It’s Time for the FDA to End Its Ban on Gay Men Donating Blood
A type O shortage is the perfect excuse to switch to the provably safer and fairer policies we should have already implemented anyway
The American Red Cross announced last month it has access to only two more days worth of Type O blood. This “critical shortage” of the most-needed blood type means something needs to change — fast. Someone in the U.S. needs a blood donation every two seconds. And with such a pressing shortage, it’s long past time the Food and Drug Administration (FDA) lifts its archaic ban on gay men donating blood.
The FDA originally banned gay men from donating blood in the 1980s during the HIV epidemic for fear of spreading the disease. In 2015, the FDA reformed the ban to only apply to gay men who had had sex within the last 12 months. Sure, these restrictions may have been understandable at the height of a 20th century crisis, when tens of thousands of people were dying annually from an autoimmune disease spread by contact with bodily fluids of the impacted, and when medical technology was less capable of detecting diseases. But now that modern tests for HIV can see results after just one week, the current FDA policy unnecessarily bars plenty of disease-free potential donors from doing their part to save lives. As a matter of fact, the Baltimore Sun found that lifting this ban could save more than a million lives annually.
The FDA admitted that the previous policy allowed some “potentially high-risk donations while preventing some potentially low-risk donations.” Even the revised 2015 policy does this.
After all, the modified ban doesn’t take into account if the man is in a committed relationship or practices safe sex. It applies even if the man has been recently tested for HIV. Meanwhile, so long as they meet health, height and weight requirements, heterosexual individuals who don’t use condoms or have sex with multiple partners can donate freely.
As former House LGBT Equality Caucus vice-chair Rep. Mike Quigley said in comments submitted to the FDA, the 12-month rule is “not based in science but appears to be modeled after other countries’ choices and fears.”
Many developing nations have restrictive policies in place, and even some wealthy nations have more rigid rules than the U.S. Until 2016, Canada had a five-year abstinence rule for gay men to donate blood, and Australia still entirely bars gay men from donating. However, most nations have been making their rules more lax, with no negative consequences. Scotland, Wales and England have all shortened their deferral period to three months.
Quigley is exactly right. Yes, gay men are more likely than their heterosexual counterparts to contract HIV. But the number of HIV diagnoses among gay men has plateaued in recent years. And there are more ways than ever before to detect and prevent the spread of the disease. With such advanced testing in abundance, there’s no legitimate excuse for the FDA’s arbitrary and broadly exclusionary policy. Today, thanks to our ability to test for the disease, the odds of contracting HIV from a blood transfusion are one in 2 million.
Instead of broad national bans, it should be incumbent upon the blood donation centers to require donors to show proof of a negative status. In Italy, for example, blood donation clinics have implemented an “Assess and Test” model, which relies on blood testing and questions about donors’ behavior, rather than arbitrary bans on certain groups. Columbia Medical Review reports that Italy has seen no increase in infected blood since implementing the policy, which it says allows Italy to “identify individuals, rather than categories, who may present a risk to the blood supply.” Additionally, Spain has no required abstinence period for gay men, instead they test the blood and ask risk assessment questions which help determine if a donor is a “high risk” and “low risk.” Much like Italy, Spain has no epidemic of contaminated blood from allowing gay men to donate.
Doctors also have a role to play in this, by urging their patients to get tested for HIV. According to a 2014 study from Kaiser Family Health, only 61 percent of gay men surveyed said their doctor had advised them to get tested.
The FDA’s ban is particularly egregious following mass shootings or other tragedies that increase the demand for blood transfusions. Take the 2016 massacre at the Pulse gay bar in Orlando, for example. In just the first 24 hours after the attack, the bloodiest on U.S. soil since 9/11, 372 pints of blood were used to help the victims. But, nonetheless, dozens of gay men were turned away from donating to help save their friends, family, and partners. OneBlood even had to issue a press release telling gay men they could not donate, after rumors had circulated that the FDA ban had been lifted and many of them had tried to help.
Less than 10 percent of the U.S. population chooses to donate blood each year. Why, then, bar thousands of disease-free gay men from donating blood and potentially saving lives? Of course, lifting the ban won’t fully address the current shortage the Red Cross is facing, that can likely only be done through education campaigns that encouraged Americans, especially those with type O, to donate. But it could certainly help. Blood donation policies should be based on testing for diseases, not stereotypes that no longer ring true.