Yesterday I donated blood at the Red Cross Blood Drive. As long as I’m not sick, I try to donate blood every time the Red Cross comes to Bates. Donating is a virtually painless, quick and easy way to literally save lives – especially since this time there was an “Urgent Need” for blood. Yet even though it’s encouraging to see so many Batesies happily volunteer to give blood and proudly walking around with “I donated” stickers, it makes me uneasy knowing that many people will never be able to feel the satisfaction of donating blood simply because they are gay. Yes that’s right: Food and Drug Administration (FDA) rules dictate that any man who has had sex with another man at any point since 1977 is banned from donating blood for the rest of his life.
The FDA defends its policy by citing public health risk: “MSM [Men who have Sex with Men] are, as a group, at increased risk for HIV, hepatitis B and certain other infections that can be transmitted by transfusion”.
This policy would make somewhat more sense if the FDA were consistent with their attempts at limiting “high risk” groups from donating; but the rules are nowhere as strict for heterosexual males. A straight male could have unprotected sex with a prostitute, share needles while using IV drugs, or have an HIV-positive opposite-sex partner and as long as all of this happened more than a year ago, you can donate all the blood you want. Even if a gay man has been in a monogamous relationship for the past few decades, has never engaged in unprotected sex, or even has only had sex with another man once, he is banned from donating for life.
The FDA website provides some epidemiological statistics to support their policy:
“Men who have had sex with other men represent approximately 2% of the U.S. population…[but] in 2010, MSM accounted for at least 61% of all new HIV infections in the U.S.”
If the FDA is trying to eliminate the groups of highest risk, then why not ban African Americans and Hispanics from donating blood? After all, the rate of new HIV infections is nine times higher in African Americans (69% of all infections) and three times higher in Hispanics (21%) than white people (9%). Or why not ban all black women, for whom HIV prevalence is 18 times higher than white women?
Of course this is a ridiculous notion – potential donors should be assessed for their individual levels of risk rather than the being lumped into a group of “higher than average risk”. Similarly, MSM should not immediately be banned from donating blood. Instead, a more detailed sexual history should be taken into account before deciding whether or not to allow them to donate.
The policy arose decades ago when there was no reliable test for HIV in donated blood. Nowadays, all donated blood is tested thoroughly by two types of assays that detect HIV antibodies and RNA in the blood, but there still remains a four to seven day window after initial infection when HIV will not be detected by these tests. However, the odds of a man with newly acquired HIV donating blood are almost none. The man would have to have had unprotected sex with someone HIV-positive, gotten infected from that encounter, and have lied to the Red Cross about his sexual orientation. And all of that would have to occur only a few days before donation. As a result, only one in two million blood transfusions results in an HIV infection.
Recently, several countries have realized this hypocrisy and have altered their policies for MSM blood donation. In 2011, the U.K. eliminated their lifetime ban for MSM donors and instead changed the policy to apply to men who have engaged in high-risk behaviors over the past year. In 2000, Australia also changed its policy to a 12-month deferral period from the previous five-year ban. A follow-up empirical study by the Australian Red Cross assessed the policy change’s effects on the risk of accidental HIV transmission from receiving infected donor blood. The prevalence of HIV among blood donors five years before the policy change was compared to the prevalence give years after the policy change. The study found “…no evidence that the implementation of the 12-month deferral for male-to-male sex resulted in an increased recipient risk for HIV in Australia.” Instead, the study found that one of the biggest problems was due to people lying about their sexual histories. All five cases of donated HIV-infected blood (out of five million total donations) in the five years after the policy change came from men who did not provide a complete sexual history to the Red Cross and were therefore not deferred from donating blood.
It is important to reiterate that it is the FDA and not the Red Cross that enforces the ban against MSM blood donation. In 2006, the Red Cross, American Association of Blood Banks, and America’s Blood Centers presented a joint position to the FDA in an attempt to change the policy. The main idea of the position was “that the current lifetime deferral for men who have had sex with other men is medically and scientifically unwarranted…” and that the policy on MSM “be modified and made comparable with criteria for other groups at increased risk for sexual transmission of transfusion-transmitted infections.”
Earlier this year, the American Medical Association also recommended that the policy be changed to one that would consider the donor based on his individual risks rather than his sexual orientation alone. In a statement from the AMA, board member Dr. William Kobler said, “The lifetime ban on blood donation for men who have sex with men is discriminatory and not based on sound science. This new policy urges a federal policy change to ensure blood donation bans or deferrals are applied to donors according to their individual level of risk and not based on sexual orientation alone.”
The FDA must listen to these groups and reconsider its policy. The lifetime ban should be switched to the one-year ban as it is in Australia and the United Kingdom. The ban on MSM blood donation is homophobic, ignores the pertinent scientific research, and was founded in a time when accurate HIV detection in blood was not possible. The ban on MSM blood donation only serves to reinforce the horrible stereotypes that gay people are somehow “unclean” or are diseased. One can only imagine the type of situations that this ban leads to. In an article in Slate, Mark Joseph Stern points out that “blood drives are common at offices, universities, sporting events, and other social activities where donors are encouraged to tour their good deed with a button or sticker.”
In these situations, gay men would be left unable to contribute and, if he is in the closet about his sexual orientation, having to think of an excuse as to why he isn’t participating. Stern adds that “it isn’t easy, after all, to explain to a colleague that though you’d like to give blood, the FDA, based solely on your sexuality, has deemed you too likely to be diseased.”
In August, Russian MP Mikhail Degtyarev proposed a new policy to the Federal Assembly that would instate a lifetime ban on MSM blood donation. Degtyarev cites the FDA’s policy as a reason for his attempts to instate the ban. The American people have rightfully been vocal in their opposition to Russia’s anti-gay laws particularly as to how they will apply to the upcoming Winter Olympics. Americans must not limit themselves to defending gay rights in Russia. We must eliminate this obsolete, homophobic policy and show Russia – and the world – that America will not stand for institutionalized homophobia.
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