High Risk Sexual Behaviour

From Anthony Nolan Medical Guidelines
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Acceptability at Recruitment

QUALIFIED

Acceptability at CT / Work-Up

QUALIFIED

Individual at Risk

Recipient

Explanation of Condition

High-risk sexual behaviour is that which puts the donor at risk of infectious diseases which may then be transmitted to the recipient/patient. This risk occurs because the donor themselves currently participate in high-risk behaviour, or currently have sex with someone from a high-risk background. Importantly we rely on donors to assess their own individual risk.

The aim is to reduce the risk of 'window period' transmissions, where a donor is infected with (for example) HIV, but the infection is too recent to be picked up by our screening tests and the infection is passed to the patient. For this reason, donors who have participated in high risk sexual behaviour say over one year ago, but do not do so currently, should be allowed to donate.

There is no strict definition of what high-risk behaviour/background is, but it would include those who have unprotected vaginal or anal sex with multiple partners (with a higher risk in men who have sex with men, or MSM), those who pay (or are paid) for sex, those from an geographical area with a very high prevalence of HIV and those with other sexually transmitted diseases.

Unprotected sex within a monogamous relationship is not necessarily seen as high-risk behaviour, regardless of whether it is a same-sex relationship.

Guidance at RECRUITMENT

UNACCEPTABLE

Guidance at VT/WORK-UP

TEMPORARY DEFERRAL

A man who has had oral or anal sex with another man (with or without condom) --> defer for 3 months

Someone who has had sex for money or drugs --> defer for 3 months

Sex with a high risk partner --> defer for 3 months

Sex with a partner who has been sexually active in areas where HIV is common --> defer for 3 months

Justification for guidance

With use of modern screening techniques, the risk of unintended transmission of an infectious disease is very small. Stem cell donors undergo in-depth medical and sexual health questionnaires, and will have a face-to-face interview with donor centre staff, allowing ample oppotunity to identify those donors at increased risk of contracting a window-period infection.

In many cases, the benefit to the recipient of receiving a donation with vastly outweigh the risk of transmission of an infectious agent.

For these reasons, the employment of fixed deferral periods for certain groups deemed to be at a higher risk of developing window period infection, particularly men who have had sex with men, is not recommended.

Version

Version 1, Edition 3

Date of Last Update

1 June 2016