If Jason Goncalves has to answer detailed questions about his sex life in order to donate blood plasma, he'll grit his teeth and do it.
Never mind that heterosexual men don't face the same inquiries, including whether they are in a monogamous relationship.
Goncalves said he's just happy to be allowed to give blood plasma – something he hadn't done since he was in high school because of a ban on blood donations from gay and bisexual men who are sexually active with other men.
"It's odd to me how prehistoric the rules still are," the 33-year-old from London, Ont., said. "But it does feel pretty amazing to actually be able to know that I'm contributing to possibly helping other people's lives."
Goncalves was allowed to make his donation as part of a pilot project by Canadian Blood Services that began recently in London and Calgary.
It grants men who have sex with men the chance to donate their plasma, so long as they and their partner have been monogamous for the past three months.
Elsewhere in the country, men who have sex with men can donate blood or plasma only if they have abstained from sex for at least three months.
Canadian Blood Services is working to update those rules and plans to submit a request to Health Canada later this year to abandon time-based requirements for gay and bisexual men.
"We recognize it isn’t ideal to be asking gay, bisexual and other men who have sex with men questions that aren't asked of other donors," it said.
"That’s one of the reasons Canadian Blood Services will make a submission to Health Canada by the end of 2021 to use sexual behaviour-based screening for all donors."
For now, the pilot project is a small step forward.
It imposes a 60-day hold on plasma donated by sexually active gay and bisexual men. The donor then has to return and donate again, and the first donation will only be used if both samples pass screenings for pathogens, such as HIV and hepatitis – which all donations are tested for.
If the donor doesn't return within nine months of their first donation, Canadian Blood Services said, Health Canada requires that the plasma be tossed. Other donors aren't subject to that same requirement.
Many criteria can affect a person's ability to donate blood or plasma, such as the use of some prescription drugs and having recently received a piercing. But Goncalves said the strictures for men who have sex with men are rooted in inaccurate stereotypes that gay men are promiscuous.
"I'm just really confused as to how a man who has maybe slept with 100 women in the last month – unprotected or not, they don't even ask that question because they don't care – it's OK to donate blood and their blood will get used straight away," he said.
The pilot project only deals with plasma – the part of blood that carries nutrients, which when separated from the rest of the blood is a wheat-coloured viscous fluid.
In some cases, Canadian Blood Services says, parts of the plasma are used to create drugs for people with burns, bleeding disorders and immune deficiencies. In other cases, patients with conditions such as liver failure and severe infections receive plasma transfusions.
The restrictions on donations from gay men have prompted fierce backlash given that Canadian Blood Services has said there's always a need for plasma.
The agency and its regulator, Health Canada, cite the higher proportion of HIV among gay men as the reason for the stricter rules.
Data from the Public Health Agency of Canada from 2018 suggests half of the roughly 62,000 Canadians living with HIV were men who have sex with other men.
But that shouldn't be the basis of what remains a "discriminatory" policy, argued Elisabeth Vesnaver, a postdoctoral fellow at the Ottawa Hospital Research Institute who is conducting research on the project in Calgary and London.
"People that donate in this program will be outed, they will be treated differently and their plasma is treated differently," she said.
Vesnaver interviewed gay and bisexual men in London and Calgary, and found many were reluctant to donate because of harsher earlier policies.
"There's this real lack of trust in the blood organization," Vesnaver said. "Individuals that I spoke to had personal histories of hurt because they were excluded from corporate blood drives, or school activities, or perhaps excluded from family cultures of donation."
She's helped Canadian Blood Services redesign its questions to gay men so they feel less singled out.
The agency has been working to repair its relationship with the gay community for years.
What started as a lifetime ban against sexually active gay men donating blood moved in 2013 to a requirement that men wait five years after having sex with another man before giving blood. Over time, the waiting period reduced to one year, and then to three months.
The ultimate goal is to remove restrictions on blood donated by gay men, but Canadian Blood Services has been held back by a lack of science, said Jacquie Gahagan, vice-president of research at Mount St. Vincent University.
Gahagan, whose pronouns are they and them, said authorities tend to "default to a narrative of risk avoidance" when it comes to plasma donations from men who have sex with men and gender diverse groups.
"You'll look at the data presented in the papers, and it will say: 'The data don't indicate a significant risk. However, if there's any risk, we should err on the side of caution, essentially, and not change the ban,'" Gahagan said.
For the time being, Goncalves said he's just happy to finally be able to donate plasma.
"It's a small step in the right direction," he said. "I'm just glad that it's a step at all."
This report by The Canadian Press was first published Oct. 22, 2021.
Nicole Thompson, The Canadian Press