supply, prevented Canadian Blood Services from relaxing the eligibility. The recent changes to the MSM blood deferral policy primarily aimed to align the ban with new epidemiological evidence of risk. Implicitly, another goal was to increase blood supply by enhancing young Canadian's perception of blood services, prompting them to become regular donors. An extensive consultation process, lasting almost a decade, was necessary to reach a compromise amongst patient groups opposed to changes to the legislation, and the LGBTTQ and student groups who wanted to eliminate the deferral for MSM altogether and reform screening practices. A consensus amongst high interest groups was reached in 2013, resulting in the implementation of a 5-year deferral (meaning MSM become eligible donors after five years without sex with other men) and three years later, a change to a 1-year deferral. The changes to the deferral policy have had a small impact on net blood supply; nevertheless, they have succeeded at improving donor compliance, satisfying activists, and advancing the possibility of introducing novel and improved screening tools that tackle the risk inherent in sexual practices rather than the risk related to sexual orientation. Un homme ayant eu ne serait-ce qu'un seul rapport sexuel avec un autre homme (HSH) après 1977 était catégoriquement exclu du don du sang au Canada entre 1989 et 2013. En dépit des objections de la communauté LGBTTQ et d'associations étudiantes selon lesquelles cette exclusion, fondée uniquement sur l'orientation sexuelle, était discriminatoire et promouvait les attitudes homophobes, la Société Canadienne du Sang se trouvait empêchée par l'ombre portée du douloureux scandale du sang contaminé ainsi que par sa volonté de maintenir la confiance du public dans la qualité du sang d'assouplir les règles d'éligibilité. Les changements récents à la politique de moratoire sur les dons de sang de HSH visaient essentiellement à adapter l'exclusion aux nouvelles données épidémiologiques sur les risques encourus. Un autre objectif, implicite, était d'améliorer l'image des services de dons de sang auprès des jeunes Canadiens, les poussant ainsi à devenir des donneurs réguliers, afin d'augmenter l'offre de sang. Un processus de consultation approfondie ayant duré pas loin de dix ans a été nécessaire pour atteindre un compromis entre les associations de patients, opposées à tout changement à la législation, et les associations étudiantes ou la communauté LGBTTQ qui souhaitaient éliminer tout moratoire pour les dons HSH et réformer les pratiques de dépistage. Un consensus fut atteint entre ces groupes d'intérêt en 2013, autour d'un moratoire de cinq ans (ce qui signifie que les HSH deviennent éligibles comme donneurs après cinq ans d'abstinence de rapports homosexuels), puis, trois années plus tard, un moratoire d'un an. Ces changements de durées de moratoire n'ont eu qu'un effet limité sur l'offre de sang ; cependant, ils ont amélioré l'observance des donneurs, satisfait les activistes, et amélioré les perspectives d'innovation en matière de dépistage, de manière à cibler le risque lié aux pratiques plutôt qu'à l'orientation sexuelle.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.015 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.011 | 0.005 |
| Scholarly communication | 0.004 | 0.001 |
| Open science | 0.003 | 0.005 |
| Research integrity | 0.006 | 0.007 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".