What Is The Policy In The Us
Despite efforts by advocates to change regulations in the U.S, the ability for gay and bisexual men to donate blood is still restricted.
A ban on gay and bisexual blood donors has been in effect since the early 1980s when fears about HIV/AIDS were widespread.
The Food and Drug Administration’s current policy states a man who has sex with another man in the previous three months can’t donate. Federal rules previously made such donors wait 12 months before giving blood, but due to low blood supplies during the pandemic the federal government changed the policy in April.
The Red Cross said they are participating in a pilot study funded by the FDA using behavior-based health history questionnaires, similar to those used inthe U.K.
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A Civic Duty On The Wane
During World War II giving blood was seen as patriotic, and the American Red Cross collected more than 13 million pints a year. When fighting ended Americans continued to offer their blood out of a sense of civic duty.
But even before the pandemic, giving had significantly declined. Weve had less and less blood donors every year for a decade, says Kate Fry, CEO of Americas Blood Centers, a national organization of 600 blood collection sites. Only about 3 percent of eligible donorshealthy people between ages 17 and 75, who weigh at least 110 poundsactually donate blood.
The lifetime ban on gay men giving blood was imposed in 1985, the year actor Rock Hudson died of AIDS-related illness. It included all men whod had sex with another man since 1977, the year the AIDS virus is thought to have first become present.
Though the deferral period has become shorter over the years, the problematic assumptions it is based on are the same, says Jason Cianciotto, vice president of communications and policy at Gay Mens Health Crisis , an HIV/AIDS service organization.
It is predicated on the belief that you get HIV based on who you are, not what you do, Cianciotto says. GMHC advocates for a shift from the present identity-based deferral system to one that is more individualized and risk-based.
If All Donations Are Tested For Transfusion
Despite the use of the most sensitive and accurate testing methods available today, there is still a period of time after a person becomes infected when it is not yet possible to detect the presence of HIV, hepatitis and other infections. This is called the window period. A window period blood donation means a recently infected person can unknowingly transmit a virus through donation and the donor may still test negative because testing methods cannot detect this early infection. A window period donation increases the risk for transmission of HIV and viruses that cause hepatitis B and C infections.
The use of blood donor screening questions helps to assess the time frame for a potential window period donation to reduce the risk of transmission of the undetected virus to a patient.
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Who Writes The Policy
The FDAs Center for Biologics Evaluation and Research regulates and establishes standards for the collection of blood and blood products. The center receives advise on this issue by the Blood Products Advisory Council, which meets regularly to consider issues such as altering the pool of potential blood donors.
Asking The Right Questions
Part of the difficulty of introducing an individual risk assessment is making sure that the public are comfortable with personal questions they will have to answer and finding a setting, face to face or online, where those questions will be appropriate, explains Smithson.
“There is a lot of value, potentially, in moving toward this individualised case-by-case risk assessment system but it has to be got right.”
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American Red Cross Statement On Fda Msm Deferral Policy
The American Red Cross seeks to build an inclusive environment that embraces diversity for all those who engage with our lifesaving mission. As such the Red Cross believes blood donation eligibility should not be determined by methods that are based upon sexual orientation and is committed to working with partners toward achieving this goal.
In April 2020, the U.S. Food and Drug Administrationwho determines blood donor eligibility– reduced the deferral time for men who have sex with men from 12 to three months. The Red Cross is encouraged by this action, which we view as an interim step to achieving our greater goal. But the Red Cross also recognizes that further progress is needed, and we continue to strongly support the expanded use of new research and technologies to work toward elimination of donor eligibility questions that would no longer be necessary.
The ADVANCE Study concluded enrollment on Sept. 30, 2022. Researchers from the participating blood centers will complete their work by the end of 2022, which includes completing follow-up visits with participants into the fall, and then forward the information to the FDA to determine the next steps. We would like to extend a heartfelt thank you to the LGBTQ+ community partners, study participants, and all those who supported the groundbreaking ADVANCE Study as we all seek to make blood donation a more inclusive process while maintaining the safety of the blood supply.
Additional Considerations For Gay Men Donating Plasma
Even though gay men are allowed to donate plasma, there are additional considerations. Gay men must abstain from sex with other men for three months before donation. That means if you plan to donate more than once, you’ll need to abstain each time.
Some plasma donation centers allow one donation a month. For gay men who have sex with men, that means they’ll need to abstain consistently to donate monthly. Advocates for the LGBTQ+ community are working hard to revise this requirement, which many see as unfair and unnecessary.
