At the height of the AIDS crisis, gay men were barred from donating blood because of the greater likelihood that homosexuals could be infected with HIV. Now, the U.S. Government is going to take another look. From the National Journal story:
The U.S. Food and Drug Administration, an HHS agency, has banned blood donation by any man who has had homosexual sex because of the risk of the AIDS virus…Men who have sex with other men, including gay and bisexual men, have an HIV infection rate 60 times higher than that of the general population, the FDA says. They have an infection rate 800 times higher than first-time blood donors and 8,000 times higher than the rate of repeat blood donors. Tests cannot pick up a new HIV infection in the blood with 100 percent accuracy; because blood is often pooled, many people may be at risk from a single infected donor.
But the Red Cross, always struggling with blood shortages, and other groups such as gay-rights organizations oppose the blanket policy. They say that there are other ways to screen out donors at high risk of HIV infection. Sen. John Kerry, D–Mass., has also been pushing for a change in policy. “We’ve been working on this a long time in a serious way, and I’m glad Secretary [Kathleen] Sebelius responded with concrete steps to finally remove this policy from the books,” Kerry said in a statement. “HHS is doing their due diligence, and we plan to stay focused on the endgame – a safe blood supply and an end to this discriminatory ban.”
Kerry has it wrong. The ban wasn’t “discriminatory.” It was based on safety.
Whether the ban should remain based on current conditions, however, is a legitimate question. Whatever the decision, it should be based strictly on science, not an ideological desire to open a door currently closed to gays. None of us has a “right” to give blood. (I was turned away by the Red Cross on 9/11, for example, because I had traveled overseas within a year.)
Bottom line: If gays can donate safely, bring ‘em on! We need all the blood we can safely get. If the risk would still be too great–keep or modify the ban. The Rainbow Flag has no place in the decision making process.
July 27th, 2011 | 12:41 am
Wesley, how right you are. How is that doctors are required to report cases of venereal diseases? Yet, a life threatening illness goes unreported? Now, the nation’s blood supply is going to be threatened by at risk donors. The inmates are surely running the asylum. I would not want to donate blood if I were at risk for Hepatitis C. Fanaticism and ideology have replaced logic and common sense.
July 27th, 2011 | 9:07 am
If you are certain that you are HIV-negative, your civic duty to donate blood far outweighs the DHHS’ hysterical and outdated policies. Obviously anyone, whether Gay or Straight, should not donate blood if they’ve fun a risk of HIV exposure in the past six months or so, but if two Gay men who have repeatedly tested HIV-negative are in a monogamous relationship, there is absolutely NO reason why they shouldn’t donate blood, no matter HOW sexually active they are. The Red Cross isn’t using polygraphs to ensure adherence to this policy. If you KNOW that you are HIV-negative, just say you’re heterosexual and donate blood, because you’ll know you are doing the right thing.
The rate of HIV infection among African Americans is disproportionately high. Can you imagine what sort of outcry there would be if DHHS banned Black Americans from donating blood?
July 27th, 2011 | 9:46 am
I think the policy should be reviewed and either modified or dismissed entirely. The Red Cross desperately needs blood donations. Emergency rooms across the nation could really use the boost. Heck, I bet Norway would love to have extra boosts of blood right now. :(
That said, only donate if you know that you *can* donate. The last thing you want is to risk someone else’s health while you’re trying to do a good deed. I can’t donate because I’m anemic (sad sad) and that’s not good. Every able-bodied person should try to share their wealth.
July 27th, 2011 | 1:03 pm
Interesting.
An acceptable solution today would be to allow “gay” (whatever that means) individuals, specifically gay men, to donate to the blood supply if they have been abstinent for 12 months (yes, 12 months).
I recall an Australian study that claimed to encounter 24 HIV hits out of 4 million donations for “standard” donation policy, and 24/4million from a 12 month “gay” abstinent donation policy.
One problem with blood donation is the pooled approach. Numerous donors of a certain type are pooled and the pool is analyzed. If one donor contaminates the pool, the whole pool is bad.
Until we have better/cheaper rapid testing, there is little else we can do at present.
For what it’s worth, I also recall a case study last year of a Bulgarian woman who received a kidney transplant from a cadaver and she contracted HIV. The threat is real.
padraig Reply:
July 27th, 2011 at 9:08 pm
@David, OK, first, how do they prove they’ve been abstinent for 12 months? How about 12 hours?
Second, you are aware that HIV can be spread via heterosexual sex? Are you going to demand heterosexuals abstain for 12 months? Would you consider that an “acceptable” solution? Better hope you don’t need a transfusion anytime soon.
Depending on abstinence works here about as well here as it does in preventing teen pregnancy, not to mention AIDS prevention.
And I doubt the Bulgarian testing systems are on a par with ours.
David Reply:
July 27th, 2011 at 10:29 pm
@padraig, The Bulgarian testing system is on par in this case. The patient was tested with a NAT (nucleic acid test). There is no test that is 100% foolproof. Note, it is far simpler to offer an HIV test than transplant a kidney – trust me. Do we really think a system could transplant a kidney, but not give an HIV screen?
