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June 22, 2025 • 17 mins

Donating blood is an important community service – one that’s desperately needed for patients, in life-threatening conditions. But up until now, those identifying as gay, bisexual or transgender had effectively been banned from donating. A lift on that ban will now significantly expand Australia’s donor pool at a time when blood - specifically plasma - is most needed by patients. But for many in the LGBTQ+  community, the changes are long overdue, and the ban has been a major source of stigma. Today, health reporter Kate Aubusson and Matthew Mottola, on why the ban has been lifted, and why it took so long.

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Episode Transcript

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S1 (00:00):
From the newsrooms of the Sydney Morning Herald and The Age.
This is the morning edition. I'm Chris Payne, filling in
for Samantha Sellenger Morris. It's Monday, June 23rd. Donating blood
is an important community service, one that's desperately needed for
patients in life threatening conditions. But up until now, those

(00:23):
identifying as gay, bisexual or transgender had effectively been banned
from donating. A lift on that ban will significantly expand
Australia's donor pool. And that comes at a time when blood,
specifically plasma, is most needed by patients. But for many
in the LGBT+ community, these changes are long overdue, and

(00:46):
the ban on donating blood has been a major source
of stigma. Today, health reporter Kate Aubusson and Matthew Mottola
on why the ban has been lifted and why it
took so long. Kate. Matthew, welcome to the Morning Edition.

S2 (01:04):
Thanks very much. Good morning.

S1 (01:06):
Kate. Let's start with you. The rules are changing around
blood donation in Australia for those who've effectively been banned
from doing so in the past. So what's the context here?

S2 (01:16):
Well, this all goes back to the HIV crisis in
the 80s, which disproportionately affected gay and bisexual men.

S3 (01:25):
A mystery disease known as the gay plague has become
an epidemic unprecedented.

S4 (01:29):
1 million Americans may have been infected with the Aids virus,
and more than.

S5 (01:32):
12 providers accused of discriminating against people with HIV.

S6 (01:37):
It could kill more Australians than World War two. But
Aids can be stopped and you can help stop it
if you have sex, have just one partner.

S2 (01:51):
And there were HIV transmission through blood transfusions at the time.
So to guard against this, many countries, including Australia, introduced
an indefinite deferral for men who have sex with men
to be blood donors, which really effectively amounted to a
ban for this group donating blood. Now, this policy did
significantly reduce HIV transmission via blood transfusions, and it was, importantly,

(02:17):
before HIV testing had been developed. Then we had HIV
testing in blood services in 1985, and they began to
routinely test blood donations for HIV. But these first generation
tests weren't good at detecting HIV in the first three
months after someone had contracted the virus.

S1 (02:41):
Okay, Kate, so tell me what's changed now.

S2 (02:43):
So testing has gotten a lot better. It's a lot
more sensitive, and it's able to pick up HIV in
blood a lot earlier. And testing now can detect HIV
within about one week of exposure, which significantly reduces the
risk of transmission through transfusions. And in 2000, the rule
was changed to allow men who have sex with men

(03:03):
and other groups considered high risk of HIV to donate
after abstaining for 12 months, and then in 2021, it
became three months, which is still the rule. Importantly, HIV
rates have been falling over the last decade.

S7 (03:19):
It was with this handshake in 1987 that the princess
first challenged prejudice about Aids treating an HIV infected man, Ungloved.

S8 (03:27):
In 2022, there were 555 new HIV diagnoses in Australia,
a drop of 46% in the past decade.

S2 (03:38):
And they've reached a point where there's evidence that it
is now safe to change these rules in conjunction with
another really big development, which is the safety measure called
pathogen deactivation. During this processing of plasma donations, this pathogen
deactivation process filters out the viruses and bacteria that may

(03:59):
be in that blood, which significantly reduces the risk of
an infection being passed on to a patient. So knowing
all this last week, the Therapeutic Goods Administration, which is
the regulator that oversees blood donations, approved major changes to
blood plasma donor rules after it received a submission from lifeblood,

(04:19):
which is the service that does all the blood donations
around Australia. And lifeblood, with Kirby Institute, have been conducting
a lot of research and modelling and risk assessments, which
determined that removing this sexual activity wait time for most
cases would. It wouldn't change the safety profile of Australia's

(04:40):
blood supply. So essentially the safety of Australia's blood supply
would not be compromised if we made these changes. And
so from the 14th of July, lifeblood is removing sexual
activity wait times for plasma donations, which will mean groups
who previously had to wait those three months after sex
can donate immediately. Now, this Now. This includes men who

(05:02):
have sex with men, females who have sex with a
male who has ever had sex with a male, transgender
donors who have sex with a male, sex workers, anyone
who has had sexual contact with a sex worker, and
anyone who has had sexual contact with a resident of
an HIV high prevalence country. And most importantly, and a
world first, people taking HIV pre-exposure prophylaxis, which most people

(05:27):
know is Prep, will be eligible to donate plasma. Now,
Prep is a medication taken by HIV negative people to
significantly reduce their risk of contracting HIV.

