The FDA has declared a relaxing of its restrictions for homosexual men being accepted for blood donations, in light of the COVID-19 pandemic. In March, Red Cross figures revealed a drop-off of 86,000 fewer blood donations across America due to nearly 2700 blood drives that needed to be canceled.
Instead of one year, if a man has sexual intercourse with another man, he needs to wait three months to donate blood. Though, controversy still surrounds that the FDA’s newest advice, as some say it’s has been based not on reality but on the bias. The initial ban on donations was born during an era when HIV wasn’t well known, and few men with AIDS survived.
“Here’s the point: it never made any sense as to how they officially policed that anyhow. How can they know if a gay man is gay? How can they know for a fact if whether potential donors have had sex with members of the same sex?
And how recently? How can they know that the assumed straight male donors haven’t had sex with another man before? How can they know if they are not bisexual?” stated James W. Harcup, a gay man who is a Florida citizen. “It just always seemed so ridiculous to me. And it is also outrageous to assume that homosexual men engage in more risky sexual behavior than straight men.”
Therein lies the rub: These guidelines have stayed in place for years, long after processes exist to check blood products to determine whether they’re safe, regardless of who donates? As per the CDC, all donated blood products are tested for HIV and other pathogens, such as hepatitis C.
The revised policy matches that in the UK, which in 2017 implemented a 3-month deferral policy for bisexual men or gay who wish to donate blood. The whole reason is that they believe men who sleep with men are at a greater risk of getting HIV.
However, “whether or not you donate blood, that blood is tested and verified and assessed before it is even passed. Just because a gay man sleeping with the other men doesn’t make my blood any less sterile. We believe it stems from the 1980s when the virus first came out when people did not really understand it. You are just as likely to get HIV, whether you are gay or straight.
Men who had sex with men (MSM) after 1977 were banned from donating blood from September 1985 to December 2015, when there was a lifetime ban against donating, even though there’d been one sexual experience. The FDA concluded this “indefinite deferment” was “because of the strong clustering of AIDS diseases and the consequent discovery of high rates of HIV infection in that population,” in background data presented in the most recent guidance document.
Thirteen years after the life ban was instituted, 1998 data in the Blood Donation Rules Opinion Study (BloodDROPS) revealed that “the extent of HIV infection in male blood donors who stated they were MSM was found to be 0.25%, which is a lot less than the approximated 11%-12% HIV prevalence in people reporting regular MSM behavior” However, the life ban stayed until December 2015.
Change Was Needed And Came
At that time, it had been decreased to 1 year–meaning a man donor who involved in sex with another man had to abstain from doing this for one year when he wished to donate blood.
The change comes when Anthony S. Fauci, MD, director of the National Institute of Allergies and Infectious Diseases (NIAID) since 1984, has taken a significant role in President Trump’s coronavirus task force. Fauci encountered the execution of this blood donation ban firsthand.
At a series of 2005 interviews with PBS, he explained his role in brokering a function for those activists who modified the FDA’s clinical trial procedure. The consensus at present echoes this opinion. Before the FDA published the revised guidelines, there was a movement among politicians to modify the constraints.
One letter from Democratic senators, who involved several former presidential hopefuls, to FDA Commissioner Stephen M. Hahn, MD, noted, “It is essential that we move away from discriminatory donor deferral policies which prohibit many healthful people from contributing much-needed blood and blood products.” They cited a potential 355,000 fewer blood donations in light of their COVID-19 pandemic, as a significant reason.
Another letter to Hahn from Rep. Alexandria Ocasio-Cortez, D-New York, and House Oversight and Reform Committee Chairwoman Carolyn Maloney, D-New York, voiced a similar opinion: “This antiquated policy isn’t based on current science, defames the LGBTQIA+ community, and weakens crucial efforts to improve the nation’s blood supply as the US grapples with the COVID-19 crisis. The coronavirus outbreak is almost sure to have significant, long-term effects on the country’s blood supply. Revising the present restriction could lead to as many as an estimated 615,000 additional pints of blood being donated annually.”
In a letter to The American Journal of Managed Care®, Jon Oliveira, director of membership and communications to Garden State Equality, a New Jersey-based LGBTQ advocacy and education organization, articulated it best, acknowledging the mixed feelings surrounding this, possibly, meaningful change in thinking: “The FDA’s decision to relax constraints on blood donations from men who have sex with men demonstrates what medical experts have been saying for years: that this ban isn’t based in science but instead discriminatory politics. The FDA’s policy shift is a sign of progress–even though pressured by the requirements of the present crisis–we must adhere to the science and keep fighting for a complete end to this crude, demeaning ban.”