How does one determine abstinence? The same way one determines “gay” on a questionnaire, or if someone is a “drug user” on a questionnaire, etc, etc.
This is how it is and this is what the data we have demonstrates, whether we like that reality or not.
We could develop synthetic blood. But that would require ingenuity, research, and a mighty intellectual challenge – things humans don’t seem to be particularly gifted at when one considers what most individuals do with their lives and time.
padraig Reply:
July 28th, 2011 at 12:38 pm
@David, the better question is, how does one RELIABLY determine abstinence? Sorry, I’m not going to bet my life on someone else’s self-reporting on a sensitive and possibly embarrassing issue.
And if the Bulgarian system was up to par as you say, then even in the face of this failure I’d be more prone to trust their test than a box someone checks off on a questionnaire. Testing failures can be catastrophic, but at least they’re rare.
The point is, self-reported abstinence is not an adequate, or in my opinion even useful, guarantee of safety. Scientific testing is the best we can do, the rest is politics.
July 27th, 2011 | 2:37 pm
What does the word “risk” mean in the end? It means we really don’t know. Something like blood donation should (and can only reasonably be) based on the particular case, the particular individual. If testing is not 100% reliable, then the risks associated apply equally to all donors/recipients, regardless of the statistics. So what this really means — “it should be based strictly on science, not an ideological desire to open a door currently closed to gays.” — is that the door should never have been closed in the first place.
July 27th, 2011 | 2:55 pm
It is a rainbow flag issue. The rainbow flag has always demanded that gay men be treated differently from other people affected by quarantine concerns.
When else have we called it “discriminatory”, “hateful” or “bigoted” to put common safety concerns above the “equal rights” or “dignity” of high-risk people?
I have heard from reliable sources that HIV can take years to show up in a test. There is no way to know for sure that you are not HIV-positive.
The reason the Red Cross isn’t getting the blood donations it needs isn’t because it is observing reasonable safety precautions. It’s because they got a lot of bad publicity for mishandling blood and other resources in the wake of the Katrina catastrophe.
HistoryWriter Reply:
July 28th, 2011 at 6:34 am
@Blake,
Enough HIV antibodies are usually present to trigger a positive test result by about 6 months post-infection. There may be exceptions, but that’s the general rule.
HW
DaJuan Hayes Reply:
July 28th, 2011 at 9:35 am
@Blake,
Blake writes, “I have heard from reliable sources that HIV can take years to show up in a test. There is no way to know for sure that you are not HIV-positive.”
I don’t know which “reliable sources” you are referring to, but these are the facts:
1: Over half of people who become infected with HIV will trigger a positive HIV antibody test after two months.
2: 90% will trigger an positive result after three months.
3: Very close to 100% will get a positive result after six months.
Those are the facts, and they have nothing to do with whether the person with HIV is Gay or Straight, male or female, Black or White.
It should be noted that people often get confused between how long it takes for a positive HIV antibody test to occur, and how long it takes for a person to progress to AIDS. Just because a person has test HIV-positive does not mean they have AIDS. On average it takes 8-10 years for a person with HIV to progress to AIDS, and an AIDS diagnosis does not HAVE to occur if a person knows he or she has HIV, follows medical advice, and takes antiretroviral medications when needed.
Bret Lythgoe Reply:
July 28th, 2011 at 11:46 am
@DaJuan Hayes, Also, it’s fair to say that, it’s a fragile virus. It doesn’t survive long outside the body. but one should never take chances with it, though. But I think some people obssess about it, and therefore suffer, worrying that they will catch it easily. It’s hard to catch.
But one should check with one’s doctor, to learn all one can about it, and follow his/her advice. I’m not a doctor.
Blake Reply:
July 28th, 2011 at 6:24 pm
@DaJuan Hayes,
DaJuan: and yet it’s been known to take years.
“Very close to”? You mean like 95%? 97%? Those are the numbers I keep seeing.
How funny for an advocate of gay rights to be arguing that 3 to 5% is an insignificant number! LOL!
July 28th, 2011 | 11:39 am
This is a very difficult issue. Since it takes time, for a positive HIV result to be detectable, under current technology, one could, in good faith, give blood, thinking one is HIV negative, and really be positive.
DaJuan Hayes Reply:
July 28th, 2011 at 3:16 pm
@Bret Lythgoe,
The current policy prohibiting Gay men from donating blood was put into place back in 1983, just a few years after the beginning of the AIDS epidemic in the United States. In fact, the HIV antibody test didn’t even become available until 1985. Needless to say, we know a tremendous amount more about AIDS and HIV testing than we did back then.
It is entirely possible for sexually active people, whether Gay or Straight, to protect themselves from HIV infection. One becomes infected with HIV only by becoming inoculated with either the blood or the sexual fluids from someone who is infected. Preventing this is very easy to do. And if two Gay men who have repeatedly tested HIV-negative get into a monogamous relationship, AIDS is not going to arbitrarily STRIKE them like a lightning bolt hurled by an angry and vindictive God.
Bret Lythgoe Reply:
July 29th, 2011 at 3:05 am
@DaJuan Hayes, That’s very important information, thanks.
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