S1 (05:39):
Okay, so it's a really significant update. How many people
are they estimating that this could open up to blood donation?

S2 (05:46):
So the Kirby Institute estimates that over 600,000 people will
be covered who were previously excluded by these wait times.
And lifeblood reckons that will mean an extra 95,000 donations
of plasma every year.

S1 (06:05):
So in the context of the whole pool of donations
in Australia, that's quite a lot. Yeah.

S2 (06:09):
Yeah. That's huge. Especially when we know that plasma is
the most important blood product that Australian patients need. Today,
I think, you know, this is such a wonderful thing,
not just for a community that has been maligned by
these rules, who have been really keen to donate. But
for the patients who really rely on this blood. I've

(06:31):
been reporting on health for so many years now, and
the number of times we get a message from lifeblood saying, please, please,
can you do a call out? We desperately need donations.
It's these donations are desperately needed.

S1 (06:44):
Matthew, thank you so much for joining us as well.
What has this ban meant for you as a gay
man and what has the feeling been in your community?

S9 (06:54):
So my first interaction with lifeblood was they had this, um,
mobile van that came to my high school, and I'm
sitting with all my friends and reading and filling out
the eligibility questionnaire. And I'm looking at it and realizing
that I can't donate because I'm starting to experiment with

(07:18):
my sexuality. And, you know, for all intents and purposes,
I'm being told that I have I have dirty blood.
And I'm sitting there, heart pounding in my chest because
I'm not out yet, and I can't tell my friends
the reason why I'm not able to donate. And so

(07:41):
this kind of message that is being given to 600,000
people across Australia, that, you know, my identity, our identity is,
is somehow risky or problematic. You know, it's it's a
deeply meaningful change that has occurred here. And, you know,
it finally acknowledges our worth and and dignity as a

(08:04):
member of the community, I've always found it incredibly hard
to reconcile the fact that I can be a registered
organ donor. Yet until now, I've been banned from from
donating blood, products and plasma. And it's a contradiction that
constantly reminds us and highlights the the stigma and discrimination

(08:27):
that the LGBTQIA+ community has faced. It's really, really fantastic
to be able to finally perform what feels like a
crucial civic duty. And, you know, it will fill me
with great pride to to donate. It's empowering to know
that my plasma can contribute positively to our healthcare system.

S1 (08:51):
Matthew, thank you for sharing that with us. First of all,
what was your reaction when you heard the news that
this change was coming? And how did those in your
community react as well?

S9 (09:01):
So it was great news to hear. We've known this
has been in the works for a little while, and
it is, you know, a world leading change. It's it's
great to see a more inclusive, evidence based model that
helps to ensure equality and fairness and inclusion without compromising
people's safety. I think that there's a lot of work

(09:23):
to go and our community is very cognizant of that.
But I think this is a really fantastic example of
how LGBTQIA+ inclusion saves lives. When we talk about that
in our community, mostly we refer to our community that
reducing discriminatory barriers and reducing stigma. It's, you know, positive

(09:47):
outcomes result. But in this specific example, it also highlights
a really tangible benefit. You know, when we eliminate prejudice
from these kinds of policies, we're we're directly saving the
lives of countless Australians. Lifeblood is constantly pleading with Australians
to help meet their critical donation shortages. And, you know,

(10:09):
many of us want to, but we haven't been able
to until now.

S1 (10:16):
We'll be right back. And there are, of course, different
rules for plasma and blood and platelets, donations for those
of us who maybe haven't donated before or haven't donated
in a while, what is the distinction between those categories?

S2 (10:34):
So the donation that most people would be familiar with
is whole blood. This is the fastest and simplest form
of donating blood. So once blood is drawn from your arm,
it's usually separated into red blood cells, plasma platelets in
the lab. So it takes ten minutes to donate. And
most people will donate about 470ml, about 8% of the

(10:56):
average adult's blood volume, and you can donate whole blood
every 12 weeks. Now, plasma, which is often referred as
the the golden part of the blood. The process takes
a bit longer. The process is called apheresis. It involves
a special machine that uses centrifugal force to separate the
blood drawn from your arm into plasma, which is that

(11:18):
yellow color, and your red blood cells. And you can
see this happening in the machine while you're sitting there.
So your red blood cells are returned to your body
during the appointment. And donating plasma rather than whole blood
means that twice as much plasma is collected. So over
half your blood is plasma, and you can donate this
much more frequently. So every two weeks, and it takes

(11:38):
between 45 minutes and an hour and a half to donate.

