ETA: Not long after this went live, I received word that the HHS committee voted against any revision on the ban. That said, the information here is still relevant to discussions about the ban in general, and it’s my hope that discussion about a revision will come up again soon.
Today marks a second day of hearings debating whether to revise the ban on blood from men who have sex with men at the Health and Human Services Administration. An advisory committee will make recommendations to the FDA, and hopefully these recommendations will lead to some changes, because this policy is discriminatory, it’s offensive, and it’s harmful. It’s time to shelve it, along with other antiquated ideas about the gay and bisexual communities. I say if men who have sex with men want to roll up their sleeves and offer some blood to their communities, bring on the phlebotomists!
The ban has been in place since the 1980s, when the US blood supply came under threat during the AIDS crisis. There was actually a great deal of controversy with several blood banks asking gay donors to voluntarily defer before a formal recommendation for a ban was made; these banks were criticised for ‘exceeding their mandate’ by taking a step that would eventually be adopted by the whole blood industry. Incidentally, the resistance from the blood industry to making changes to ensure the safety of the blood supply, like screening blood for contaminants, was quite entrenched and incredibly shameful.
The ban is not a deferral period, as is the case for most things that exclude people from donation. It is a lifetime ban. If you are a man who has had sex with a man since 1977, you are not allowed to donate blood in the United States. Period. End of discussion.
Meanwhile, if you are a heterosexual man who has had sex with a woman whom you know to be HIV positive, there’s a year waiting period on blood donation.
Let me reiterate this: The FDA has determined that a year waiting period to eliminate any possible concerns is enough if you have been exposed to a known risk factor for HIV infection and you are heterosexual. Meanwhile, if you are a gay or bisexual man, you are banned from donation for life unless you haven’t had sex with a man since 1977. Regardless of risk factors. Only had one monogamous partner since 1977, and you’ve both been tested? Banned. Only had protected sex since 1977? Banned. Get regular HIV tests that are always negative, and been tested since the last possible window period? Banned.
Rooted in very real concerns about skyrocketing rates of HIV infection in gay men in the 1980s, the ban as it stands today is clearly homophobic and biphobic. It limits availability of blood from numerous gay and bisexual men who would be absolutely delighted to donate. And it perpetuates some of the worst kinds of stereotypes about gay and bisexual men, their sexuality, and their relationships.
It sounds like what’s being considered right now is a year waiting period; men who have sex with men will be allowed to donate, in other words, if they haven’t had sex with a man in the last year. I am not thrilled by this. I am, in fact, pretty unthrilled by this. It’s a small step in the right direction but it still treats gay sex as a risk factor, rather than focusing on screening for more meaningful risks, like whether someone has had unprotected sex.
Keeping the blood supply safe is of paramount importance. Because of the way blood is processed, a single contaminated donation can result in significant wastage. I am absolutely in support of measures that will screen for potential hazards and address them. The ban on blood donation from men who have sex with men is not such a measure.
I would prefer to see a blanket lift of the ban, with the understanding that the questions people already answer at the time of blood donation adequately check for obvious risks that might make a donor of any gender or sexual orientation unsafe.
What the ban is basically saying is that all men who have sex with men are the same, and always have been. That every man who has had sex with men since 1977 has engaged in unprotected sex. That gay sex itself is scary and dangerous and inevitably ends in a sexually transmitted infection. It implies that men who have sex with men have unprotected sex with multiple partners and unknown partners. It suggests that men who have sex with men are not to be trusted; that a man can’t be relied upon to self report risk factors that might make his blood unsafe. Meanwhile, heterosexual men face no such obstacles to blood donation. Neither do women and people of other genders.
Men who have sex with men are just as varied as everyone else in the world. Like other sexually active people, some of them engage in behaviours that can be risk factors for HIV transmission. Others do not. They can in fact self-report on a blood donation screening form that can be used to determine whether they are suitable donors. Men who have sex with men aren’t on a mission to taint the blood supply. If they were, they’d just lie during the screening. They care about the safety of the blood supply, and they want to be allowed to donate.
There’s no earthly reason to maintain the ban on men who have sex with men.
Dr. Jerry Holmberg, the Executive Secretary of the committee, is the party taking public comments. Please take a moment to email him (jerry.holmberg[@]hhs.gov) to let him know that you favour a lift of the ban on men who have sex with men. No matter your gender or sexual orientation, your input matters. The more blood we can get into the blood supply, the more blood will be available to save lives. And that’s a good thing.