FDA To Consider Adjusting Restrictions on Gay Blood Donors

Federal policies barring any man who had ever had sex with a man from donating blood began in 1983 as the HIV/AIDS crisis ravaged parts of the U.S. Today, in an age of highly effective blood testing and much lower transmission rates, the regulations feel more like a relic of gay panic than a public safety measure.

This week, the Food and Drug Administration will consider recommendations from the American Medical Association, the Department of Health and Human Services and numerous gay advocacy groups to adjust the rules that prohibit blood donation by any man who has had sex with another man since 1977. Trans women who have sex with cis men currently face the same restrictions as gay men. The recommendation is to drop the lifetime ban in favor of a one year deferral period, which would prohibit men who have had a sexual encounter with a man in the last 12 months from donating.

The policy mirrors those in the England, Australia and Japan, which have one-year deferrals. A study by the Australian Red Cross found that the policy change there led to no increase in the number of HIV-infected units but an overall increase of 900,000 units donated. Scientific and medical evidence demonstrates that the policy would keep blood recipients safe, and it would be a step forward for gay rights, advocates say.

“The evidence is there; they’re just being cautious about implementing it,” said Ryan James Yezak, founder of the National Gay Blood Drive, to the Washington Post. “[But] we will get to where we want to be. . . . People want to serve their country. They want to do this thing that other humans partake in. Not being able to do this is wrong.”

You can watch Yezak speak before the HHS blood advisory committee on November 13th, the day they voted 16-2 to recommend the policy change.

The policy under consideration still may exclude men in longterm, monogamous same-sex relationships despite their very low risk for HIV. According to Vox, “the FDA has maintained that it still hasn’t figured out which eligibility questions they’d need to ask to ‘reliably identify’ gay men who are at a lower risk of infection.”

Today, World AIDS Day, is an important opportunity to remember the history of HIV and its impact on gay and queer communities both as a medical epidemic and a social disaster. Gay and bi men fought from their sick beds for their partners’ right to visit them in the hospital and to receive inheritance. Meanwhile, politicians like President Ronald Reagan literally laughed off the devastating illness in 1982, five years after the outbreak began and a year before the FDA banned male gay and bi blood donors.

The Silence = Death campaign began in New York in 1987.

The Silence = Death campaign began in New York in 1987.

So this week, as the FDA considers this important change, let’s remember how AIDS continues to brutalize queer and people of color (and QPOC) communities disproportionately, examine how we still stigmatize AIDS patients and criminalize gay and bi men, sex workers, drug users and others as potential AIDS carriers, and continue working to eliminate the disease around the world. Find a local or national AIDS research or advocacy organization to support — The National AIDS Trust in the UK and the AIDS Research Alliance in the U.S. are good places to start.  A change to FDA policy matters not just because it is based on sound science and will potentially increase blood donations — it would be a powerful and tangible step away from a culture that criminalized homosexuality and AIDS for decades.

Adrian is a writer, a Texan and a divinity student at Vanderbilt University. They write about bisexuality, gender, religion, politics, music and a whole lot of feelings at Autostraddle and wherever fine words are sold. They have a dog named after Alison Bechdel. Follow Adrian on Twitter @adrianwhitetx.

Adrian has written 143 articles for us.

11 Comments

  1. I mean, it’s a step in the right direction, but why keep a 12-month deferral period? I’m not intimately familiar with the finer details of blood donation procedure, but isn’t the blood tested for HIV after it’s taken anyway? Why not just do away with the ban altogether? There might be a legitimate reason (please tell me if there is), but I feel like there would still be an unhealthy level of stigma surrounding both HIV and people with penises having sex with other people with penises even if the recommendation was followed.

    • Totally agreed, Erica. But, the FDA has an opening to add further clarity and exceptions to the policy while they’re reviewing it this week, so I’m very curious to see what the new regulation actually looks like before I say it’s not enough of a step.

