FDA refuses to allow gay blood donations

American Medical Association calls policy 'discriminatory and not based on sound science'
Associated Press
Sep 16, 2013

 

The U.S. gay-rights movement has achieved many victories in recent years — on marriage, military service and other fronts. Yet one vestige of an earlier, more wary era remains firmly in place: the 30-year-old nationwide ban on blood donations by gay and bisexual men.

Dating from the first years of the AIDS epidemic, the ban is a source of frustration to many gay activists, and also to many leading players in the nation's health and blood-supply community who have joined in calling for change.

In June, the American Medical Association voted to oppose the policy. AMA board member William Kobler called it "discriminatory and not based on sound science." Last month, more than 80 members of Congress wrote to the Department of Health and Human Services, criticizing the lifetime ban as an outdated measure that perpetuates inaccurate stereotypes about gay men.

On some college campuses, students have urged boycotts of blood drives until the ban is repealed. Over the summer, activists organized a "National Gay Blood Drive" — asking gay men to visit blood centers, take tests to show their blood was safe, and then try to donate in defiance of the ban.

In the face of such pressure, the Food and Drug Administration — the HHS agency that regulates America's blood supply — has been unwavering. The lifetime ban will be eased, the FDA says, "only if supported by scientific data showing that a change in policy would not present a significant and preventable risk to blood recipients."

Under the auspices of HHS, a few studies are in progress that might lay the groundwork for a review of the policy. Department spokeswoman Diane Gianelli said the studies reflect a commitment to "continuously improving the safety and availability of the nation's blood supply."

However, some activists are impatient at the prospect of a research process that's likely to extend over several years with an uncertain outcome. They argue that the U.S. could move now to emulate Spain and Italy, where blanket bans on gay blood donations have been replaced by policies that ban donations by anyone — gay or straight — who's recently had unsafe sex, while allowing donations from gays and bisexuals whose blood is tested as safe and whose sexual behavior is deemed to pose no risk.

"We do not think HHS is moving fast enough," said Jason Cianciotto of Gay Men's Health Crisis, a New York-based nonprofit engaged in AIDS prevention and care.

Cianciotto said the ban "perpetuates the stigma that gay and bisexual men are dangerous to public health," and thus undercuts efforts to combat HIV.

The FDA says its policy is not intended as a judgment on donors' sexual orientation, and instead is based on the documented risk of blood infections, such as HIV, associated with male-to-male sex.

According to the FDA, men who have had sex with other men represent about 2 percent of the U.S. population, yet accounted for at least 61 percent of all new HIV infections in the U.S. in 2010.

The FDA implemented the ban in 1983, when health officials were first recognizing the risk of contracting AIDS via blood transfusions. Under the policy, blood donations are barred from any man who has had sex with another man at any time since 1977 — the start of the AIDS epidemic in the U.S.

Critics say the policy has been rendered obsolete by advances in testing which can which can detect HIV — the virus that causes AIDS — within days of infection.

Some critics say the lifetime ban could be replaced with a policy barring blood donations on the basis of gay sex within the past 12 months, or the past five years — as Canada recently decided to do. Others say there should be no set time periods, and that the screenings — as in Spain and Italy — should focus on high-risk behaviors of both gay and straight people, while making it easier for gays in monogamous, safe-sex relationships to qualify as donors.

"It's very personal to a lot of people who would like to donate and yet are barred while knowing themselves not to be at risk," said Brian Moulton, legal director of the Human Rights Campaign, a national gay-rights group.

"People perceive of giving blood as a civic duty," Moulton added. "The current policy puts gay and bisexual men who are going to be honest in an awkward position during a blood drive. People ask, 'Why aren't you giving blood?'"

The FDA acknowledges that the ban leads to rejection of many healthy donors.

However, it says the policy "minimizes even the small risk of getting infectious diseases such as HIV or hepatitis through a blood transfusion." And it says the blood supply in the U.S. has been stable.

Susan Stramer, executive scientific officer with the American Red Cross, agrees that the magnitude of the blood supply isn't a decisive factor in the debate.

"We have a surplus of blood," she said. "The question is about what's equitable."

The push for changing the policy gained momentum in 2006, when the Red Cross, the American Association of Blood Banks, and America's Blood Centers reported to an FDA-sponsored workshop that the ban "is medically and scientifically unwarranted."

Over the next few years, the California State Assembly and the city councils in New York and Washington, D.C., urged repeal of the ban.

Faced with such appeals, HHS sought input in 2010 from its Advisory Committee for Blood Safety and Availability. The committee concluded that the donor-screening policy is "suboptimal" — permitting some potentially high risk donations while preventing some low risk donations — but recommended that the ban on donations by gay and bisexual men be retained pending further research.

In March 2012, HHS asked for comments on a possible pilot study to assess alternatives that would permit some gay and bisexual men to donate blood while maintaining the current high level of blood safety. That study has yet to begin.

