HIV/AIDS Advocates Raise Concerns About Canadian Health Ministry Ban on Organ Donations From MSM
Some HIV/AIDS advocates in Canada recently raised concerns about a regulation adopted by Health Canada, the country's health ministry, in December 2007 that bans organ donations from men who have sex with men, the Toronto Star reports. According to the Star, the ban prohibits organ donations from sexually active MSM, injection drug users and people living with hepatitis to limit the risk of spreading bloodborne infections, including HIV.
Gary Levy, head of the University Health Network -- the country's largest organ transplant program -- said Health Canada's new regulation formalizes precautions in use across Canada for at least 10 years. The regulations are based primarily on blood donor criteria that exclude MSM, Levy said, adding that the restrictions likely go too far in excluding all sexually active MSM. Levy said transplant surgeons will continue to make the final decision on which organs are suitable for use. He added that many organs from known MSM have been used after physicians determined from retrieval agencies that the donor's sexual behavior did not carry a significant HIV risk. Under the new regulations, physicians will have to sign a form stating they authorized the use of an organ that would normally be excluded, the Star reports.
Phillip Berger, head of family and community medicine at St. Michael Hospital in Toronto, said the regulation is fundamentally flawed because the organ harvesting system depends entirely on the honesty and goodwill of donors and their families. He added that current screening tests can determine the HIV status of donated organs rapidly and with almost 100% certainty. The only risk would come from donors in the "so-called window period, when they've been recently infected" with HIV, which is an "infinitesimal" worry, Berger said. "To exclude bona fide donors because they've had sex with another man ... would exclude a lot of people who are no risk at all" for HIV, Berger added (Hall, Toronto Star, 1/9).
Stephen Beed, an intensive care specialist and medical adviser to Nova Scotia's organ donation program, said the regulation is extreme. "We need to be careful that we don't screen with too broad a brush," Beed said, adding that the screening system is not perfect and that blood tests can produce false positives. According to Beed, the possibility of HIV transmission needs to be weighed against the potential life-saving benefits of organ transplantation. Carole Saindon, spokesperson for Health Canada, said the regulation is based on risk of HIV transmission and not the lifestyle of MSM. She added that MSM who have had sex within five years are at a high risk of HIV (Gillis, Halifax Chronicle-Herald, 1/9).