Until that time, the revised limitations will stay in effect through at least 60 days following the COVID-19 emergency declaration that has been lifted. They’ll be revised again, with comments incorporated from the general public.
Health Experts Urge FDA to Ax ‘obsolete’ Gay Blood Donations Restrictions
Amid a blood shortage ignited from the coronavirus pandemic, over 500 health specialists signed an open letter Thursday urging on the Food and Drug Administration to remove “the scientifically outdated ban” on blood donations from gay and bisexual men. This policy traces its origins to the early days of the AIDS crisis.
“As you well know, we’re on the precipice of a severe nationwide shortage of blood products,” the signatories wrote. “This critical shortage could be mitigated if antiquated constraints lacking scientific data were lifted.”
The letter — addressed to the FDA’s Blood Products Advisory Committee and signed by infectious disease specialists, public health professionals, clinicians, and others — comes only two weeks after the FDA revised its blood donation guidelines to shorten the essential sexual abstinence interval for men who have sex with men to three weeks from 12 months.
“While the FDA’s new decision to reduce the prohibition window to 3 weeks is a great step, it doesn’t go far enough in reversing the unscientific ban,” the letter says.
The Signatories demanded “a more scientifically rigorous” strategy to screening blood donors that better reflects contemporary HIV-testing technology.
Their letter asserts that the critical blood deficit resulting from the worldwide coronavirus pandemic is why the FDA should act now to further decrease the waiting period for homosexual and bisexual men. In March, Surgeon General Jerome Adams stated an estimated 86,000 blood donations were lost because of canceled blood drives, and since then, the public health crisis has just grown worse.
The American Red Cross, though, said in a press release shared with The New York Times that the blood supply is stable this month since “many” blood donors stepped up in recent months.
A 2014 research by UCLA Law’s Williams Institute discovered that fully abolishing the homosexual and bisexual blood donation restrictions may potentially unlock over a half-million blood units annually from men who have sex with men — a whole increase in the supply of 2% to 4%.
The letter adds that removing the”ban would raise the number of convalescent plasma donors, a hopeful treatment for COVID-19.”
In recent weeks, homosexual and bisexual guys who have recovered from COVID-19 have sought to contribute their antibody-rich blood for experimental convalescent plasma therapies and have been rejected, including the urgency to those new calls for reform.
Thursday’s letter, issued by LGBTQ advocacy group GLAAD, said that because new blood-testing technologies can definitely detect HIV about a week after infection, it is “unscientific and based on obsolete antibody-based HIV testing algorithms” to need homosexual men to abstain from sex for three weeks before donating blood.
Modern HIV tests search for antigens, which appear in the bloodstream days after infection. Older tests looked for antibodies, which seem weeks and maybe even months following an illness. Gay and bisexual men represent about 70% of all new HIV infections in the US.
The FDA banned homosexual and bisexual men from giving blood in 1983, then revised the life ban in 2015 to a year’s sexual abstinence.
The letter says that other countries have better addressed the problem by making new protocols that ask people about current risky behaviors regardless of sexual orientation. It is described as”a far more scientifically meticulous and nondiscriminatory way to maintaining a safe blood supply.”
Men who are in monogamous relationships and have sex with men, “those on Pre-exposure Prophylaxis [PrEP], and people who consistently use condoms have a particularly low risk of HIV acquisition,” the letter states.
In a report shared with NBC News, the FDA said it “remains committed to collecting the scientific data that support donor deferral policies which are non-exclusive, helping to ensure a high level of blood safety.”
“To explore the scientific validity of such an approach, the FDA is working on starting a pilot study that will register about 2000 men who have sex with men and who’d be willing to donate blood,” the FDA reported. “This study, being held at community health centers in key locations across America, could create data that will assist the FDA in determining donor questionnaire based on individual risk assessment would be as successful as time-based deferrals in lowering the risk of HIV.”
The letter’s signatories join a viable coalition of LGBTQ advocates, politicians, and physicians is calling for the complete repeal of blood donation restrictions on gay and bisexual guys.
The FDA’s updated guidelines came only weeks after 15 Senators sent a letter to the FDA requesting an overhaul in the blood donor guidelines on men who have sex with men.
“The Coronavirus pandemic has created a national blood shortage, and we have to work to increase our country’s supply based on facts and science. The FDA has to change its discriminatory blood donation policies to deal with this challenge and help save lives.
Other 12-month deferral periods have also been shortened under the updated FDA Guidelines, such as for men and women who have traveled to areas with specific Endemic diseases, injected medications, or engaged in commercial sex work.