By Gennady Vulakh
While many of us were scared of getting our shots and blood tests as children (or remain scared as adults—no judgment here), some of us had no such fear and moved on to donating blood and saving lives. For decades, the U.S. Food and Drug Administration and the local government and organizations have implemented policies to ensure the safety and cleanliness of the blood supply. There are guidelines for recent travel, certain conditions & medications, height/weight requirements, and a slew of other topics relevant to the condition of the blood you’re planning to donate. In light of the COVID-19 crisis, the FDA has adjusted its guidelines for blood donor deferral. Among other things, men who have sex with men (MSM) are now recommended to be deferred if they had sexual contact with another man three months prior, as opposed to the previous policy of twelve months prior. But is that enough?
Blood products collected from donations are critical. Science has not found a synthetic alternative to human blood, so it must be collected from willing volunteers. Blood products are used to help burn and accident victims, patients undergoing operations, and people suffering from conditions like cancer. Because of this volunteer/donor-based supply, and our high-density city, NYC is often in desperate need of blood—and COVID19 has done us no favors. Because of social distancing, roughly 2,700 blood drives across the country have been canceled, resulting in a loss of approximately 86,000 donations. In light of this, the FDA has relaxed its restrictions on MSM and other people, such as females who have had sexual contact with MSM, and those who have had tattoos in the last year, recommending deferral of three months as opposed to one year.
But why are men who have had sexual relations with other men deferred from donating blood? The answer, of course, stems from the HIV/AIDS crisis. From 1977 to December of 2015, MSM was banned from donating; however, since 2015, MSM (or women who have had sexual contact with an MSM) had to wait a year since their last sexual encounter with another man (or the MSM in question). This was out of fear that MSM (AKA gay/bisexual/queer or questioning men and any women who had sexual contact with those men) were at a higher risk of HIV/AIDS. But what, if any, foundation is there for that fear?
Donated blood is tested for pathogens and diseases of all kinds, regardless of the questionnaire taken before the donation, including HIV/AIDS. Since April of 1985 HIV testing was done on the blood supply, and the supply was declared clean of HIV by July. Rigorous testing continues to this day. In 1998, thirteen years after the lifetime ban on MSM from donating, the Blood Donation Rules Opinion Study (BloodDROPS) stated that “the prevalence of HIV infection in male blood donors who reported that they were MSM was determined to be 0.25%, …much lower than the estimated 11%-12% HIV prevalence…”
With the exaggerated risk of HIV/AIDS in MSM (and their female sexual partners) and the continued rigorous testing of blood regardless of MSM status, many have asked the question: why continue the deferrals? While it’s nice that with the turmoil of COVID-19 we have reevaluated some long-standing (arguably) prejudicial policies, it is long overdue.
In my opinion, it is essential to recognize systems of prejudice and oppression from every angle and institution. It may seem small and insignificant, but the denial of MSM as viable blood donors is a vestige of homophobia and marginalization. As citizens who strive for equality for all people, we should be finding these institutional defects and correcting them, as allies and as intersectional people all fighting for the same goal. The deferral shouldn’t be shortened, it should be removed. With the testing done on every blood product collected, there should be no reason not to take blood from a willing, and otherwise healthy donor. Gay, bisexual, queer, and questioning men deserve the right to save lives just as much as any other healthy person.
Fabry, M. (2016, June 27). National HIV Testing Day: How the Test Was Invented. Retrieved from https://time.com/4377408/history-hiv-testing/
Marks, P. (2020, April 2). Coronavirus (COVID-19) Update: FDA Provides Updated Guidance to Address the Urgent Need for Blood During the Pandemic. Retrieved April 24, 2020, from https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-provides-updated-guidance-address-urgent-need-blood-during-pandemic
Shaw, M. L. (2020, April 4). FDA’s Revised Blood Donation Guidance for Gay Men Still Courts Controversy. Retrieved April 24, 2020, from https://www.ajmc.com/focus-of-the-week/fdas-revised-blood-donation-guidance-for-gay-men-still-courts-controversy