DoNotPay can help straighten out eligibility requirements and get you donating as soon as possible.
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If Officials Can Test For Hiv In Blood Why Dont They Allow Anyone To Donate And Then Destroy Tainted Units
Every donated unit of blood undergoes a rigorous series of tests to determine any possible presence of HIV, hepatitis, syphilis and other blood-borne disease. None of these tests, however, are 100 percent accurate, and they can produce faulty results. For instance, despite current restrictions and testing of approximately 12 million units donated each year, 10 HIV-infected units have slipped through. To ensure the safety of blood and other tissues for donation, the FDA uses scientific data to automatically defer certain populations. Because gay and bisexual men have higher incidence of disease, they are eliminated from the donor pool immediately.
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“It really amounts to being an effective ban, based on a person’s identity rather than an actual factor on the science,” she added.
In 2015, the guidance changed from a lifetime ban to a 12-month deferral, and the FDA determines the guidance used by all U.S. blood collection organizations.
Restrictions on blood donations from gay and bisexual men, who are considered to be at high risk for HIV or AIDS transmission, date back to the 1980s.
Gay and bisexual men undergo individual risk assessments instead of time-based bans in countries around the world, recently including Greece and France, according to international reports. Italy, Israel, and several other countries have similar requirements.
In 2020, ABC News broke the story that several major blood donation organizations — including the American Red Cross, Vitalant, and OneBlood — announced that they are working together to study and provide data to the FDA to determine if eligibility based on an individualâs risk can replace the current time-based deferral system while maintaining the safety of the blood supply.
Vitalant told ABC News in a new statement that researchers are halfway toward its goal of enrolling 2,000 participants across eight cities: Washington D.C., San Francisco, Orlando, New Orleans/Baton Rouge, Miami, Memphis, Los Angeles, and Atlanta. They encourage gay and bisexual men who are 18 to 39 years old to participate in the research.
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Previous Changes To Blood Donation Rules
The emergence of AIDS in the early 1980s and the recognition that it could transmit via blood changed the U.S. blood system.
Due to a lack of effective screening methods, a poor understanding of potential risk factors, and heterosexist perceptions, the U.S. implemented a lifelong ban on MSM, preventing them from donating blood between 2015 , the FDA changed the indefinite deferral to a 12-month deferral from the most recent sexual contact with another male. The organization selected this time window to allow adequate time to detect potential infections present in the blood. Research notes that this change did not result in an increase in HIV incidence among first-time donors.
In April 2020, in light of COVID-19-related blood shortages, the FDA further reduced the deferral to 3 months to respond to the urgent need for safe blood products.
Researchers have suggested that the current criteria rely on old biases and that scientists should advocate for policies rooted in science and against ones that unnecessarily marginalize groups of people.
Groups such as the Human Rights Campaign advocate for the FDA to revise donation eligibility to evaluate the risk of sexual behaviors equally, without regard to sexual orientation or gender identity.
The FAIR steering group in the United Kingdom suggests the following changes to ensure a fair and safe screening system for everyone:
- allowing those who have only had oral sex to donate
- asking all donors about their sexual history
What Is Plasma Donation
Plasma donation takes a bit more time than regular blood donation because it is more complicated. Blood donors are hooked up to a bag, and blood flows from their vein until it is filled. Once the bag is full, the donation is complete.
Since plasma donation is more complicated than a regular blood donation, plasma donors are often paid. Some donors can make up to $1,000 a month. To maximize compensation, you’ll need to choose the right donation center.
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The restriction on blood donations came out of the HIV/AIDS crisis of the 1980s, when limited testing technology and capacity existed to screen blood for HIV. In 1983, the FDA implemented a lifetime ban on blood donations from all men who had sex with men after 1977.
The FDA removed the lifetime ban and enacted a 12-month deferral period in 2015, meaning gay or bisexual men had to abstain from having sex with other men for at least 12 months before donating blood. That deferral period was reduced to three months in April 2020 amid blood supply shortages in the beginning months of the COVID-19 pandemic.
Despite cutting of deferral periods in recent years, the current federal policy remains a blanket policy covering LGBTQ+ people, and does not take into account individual risk.
“The legacy of bans on blood donation continues to be painful, especially for LGBTQI+ communities,” the White House official told ABC News in a statement. “The President is committed to ensuring that this policy is based on science, not fiction or stigma. While there are no new decisions to announce at the moment, the FDA is currently supporting the ‘ADVANCE’ study, a scientific study to develop relevant scientific evidence and inform any potential policy changes.”
