The Irish Blood Transfusion service introduced the Individual Donor Risk Assessment (IDRA) in November 2022 in order to bring the national donor selection criteria into alignment with other countries within Europe.
Fundamental to the scientific process is that the risk of transfusion transmitted infection should be as low as possible, and that in most cases there is a window period after infection where blood may be infectious but the levels of the infectious agent are below the limit of detection of modern techniques.
The IBTS uses world leading individual sample nucleic acid testing (NAT) to minimise this window period, compared to the majority of countries in Europe which test using pooled donations. The IBTS introduced a new, more modern testing technique in May 2025 to improve their ability to process and screen samples.
The Health and Lifestyle Questionnaire (HLQ) which underpins IDRA is a set of questions based on rigorous assessment of the scientific evidence that certain behaviours, such as having anal sex with multiple partners or anal sex with a new partner, increase the likelihood of transmission of certain infectious agents, notably HIV, Hepatitis B and C, Syphilis and Gonorrhoea.
The evidence behind these behaviours being higher risk applies regardless of gender and sexual orientation and is very comprehensive.
The HLQ does not contain any questions which discriminate donors based on their sexual orientation. The only questions which identify gender are present because of the scientific evidence that donations from women who have had previous pregnancies may contain antibodies which are clinically relevant. The data recorded makes sure the IBTS use these donations appropriately but does not preclude donors from donating.
The selection of donors and the safety of the blood supply are outlined within EU guidance 2002/98/EC and the IBTS adhere fully to this guidance. The selection of donors for donation is based on the risks to the donor and to the recipient and the established limits of detection within testing methodologies.
Over the period from November 2022 to August 2025, a total of 94 donors (54 male and 40 female) were deferred from donation because of anal sex in the past four months with a new sexual partner and a total of 16 donors (8 male and 8 female) were deferred for having had multiple sexual partners and anal sex with at least one of them.
It is not possible for the IBTS to determine the sexual orientation of these deferred individuals as they neither ask for nor record this, but it is clear that there is no significant difference between the number of men and women deferred under IDRA for sexual behaviours and as such it can confidently be stated that the IBTS are not discriminating against individuals based on their gender or sexual orientation.
PrEP use may interfere with the IBTS testing methodology by extending the window period during which a donation may be infectious and not detected by testing. Given that PrEP use is highest amongst those engaged in behaviours which would also increase the risk of transmission the IBTS have a 4 month deferral for any donor who uses PrEP. The 4 month deferral period is in keeping with other 4 month deferral periods mandated in the Commission Directive 2004/33/EC.
The IBTS is awaiting the outcome of the UK led FAIR study, which Ireland was involved with, to assess how accurately individuals self-report their behaviours to determine if another review of IDRA is required.
The IBTS has engaged with the wider community, including many groups representing sexual diversity such as LGBT Ireland, and are actively promoting the message that these criteria are not based on sexual orientation.
The IBTS has an IDRA Safety Monitoring Committee (ISMC) which includes membership from outside the IBTS. This monitors the impact of IDRA and the incidence of infectious diseases has been tracked post the introduction of IDRA. The IBTS also continue to review selection criteria with internal monthly governance meetings to ensure that they are meeting the optimal balance between accepting donations and ensuring the safety of the blood supply.
The IBTS remain committed to equality within the donation process and to not deferring donors based solely on gender or sexual orientation.
