Gay and bisexual men, including those taking preexposure prophylaxis (PrEP) to prevent HIV infection, can now donate plasma in Australia without any waiting period after recent sexual activity, according to new donation criteria from the government-funded blood supply organization Lifeblood.

Lifeblood is also moving toward gender-neutral sexual activity assessments for blood donation, which means that all donors will be asked the same questions about their sexual activity.

The changes have come about as part of a regular review of donor eligibility criteria, Lifeblood’s Chief Medical Officer Joanne Pink, MD, told Medscape Medical News. This review included consultation with stakeholders, including patients, medical organizations, and groups representing patients with hemophilia. “These sorts of changes take time because we need to ensure that any changes are supported by the best available science and evidence,” said Pink.

In the 1980s, many countries banned gay and bisexual men from donating blood or plasma because of the HIV epidemic. Australia was one of the first countries to revise this practice in 2000 by instituting a 12-month wait after sexual activity to allow for the window period to detect infections relevant to blood safety.

In 2021, that deferral period was shortened again to 3 months, and on July 14, 2025, it was removed entirely for plasma donations from gay and bisexual men, transgender people, men taking PrEP, sex workers, and their partners. The main exception is if the donor’s partner is known to have one of the key blood-borne infections such as HIV, hepatitis C, or hepatitis B.

More Eligible Donors

The inclusion of men taking PrEP is significant because the antiviral prophylaxis suppresses viral replication and can therefore extend the window of negative tests after contracting HIV.

Nevertheless, collected plasma undergoes processing that removes or inactivates any pathogens, said Pink. “This plasma pathway was also independently evaluated by our plasma fractionator, who concluded that there was no change in residual risk,” she said.

The changes make Australia the least restrictive country in the world for plasma donation, which partly reflects the epidemiology of HIV in Australia, said Yasmin Mowat, PhD, a public health researcher at the Kirby Institute at UNSW Sydney, Sydney. “The risk for HIV transmission in Australia is far, far less than it used to be,” said Mowat. “It’s also due to improvements in HIV testing, and that plasma is processed using extra techniques that kill viruses and bacteria, allowing for less-strict donation rules, compared with whole blood.”

Mowat’s own research suggests that the changes will mean that around 626,500 more people will now be eligible to donate plasma in Australia.

The gender-neutral sexual activity questions for blood donation mean that all donors, not just men, will now be asked whether they have had a new sexual partner in the past 6 months or whether they’ve had sex with more than one partner in the past 6 months.

If a donor answers no to either of those questions, they are eligible to donate blood. If they answer yes, then they must answer further questions to determine eligibility.

Promoting Inclusivity

“We wanted to have the same donation experience because it’s really important to us from an inclusivity perspective,” said Pink. Lifeblood’s research suggests that the changes will lead to around 20,000 extra donations each year. There may also be an additional boost from people who have previously refused to donate out of solidarity with gay and bisexual men. “We’re also aware that there are a lot of friends and allies of gay and bisexual men who are already eligible, but they basically don’t agree with our rules, so they don’t donate.”

But the new rules may also mean that some who would previously have been eligible to donate will now be ineligible. “If you’re a heterosexual with a recent new partner or multiple partners, and you engage in anal sex — which is relatively common, particularly in the younger age groups — then you will be deferred,” said Pink.

The blood donation criteria changes have been approved by Australia’s drug regulator, the Therapeutic Goods Administration, but have yet to be implemented nationally.

The changes to plasma and blood donation criteria have been welcomed by the LGBTQIA+ community, said Dash Heath-Paynter, CEO of Health Equity Matters, a national federation of HIV and LGBTIQA+ organizations. “Blood safety is critically important and has always been and will continue to be our top priority,” Heath-Paynter told Medscape Medical News. “But we understand the donation rules have been difficult for many members of the LGBTQIA+ community.”

The feedback from newly eligible donors had been fantastic, said Pink. “People who have not been able to donate for many, many, many years have said it’s life-changing because they feel so included,” she said, and the organization had already received around 1000 additional donations, primarily from gay and bisexual men.

Pink is an employee of Lifeblood. Mowat has received funding from the National Health and Medical Research Council. Heath-Paynter reported having no relevant financial relationships.