After 31 years of barring blood donations from men who have had sex with other men, the Food and Drug Administration (FDA) is set to revisit the policy this week, and potentially lift one of the last remaining federal bans on gay Americans.
A two-day meeting on the issue, which begins Tuesday, comes on the heels of the 26th annual World AIDS Day -- a time when hundreds of events from Argentina to Cambodia took place to honor the 35 million people who have died from the disease, as well as the 34 million currently living with HIV. While no one disputes the fact that the global community still has work to do in terms of creating a truly “AIDS-free generation” (World AIDS Day’s theme this year), many medical experts, lawmakers and LGBT advocates argue that the current FDA ban on blood donations from gay and bisexual men should be left out of the equation.
"We believe that it’s important to screen out high-risk individuals from the donor pool, but the current policy doesn’t do that,” said Dr. Sean Cahill, director of health policy research at the Fenway Institute, in an interview with msnbc. “The ban may have made sense in the early ‘80s, but it no longer makes sense today.”
In 1983, when little was known about HIV/AIDS except for the fact the it was decimating gay communities across the U.S., the FDA imposed a policy that barred any man who’d had sex with another man after 1977 -- the year the epidemic effectively began -- from donating blood. That was a time when AIDS was still considered a “gay plague,” or as Pat Buchanan wrote in a 1983 New York Post piece, nature’s “awful retribution” against “the poor homosexuals.”
Since then, both the medical response to AIDS and the LGBT equality movement have made tremendous gains, leaving behind the era of bigotry and discrimination that for so long painted gay men as diseased. But the FDA blood ban remains a relic from a time that is quickly vanishing. It’s true that gay and bisexual men continue to be the population most profoundly affected by HIV in the U.S. The FDA did not respond to a request for comment for this article, but has in the past defended the blood ban on the grounds that men who have sex with other men account for more than half of new HIV infections in the country.
But while men who have sex with other men still experience higher rates of transmissible diseases, other factors that led to the current FDA policy have changed significantly since 1983. Over the last three decades, scientists have developed highly sophisticated tests that can detect communicable diseases in blood shortly after infection. Blood banks in the U.S. currently screen every donor sample using a process known as Nucleic Acid Testing (NAT), which can pick up HIV in a unit of blood as soon as nine days after the donor was infected.
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Therefore, prohibiting a man from donating blood simply because he had sex with another man in 1977 no longer makes scientific sense. If that sexual encounter resulted in an HIV transmission, NAT would have no problem weeding it out of the nation’s blood supply.
The American Medical Association, American Red Cross, America’s Blood Centers, American Association of Blood Banks (AABB), and the American Plasma Users Coalition have all stated that a lifelong ban on gay and bisexual male blood donors is no longer medically necessary. Additionally, a number of lawmakers have called for an end to the ban.
But still, it lives on.
“I think it’s still here because there’s been a lack of attention to do anything about it,” Ryan James Yezak, founder of the National Gay Blood Drive, told msnbc. “We’re seeing that change now; people are coming forward.”
Some universities and workplaces have boycotted blood drives because they find the current policy discriminatory. Additionally, more than 44,000 people signed a National Gay Blood Drive petition calling on the Department of Health and Human Services and the FDA (an agency within HHS) to end the ban on gay and bisexual blood donors. That goal now looks to be in sight, with a recent recommendation from an HHS advisory panel to change the policy from a permanent ban to a one-year deferral for men who’ve had sex with other men.
Should the FDA follow suit, the new policy would allow a gay or bisexual man to donate blood as long he lets a year pass without having sex with another man. More than 20 countries have replaced similar lifetime bans with deferral periods that vary in length from six months to five years. Australia, Britain and Japan all have 12-month deferral periods like the one HHS recommended for gay and bisexual male donors. And furthermore, in the U.S., a one-year deferral period is perfectly sufficient for heterosexual donors who engage in what is arguably riskier behavior than two men having sex.
“The current situation is one in which a straight guy can walk in and say, ‘I had sex with a sex worker last week,’ and he’s deferred for a year. But a gay man who tested negative for HIV last week, and whose husband is HIV-negative, and they’re in a monogamous relationship -- he can’t donate blood ever,” said Cahill.
Based on these facts, Yezak is confident the FDA panel is going to make the same recommendation as HHS and push for a one-year deferral, which some insist is still too conservative of a policy.
“I hope that they take a more progressive recommendation that reflects science,” said Yezak. “The HHS recommendation was overly cautious, and I think the FDA could go a step further.”
But change, many argue, has to start somewhere. And this one could save lives.
According to the Williams Institute, lifting the current ban could increase the total annual blood supply by between 2% and 4%, adding up to 615,300 pints of blood each year. Changing the ban to a 12-month deferral would add about half the number of pints, which -- tiny though it may seem -- could mean the difference between life and death.
“We frequently have blood shortages, so 2 to 4% is not 20 to 40, but it’s still significant, and if you’re the person lying in a hospital and in need of a pint of blood, that would make a difference to you,” said Cahill.
"There are several million gay and bisexual men who could donate blood, but aren’t considering it. And that’s really tragic."'
Easing the ban would also have a huge impact on the lives of the new donors.
“An overwhelming majority of gay men don’t have HIV, and we’re unable to share the gift of life with other Americans,” said Cahill. “That’s unfortunate from a public health perspective, but also from a human perspective. There are several million gay and bisexual men who could donate blood, but aren’t considering it. And that’s really tragic.”