High Risk Sexual Behaviour - Revision history

Maram.Ghiti@anthonynolan.org at 17:25, 19 December 2024

2024-12-19T17:25:11Z

Maram.Ghiti@anthonynolan.org: /* Acceptability at CT / Work-Up */

2024-12-19T17:14:49Z

Acceptability at CT / Work-Up

JoseRosSoto: /* Guidance at VT/WORK-UP */

2018-09-26T10:01:00Z

Guidance at VT/WORK-UP

JoseRosSoto: /* Guidance at VT/WORK-UP */

2018-09-26T10:00:24Z

Guidance at VT/WORK-UP

JoseRosSoto: /* Guidance at VT/WORK-UP */

2018-09-26T10:00:11Z

Guidance at VT/WORK-UP

JoseRosSoto: /* Guidance at VT/WORK-UP */

2018-09-26T09:59:54Z

Guidance at VT/WORK-UP

JoseRosSoto: /* Guidance at VT/WORK-UP */

2018-09-26T09:59:24Z

Guidance at VT/WORK-UP

JoseRosSoto: /* Guidance at VT/WORK-UP */

2018-09-26T09:58:57Z

Guidance at VT/WORK-UP

PaulM: /* Guidance at VT/WORK-UP */

2018-01-26T13:10:22Z

Guidance at VT/WORK-UP

PaulM: /* Guidance at VT/WORK-UP */

2018-01-26T13:08:36Z

Guidance at VT/WORK-UP

@@ Line 3: / Line 3: @@
 ==Acceptability at CT / Work-Up==
-QUALIFIED - MAY NEED TEMPORARY DEFERRAL
+QUALIFIED - A TEMPORARY DEFERRAL MAY APPLY (SEE BELOW)
 ==Individual at Risk==
@@ Line 11: / Line 11: @@
 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.
+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.
 ==Guidance at VT/WORK-UP==
-TEMPORARY DEFERRAL
+The following behaviours are classified as high-risk sexual activities which typically require a deferral period (unless an exception is granted by the MO and TC):
-- Sex with a partner who has been sexually active in areas where HIV is common --> defer for 3 months
+* A donor who has had sex for money or drugs --> defer for 3 months.
-- There is no deferral for men who had sex with men
+* A donor who has had a new sexual partner in the last 3 months <b>and</b> anal intercourse occurred --> defer for 3 months. A donor is eligible to donate 3 months after first sexual contact with one exclusive partner, even if anal sex occurs.
-*QUESTIONNAIRE:
+* A donor who has taken oral or injectable PrEP/PEP --> See [[PrEP/PEP]]
-) Long-term partner/multiple partners?
+* A donor who has participated in chemsex (including the use of stimulant drugs such as methamphetamine, mephedrone, or GHB/GBL) --> defer for 3 months.
-) Protected sex?
+* A donor who has been diagnosed with gonorrhoea --> defer for 3 months after completing successful treatment and follow-up. A test confirming the elimination of the infection is required. This may be a verbal report of the result from the donor.
-) Via: Vaginal / anal / oral
+* A donor who has had sexual contact with a high-risk sexual partner -- > defer for 3 months if the donor has had sexual contact with a partner who is known or suspected:
-) Partner/s: From high-prevalence HIV area? On IV drugs?
+These deferral periods apply even if the donor has used a condom, though the use of a condom may factor into a TC decision on whether to defer the donation.
-) Paid for sex?
+For the purposes of donor selection, a new partner is someone that a donor has not had sex with before, or a previous partner with whom they have restarted a sexual relationship in the last 3 months.
-) Time from the last sexual encounter
+Deferral periods may be shortened based on individualised risk assessments if the urgency of transplantation outweighs the infectious disease risk. Such decisions should be made collaboratively by the Medical Officer and the Transplant Centre, with a concessionary release form completed if proceeding.
 ==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.
+These guidelines are based on the FAIR III report (2022) and are designed to ensure safety while accommodating an individualised approach to donor selection.
+Chemsex is considered high risk as it is more likely to involve multiple sexual partners, prolonged sexual activity, and an increased likelihood of risky behaviour.
-In many cases, the benefit to the recipient of receiving a donation with vastly outweigh the risk of transmission of an infectious agent.
+Deferral periods apply with the use of PrEP as the medication can decrease the accuracy of HIV testing.
 ==Version==
-Version 1, Edition 3
+Version 2
 ====Date of Last Update====
-June 2016
+th December 2024

@@ Line 3: / Line 3: @@
 ==Acceptability at CT / Work-Up==
-QUALIFIED
+QUALIFIED - MAY NEED TEMPORARY DEFERRAL
 ==Individual at Risk==

@@ Line 36: / Line 36: @@
 *QUESTIONNAIRE:
-) Duration: Long-term partner/multiple partners
+) Long-term partner/multiple partners?
 ) Protected sex?

← Older revision		Revision as of 10:00, 26 September 2018
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−	=QUESTIONNAIRE:	+	*QUESTIONNAIRE:

	1) Duration: Long-term partner/multiple partners		1) Duration: Long-term partner/multiple partners

← Older revision		Revision as of 10:00, 26 September 2018
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−	QUESTIONNAIRE:	+	=QUESTIONNAIRE:

	1) Duration: Long-term partner/multiple partners		1) Duration: Long-term partner/multiple partners

← Older revision		Revision as of 09:59, 26 September 2018
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−	* QUESTIONNAIRE:	+	QUESTIONNAIRE:

	1) Duration: Long-term partner/multiple partners		1) Duration: Long-term partner/multiple partners

@@ Line 25: / Line 25: @@
 TEMPORARY DEFERRAL
-Someone who has had sex for money or drugs --> defer for 3 months
+- Someone who has had sex for money or drugs --> defer for 3 months
-Sex with a high risk partner  (ie with HIV, HBV, HCV, syphilis, HTLV, person who has received money or drugs for sex, person who has injected or been injected with non- medically prescribed drugs)  -> defer for 3 months
+- Sex with a high risk partner  (ie with HIV, HBV, HCV, syphilis, HTLV, person who has received money or drugs for sex, person who has injected or been injected with non- medically prescribed drugs)  -> defer for 3 months
-Sex with a partner who has been sexually active in areas where HIV is common --> defer for 3 months
+- Sex with a partner who has been sexually active in areas where HIV is common --> defer for 3 months
-(There is no deferral for men who had sex with men)
+* Questionnaire:
 ==Justification for guidance==

← Older revision		Revision as of 13:10, 26 January 2018
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	Sex with a partner who has been sexually active in areas where HIV is common --> defer for 3 months		Sex with a partner who has been sexually active in areas where HIV is common --> defer for 3 months
		+
		+
		+	(There is no deferral for men who had sex with men)

	==Justification for guidance==		==Justification for guidance==