    • The blood is tested, but the general rule of thumb is that HIV can’t be ruled out for 3 months after last sexual contact or other high risk activity, such as intravenous drug use. The blood you donate is used before then, so there is always a chance of transmitting HIV in a blood donation. The initial point of the ban was to keep the highest risk population from donating. The interesting thing was they didn’t keep the second highest risk population from donating, which was high by a significant margin, which suggests a bit more politics than concern for health. Black women who have sex with men are that second highest population.

      As of 2010 CDC stats men who have sex with men, which I believe they define as anyone with a penis, still account for 63% of all new infections. This excludes infections from intravenous drug use by men who have sex with men. Of course new infections are down to about 50,000 a year.

  2. I have conflicted feelings about this. People with penises who have sex with people who have penises are still the highest risk group for HIV and HIV new infections per year in the Western world. So to me it makes sense that this is one of the many groups that is not allowed to become blood donors. Getting a transfusion is a risk and I’d like to keep this risk as low as possible for everyone who needs it.

    While it bothers me that even monogamous homosexual men are not allowed to donate blood, it also makes some kind of sense. No one (no matter what orientation) can ever be 100% percent sure that their partner does not cheat on them. Compared to the rest of the population the percentage of HIV in the population of gay and bisexual men is so so much higher that even a cheating partner will put you at a so much higher risk than a straight guy, straight woman or gay woman will ever be in a monogamous relationship.

    So I don’t think this “law” is based solely on discrimination but has it’s problems.

    The new approach is interesting but still excludes the biggest part of gay men and a big part of trans women.

    • I agree, there are definitely valid reasons. I think whether or not the ban is still needed relies on how big of an epidemic HIV is in our particular country. Men who have sex with men can make up 90% of all reported cases, but it won’t matter if there are only 10. Statistically speaking I really don’t know where 50,000 is in the spectrum of things, I just know that it’s a lot smaller than what it was.

      As for women who *only* have sex with women, as defined by having a vagina, and don’t use intravenous drugs, we’re not even a statistic. I’m not saying go crazy, but apparently there has only been 5 cases. I can’t tell when the start date is on that number though. The CDC doesn’t bother to chart us. We can’t even begin to be compared to the other groups.

      • I don’t know where you got your stats from, but there’s no way ‘men who have sex with men’ make up 90% of all reported cases… more like 65%. But more importantly, the number of cases from other sources (IV drug use, women having sex with a seroconverted man) tend to be widely under reported and most often happen in low-income communities. More importantly, 60% of all young people with HIV don’t even know they have it (including women who’ve had anal sex with men). Putting all the focus on MSM is putting one’s head in the ground as to where the new infections are coming from. Yes, a cis woman having sex with another cis women has a negligible chance of transmission, but there are a lot of other factors like drug usage, one partner doing sex work and having sex with bi women which raise those odds. Oddly enough, some of the incidence of transmission due to drugs has gone down because so much of the opiate drug usage is no longer by injection.

        • I don’t know how you read my comment my comment but I didn’t say that. I even said in a comment above that men who have sex men make up 63% of cases, not including intravenous drug use.

          My point was even *if* msm made up 90% of cases IT WOULDN’T MATTER if the amount of cases was so small it amounted to say a hypothetical 10 a year. I was trying to emphasize the importance the number of infections, not just the percentage of the pie one population has of those infections.

          I really don’t see how I could be misconstrued?

  3. I’m not at all an expert, but I think the argument is that there could be a more evidence-based system that screens blood donors based on risky behaviors as well rather than sexual orientation alone, and that the data backs this up as a method of quantifying risk of HIV transmission. Ie, a monogamous gay man is at lower risk of being HIV+ than say, a straight man who has had unprotected anal sex with multiple women. So you could ask potential blood donors about number of partners, if protection was used, and what type of sex acts, as well as whether they were MSM, and get a more accurate assessment of that individual’s risk of being HIV+.

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