Regardless of the pilot study's fate, Stramer said it's possible federal officials could gather enough data from other ongoing research to make an incremental change, such as emulating Canada by barring donors who've had male-on-male sex during the previous five years.

"We've mounted as much pressure as can be mounted," Stramer said. "Now it's a question of time... The best we can hope for is a gradual change in policy."

Stramer doubts there will be any groundbreaking findings from current studies. Their goals include evaluating the questionnaire presented to potential blood donors to ascertain their risk level, assessing the risk that quarantined blood donations might accidentally be released into the blood supply before being cleared via testing, and examining the phenomenon of some gay and bisexual men thwarting the ban by not acknowledging their sexual activity.

HHS, in a statement provided to members of Congress, said it hoped the studies would yield data sufficient to support a reassessment of the lifetime ban.

"The Department is committed to a full evidence-based evaluation," HHS said. "If the data indicate that a change is possible while protecting the blood supply, we will consider a change to the policy."

Moulton, the Human Rights Campaign official, says he is frustrated that the ban persists and yet acknowledges that scientific data gleaned through deliberative studies could help strengthen the case for change.

"I hope people understand there is a public health aspect to this that isn't there in other aspects of the (gay-rights) movement," he said. "We understand HHS is doing what they have to do."

Dr. Louis Katz of America's Blood Centers, a national network of community-based blood programs, favors replacing the lifetime ban with a ban on donations from men who've had male-on-male sex in the past 12 months. Though he shares the frustrations of more militant advocates, he advises them not to view the FDA as antagonists.

"The FDA is not homophobic — they are risk-averse," said Katz, the network's executive vice president. "We are going to get rational on this only by being patient and dogged."

Katz says activists campaigning for change would be wise to solicit input from groups representing hemophiliacs and other users of blood banks whose overriding goal is to keep the blood supply safe.

The past president of one of those groups, the World Federation of Hemophilia, says he'd be open to changes in current policy if they are based on authoritative research.

"What we support very much is a review of the policy," said Mark Skinner, the federation's president from 2004 to 2012. "We want to move toward a system that reduces discrimination but does not increase risk."

 

Comments

registerer

Interesting position for the AMA. I served in the Army and was stationed in Germany during the 80's. My wife also lived there and my daughter was born in Germany as well. To this day, if we give that info, the American Red Cross will not allow us to donate blood. Something about mad cow disease in Europe during that era.

So, I ask, AMA what do you have to say about that?

Nemesis

Clearly, it's because they're haters, right?

ladydye_5

All the technology of today and it cannot be tested to be sure it is "clean"? Do they not test ALL blood? What is the difference? I must not understand something. Not every gay person is ill and not every straight person is healthy. This is the 21st century, wake up! We have technology for a reason. USE IT. I must be missing something.

Licorice Schtick

Experts devote their lives to knowing everything they can about a particular subject, but the moment they go to work for the government, people who know little or nothing about it are ready to dispute their judgement.

That's stupid.

Kudos to you for recognizing that you must be missing something.

It's reassuring to know that a Federal agency is willing to suspend political correctness for the sake a of safer bloot supply. Surely they've done the arithmetic. I'd like to see the numbers.

Factitious

Even if it's true that the facts that led to the policy are no longer true, it does not necessarily follow that the policy is no longer valid. That's clearly part of the position the FDA is taking. Less clearly, it seems they are also suggested that the facts we have now still support the policy.

At least two of the proposed interrim changes are no less discriminatory. So why bother?

The blood industry (I don't know if Red Cross makes money on it, but others do) seems to be promoting this change. I would like to know how it affects their bottom line. Are gay rights activist their dupes?

"...an outdated measure that perpetuates inaccurate stereotypes about gay men."

Nah. There's a lot of stuff that contributes to stereotypes about gay men. This one isn't of much consequence.

"...students have urged boycotts of blood drives until the ban is repealed."

Brilliant. Punish the people who need the blood.

"We do not think HHS is moving fast enough..."

That comment seems to reflect a sense of priorities twisted way beyond mere bias.

"...studies could help strengthen the case for change."

Or strengthen the case for no change.

Nemesis

ladydye, the tests are not foolproof.

Ehovemom

Banning "gay" blood is ridiculous. Persons who identify as "gay" do not have any "gay only" diseases to pass on. Persons who are gay have the same diseases as anyone else and hopefully all donations are screened. I guess it is not the 21st Century in the Red Cross world.

VOTENO

Boycott all blood!

The Big Dog's back

Really? If the Dr. tells you that you need blood now or you will die, I don't think you're going to ask whose blood it is.

Factitious

Ignore the troll.

VOTENO

Boycott all red blood now!

Justme...

Oh for goodness sakes big dog. You are smarter than that. It has to do with higher rates of HIV not the fact that the person is gay.

deertracker

Lots of women get HIV from their husbands!!!!!

Justme...

These decisions were based on statistics.

rippedhippy1

More than husbands getting it from wives? Unless you happen to be a stat?

Justme...