In what seems like a clash over risk vs. stigma, LGBTQ+ advocacy groups and many in the medical community are aligned on the idea that the current federal policy on LGBTQ+ blood donor eligibility is largely discriminatory.
Why Did The Uk Make This Change
The NHS moved to alter its blood donation eligibility rules following a review by the FAIR steering group. The panel determined an individualized, gender-neutral approach to determining who can donate blood, platelets, and plasma is fairer and still maintains the safety of the U.K.’s blood supply.
The findings were accepted in full by the government last December.
Researchers will continue to monitor the impact of the donor selection changes for the next 12 months to determine if more changes are needed, NHS said.
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Risk Of Std Transmission
In some European countries, high-risk sexual intercourses lead to a temporary ban, regardless of the sex of the partner. In fact, advocates for change in other countries note that the ban encompasses all same-sex sexual contact, even if the partner’s HIV status is shown beyond doubt to be negative. Advocates for change point out that a promiscuous straight male is a higher-risk donor than a gay or bisexual man in a monogamous relationship, but the former will usually be allowed to donate blood. Furthermore, in some countries, other high-risk activities determine a temporary ban, such as sexual contact with anyone who has used needles to take drugs not prescribed by their doctor, whereas MSM donors are deferred indefinitely.
Reasoning For The Restrictions
Blood services first and foremost must ensure that all blood received for donation is safe for transfusion purposes. This is achieved by screening potential donors for high risk behaviors through questionnaires and interviews before blood is taken, and subsequent laboratory testing on samples of donated blood.
Blood services commonly justify their bans against MSM due to the marginal increase in the risk for transfusion-transmitted HIV. Other groups with similar restrictions, or complete prohibition to donate blood, due to increased or possible risk for certain infectious diseases include intravenous drug users, recipients of animal organs or tissues, and those who have traveled or lived abroad in certain countries.
In the 1980s, when the HIV/AIDS epidemic outbreak occurred, there was a high prevalence of the disease on MSM and no reliable tests for the virus, which justified blanket bans on blood donations from high-risk groups.
These restrictions are similar to current restrictions on people with certain residence in the United Kingdom, France, or Saudi-Arabia during the height of the BSE epidemic of 1980 through 1996, due to the absence of a test for its human form, variant CreutzfeldtâJakob disease .
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‘the Policy Remains Discriminatory In Nature’
Gunther and Estok share in outrage from the LGBT community over what they call a discriminatory experience.
“Not only is it imperative that gay and bisexual men who are now able to donate blood be allowed to do so without delay, the FDA must also lift the 3 month deferral in its entirety,” said Sarah Kate Ellis, CEO of GLAAD, a LGBTQ advocacy organization. “The policy remains discriminatory in nature, unaligned with science, and continues to prevent LGBTQ Americans from saving lives.”
But those who are deferred under the old guidelines will still have to wait. Gunther said he wants to encourage others like him to keep trying to donate and not be discouraged if they are turned away.
“We have perfectly good blood to give, and we want to give it and help.”
Kate Fry advised that those who are newly eligible under the FDA guidelines should keep in touch with their local blood bank to check on when the facility expects to finalize implementation.
“We’re so excited to have these individuals become donors again,” said Fry. “We are absolutely working as fast as we can as an industry. Patience is what we ask for our guests during this time and we’ll get them into the fold as quickly as possible.”
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The revised guidance also includes people with recent tattoos and piercings and women who have had sex with a gay or bisexual man the recommended deferral period is now three months versus 12 months.
Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, said in a statement: “Based on recently completed studies and epidemiologic data, we’ve concluded that the current policies regarding the eligibility of certain donors can be modified without compromising the safety of the blood supply.”
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Can Gay Men Give Blood
Gay and bisexual men are not automatically prevented from giving blood.
Men who have sex with men and who have had the same partner for 3 months or more and meet our other eligibility criteria are able to give blood.
We assess your eligibility to give blood based solely on your own individual experiences, making the process fairer for everyone.
If you are taking pre-exposure prophylaxis or post-exposure prophylaxis you will be unable to give blood. If you stop taking PrEP or PEP, you will need to wait 3 months before you can give blood.
We appreciate that any deferral is disappointing if you want to save lives by giving blood.
If you have previously been unable to give blood because of the guidelines and would like to donate, please call us on 0300 123 23 23. One of our team can review the new guidelines with you and, if eligible, book your next appointment.