"In recent years, the criteria for sexual risk behavior among blood donors have been changed all over the world, including Estonia," said Ave Lellep, head of the Blood Center at the North Estonia Medical Center (PERH).

"In 2018, the permanent ban on blood donations from men who have had sex with another man was changed to a 12-month restriction period," Lellep recalled. "A few years later, the restrictions were reviewed and, taking into account both epidemiological data published for Estonia and improvements in donor blood testing technologies, it was decided to further relax the restrictions on blood donation in Estonia."

Beginning in 2022, men in Estonia were allowed to donate blood starting four months after their last sexual contact with another man, she continued. Starting this Friday, the donor questionnaire and selection criteria will be the same for all relationships.

With many countries now allowing men who have had sexual contact with another man to donate blood on an equal basis with other donors, the Estonian Society of Transfusion Medicine (ETMS) put the issue of risk behavior restrictions back on the agenda last year. In order for the new donor selection criteria to be implemented in Estonia, however, the impact of the change on donor blood safety had to be assessed.

ETMS, in collaboration with Estonian blood banks, conducted a risk assessment based on European Medicines Agency (EMA) methodology, taking into account the prevalence of blood-borne infections in the target population and the sensitivity and specificity of the testing methods used by the blood banks to screen donors.

The results of the risk analysis showed that the addition of men who have had sexual contact with another man to the blood donor population increases the residual risk to some extent, but does not change the overall risk estimate for blood-borne viruses (HIV, HBV and HCV). In Estonia, for example, the chances of dying in a car accident or being struck by lightning are several times higher than the chances of contracting HIV, HBV or HCV from a blood transfusion.

As there is no need in Estonia to ask blood donors about the orientation of their sexual relations, starting this Friday, the donor questionnaire and selection criteria will be the same for all donors, regardless of gender or orientation.

Sex work, casual sex and a new sexual partner will continue to be classified as sexual risk behaviors, disqualifying a potential donor from donating blood for a period of four months.

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