I get the frustration of the gay community, in light of the fact that screening should make the ban unnecessary. Of course you can understand why they instituted the ban in the 80's. But to try to organize boycotts for blood donation? Wow. No words. It sounds like they care waaaay more about their own cause than they do about saving lives, which is the point of giving blood. Kinda selfish (not mention ironic) if you ask me.

Nemesis

Actually, boycotts of blood donation just make it easier to follow the regulation.

Tool Box

I think they are worried that gay blood injected into straight men will create more gay men!

deertracker

Reminds me of the hitman that needed blood but would only accept it from his hitman buddies! Died of AIDS a few years later! KARMA?

goofus

Urban Legend????? or are facts ands references not your strong suit!!!!!

deertracker

Joe Scarpa! Look it up or is reading not your strong point?

SanduskyExpat

@deertracker, it seems that reading isn't your strong suit either. It was Gregory Scarpa Sr., who refused blood donations from the hospital because he didn't want blood from African Americans.

deertracker

You got me on that one. I stand corrected. I did not read it I saw it on tv. However, the only thing I got wrong was his first name because I didn't think most would identify him with his nickname.......the grim reaper. Oh yea, those dirty black people are going to give a hitman aids. How did that work out?

thinkagain's picture
thinkagain

Two percent of the population account for the highest percentage of the HIV population. It's an HIV thing, not discrimination. It's better to err on the side of caution. Grow up and get over your victim hood pathology.

starryeyes83

HIV hasn't gone away. Remember Elizabeth Glaser?

This is an issue of public safety.

Gays can't have it both ways. This same article was on yahoo the other day, and it was interesting reading the comments.

The Big Dog's back

Ahhhhh, yes they can starry.

starryeyes83

I disagree.

The Big Dog's back

AC-DC.

starryeyes83

I wasn't referring to the switch hitters, BD.

Perkins2060

How will they know if one is a gay?

happyfeet64

It is an outdated policy. Not every person who has contracted HIV has contracted it through unsafe and high risk behavior. If you are going to continue the ban then maybe you should also ban any donations coming from the baby boomers since the CDC is pushing for testing for HCV,since there are an estimated 3 million with the virus. In the next 25 years it will kill more people in the US than all the AIDS cases combined. One of the ways it was introduced was through our domestic blood supply before identification was made. If they continue supporting such an outdated policy, maybe they should consider banning ANYONE who received transfusions during the '70s,'80s and '90s.

Nemesis

No, not every person, but the correlation is more than strong enough to warrant their caution.

2cents's picture
2cents

Historical data and the start of the epidemic are based around gay men traveling to the Africa's to have sex with young men. If my history is correct the disease came from monkey bites the banana pickers received doing their job and was transmitted to the men who visited. Lets not make this a rights issue, it is a safety issue and if we are in short supply of blood then we can use it if necessary. Can anyone for sure tell you that this disease is not lying dormant in some people and would propagate in others? It is the safe thing to do for now, if we get into WWIII then we can start drafting 15 year old boys and girls as well!

ladydye_5

Is there no way to TEST the blood to be sure it is not INFECTED? Do they not test ALL blood before it is used anyway? How do they KNOW if some one is gay? When Joe Schmoe walks thru the door do they just ask him if he is gay? What happens if he lies?

starryeyes83

It doesn't show in the blood , right away.

Nemesis

The test is not foolproof. They ask if the donor has engaged in certain acts.

They also ask if the donor has visited certain countries, and reject them if they have - is THAT because they're haters, too?

They have detailed statistics regarding carriers of blood-borne pathogens, and without any judgement, reject donors whose history correlates with those statistics. Period.

Stop It

I was in the hospital in 2010 after an accident. They had me stoned to the gills with pain killers and asked me 1 and 1/2 hours of questions. I just wanted to sleep. I still knew, that I personally didn't/don't want to put on resuscitation. They came in the next day and asked if I needed a blood transfusion if I would accept. I said, "NO, and I told ya that yesterday."

Nurse proceeded to ream my butt and cuss me out saying it wasn't the same. Huh? If I need that transfusion to stay alive, that is resuscitation, to me. She was throwing things when she walked out. Ah well, I don't trust the blood. I made my point known.

When, I turned on the TV full volume...well...I reckon she got the message.

B*^%& unplugged my TV on the way out. Hadda call the nurses station to get it back on. It was funny then, and is now. And no, I did not fill out a bad report on her.

grandmasgirl

Blood is not just tested for HIV. It is tested for a lot of different diseases. There are many questions asked in the booklet that you have to read and the questions you are asked BEFORE you give blood. There are a lot of people who find out they have a disease BECAUSE they went to donate blood. What amazes me is that on 911 there was a waiting line of over 4 hours to give blood. At the last drive I attended, there were about 50. People need blood all the time, not just during a national tragedy.

deertracker

If you are worried about receiving bad blood, set some of your own aside while you are healthy!

Stop It

No. They might throw mine away and give me someone else's like they had to do in Toledo with the kidney.