Abstract
BACKGROUND AND OBJECTIVES: As blood donor deferral policies in many countries transition from blanket time-based approaches towards individualized risk-based approaches, blood services need to understand whether and why men who have sex with men (MSM) intend to donate blood. Such knowledge can help blood services develop communication strategies with a population they have historically excluded. We examined why MSM in New Zealand (NZ) intended or not to donate blood. MATERIALS AND METHODS: In a large and diverse NZ online human immunodeficiency virus behavioural surveillance survey (n = 3838), we asked participants: 'In your own words, please tell us why you intend to or don't intend to donate blood in the future?' We interpreted 2363 responses by MSM using reflexive thematic analysis. RESULTS: We constructed four themes to explain why MSM intend to donate blood: (1) helping out by donating blood, (2) donor ineligibility and hesitancy, (3) considerations of individual and collective risk and (4) discrimination, exclusion, frustration and resentment. Our study showed that whether or not MSM in NZ assessed blanket deferral policies as discriminatory, many MSM in NZ were altruistically and civically motivated to donate blood. Some MSM were reluctant to donate because they were resentful or mistrustful of the New Zealand Blood Service (NZBS) or believed that donating blood was inconsistent with their indigenous values. CONCLUSION: Further research is required to enhance communication, improve MSM's understanding of the donation process and residual risks and accommodate the cultural values of prospective indigenous donors.