S1 (11:41):
And there was an important announcement, too, about blood donation.
Can you walk us through that please Kate.

S2 (11:47):
Mhm. That's right. So we also learned that the TGA
has approved removing gender based questions for potential blood donors,
which is separate to to plasma. But this won't come
into effect until probably sometime next year. This change would
see all prospective blood donors ask the same questions about
their sexual activity, regardless of their gender and sexuality. So

(12:08):
basically everyone you, me, everyone will be asked if they've
had anal sex with a new or multiple partner, and
if the answer is yes, they will need to wait
three months to donate blood, but they're eligible to donate
plasma with no delay. This means, and this is really important,
that men in long term monogamous relationships will no longer
be discriminated against. So if they're having sex with the

(12:32):
same monogamous partner, they're eligible to donate blood and platelets.
People on Prep will still be ineligible to donate blood,
and that's because it's possible for people on Prep or
Prep to have such low levels of HIV that it
can still be missed in lifeblood's testing for blood, and
that can pose a risk of it being passed on

(12:55):
through transfusion. But people on Prep can donate blood plasma
because of this pathogen deactivation process that goes on with plasma.

S1 (13:05):
Now, I think you both share the belief that this
is a change that's long overdue. The science has advanced, obviously,
but so has society. I think it's fair to say.
How do you both think the stigma surrounding HIV had
hindered progress on this issue? And what do you think
has changed? I'll start with you, Matthew.

S9 (13:22):
For decades, a gay and bisexual men, sex workers and
many transgender people have been unfairly branded as inherently risky
or unclean. And this has been a damaging stereotype that's
rooted in the really traumatic legacy of the Aids crisis

(13:43):
and the infamous Grim Reaper campaign. My community is highly
proactive and aware when it comes to sexual health. You know,
we have a duty to take care of ourselves, but
most importantly, the people around us. And the implication that
our blood is dirty has always been deeply harmful and offensive,

(14:07):
and it perpetuates this, this damaging myth that it just
doesn't have a place in modern Australia. Now these attitudes
have changed, and it's great to see that the policies
are finally catching up to reflect contemporary values, and rigorous
scientific evidence is backing that up. Lifeblood's progressive approach is

(14:31):
a really clear recognition that our community's blood products are
just as safe and valuable as anyone else's, and this
world first shift from lifeblood sends a really powerful message
about equality, about dignity, and about inclusion. And to me,

(14:51):
it underscores the importance of having healthcare policy that is
aligned with modern science and ethics.

S1 (14:59):
Now, Kate, this assessment from the TGA is significant, but
there is still a way to go, right? What are
the next steps for state governments or institutions themselves?

S2 (15:09):
Yeah. So when it comes to implementing the changes to
whole blood donations, lifeblood will still need to update their systems,
their questionnaires. They'll need to train their staff. They'll need
to inform the public before this change can be rolled out,
which they expect to happen next year. Something else they'll
need to do is seek approval from all state and

(15:30):
territory governments. Lifeblood's also said that it will be continually
monitoring the effects of these changes, most importantly the safety profile,
but also things like how this affects donor numbers, how
it affects public perception of donating blood, and essentially just
to ensure that blood donation policies continue to be evidence

(15:52):
based and equitable.

S1 (15:54):
Well, Kate and Matthew, thank you both so much for
joining the Morning Edition.

S9 (15:57):
Thank you. Thank you for having me.

S1 (16:06):
Today's episode of The Morning Edition was produced by Julia Carcasole,
with technical assistance from Taylor Dent. Our executive producer is
Tammy Mills. Tom McKendrick is our head of audio. To
listen to our episodes as soon as they drop, follow
the Morning Edition on Apple, Spotify, or wherever you listen

(16:28):
to podcasts. Our newsrooms are powered by subscriptions, so to
support independent journalism, visit The Age or SM COVID-19. And
to stay up to date. Sign up for our Morning
Edition newsletter to receive a summary of the day's most

(16:49):
important news in your inbox every morning. Links are in
the show. Notes. I'm Chris Payne. This is Morning edition.
Thanks for listening.
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