Aug Sept 2016
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The Advocate

FDA Formalizes 1-Year Abstinence Update to Gay Blood Ban 

blood donation

The U.S. Food and Drug Administration made formal a previously announced policy revision that loosens the long-standing ban on blood donation by gay and bisexual men, reports BuzzFeed

According to the new guidance, published on the FDA's website today, gay and bi men are now eligible to give blood — provided they have abstained from sex with another man for at least a year.

"The FDA’s responsibility is to maintain a high level of blood product safety for people whose lives depend on it," said the FDA’s Acting Commissioner Stephen Ostroff, MD, in a statement on the website. "We have taken great care to ensure this policy revision is backed by sound science and continues to protect our blood supply."

But when draft guidance was first announced in May, critics were quick to argue that the revised policy is still stigmatizing to gay and bisexual men, as it implies that their blood is more likely to be HIV-positive, despite the fact that all donated blood is screened for HIV and other chronic illnesses and infectious diseases before it is accepted or used in transfusions.  

"This new policy prevents men from donating life-saving blood based solely on their sexual orientation rather than actual risk to the blood supply," said David Stacy, the Human Rights Campaign's director of government affairs, in an emailed statement. "While it's a step in the right direction toward an ideal policy that reflects the best scientific research, it still falls far short of a fully acceptable solution because it continues to stigmatize gay and bisexual men. It simply cannot be justified in light of current scientific research and updated blood screening technology. We are committed to working towards an eventual outcome that both minimizes risk to the blood supply and treats gay and bisexual men with the respect they deserve."

Twitter recently announced that it was ending all company blood drives until the FDA updated its policy and allowed all those willing to donate blood to do so without regard to their sexual orientation. Meanwhile, advocates have pointed to the recent liberalizing of blood donation policies in other nations, including November's news that France will lift its ban on gay blood donors, while in Canada there is hope that the newly elected administration will follow suit, after Canada revised its own long-standing ban in 2013 to allow gay and bi men to give blood after five years of abstinence. 

Since 1983, the U.S. Food and Drug Administration has barred all men who have ever had sex with another man — since 1977 — from donating blood, according to the FDA website. Prior to this new policy shift, the FDA generally considered trans women who have sex with men to be part of the group of "men who have sex with men," who are barred from giving blood. 

According to BuzzFeed, the new rule does address transgender donors but offers little clarity for those hoping to see their gender identity affirmed in FDA-approved blood drives. 

A "note" in the guidelines states that "FDA recommends that male or female gender be taken to be self-identified and self-reported," but does not offer additional guidance. In a statement to The Advocate, FDA spokeswoman Tara Goodin didn't provide much more detail other than saying the policy is an evolution of their previous stance that recognized gender based on sex at birth. Goodin added that the FDA "recommends in this guidance that blood establishments educate all potential donors about the risk of HIV transmission by blood and certain behaviors associated with the risk of HIV infection so that donors can self-defer." 

The HIV and AIDS activist group Gay Men's Health Crisis issued a blistering statement today after the FDA posted its new guidance. GMHC CEO Kelsey Louie said:

"The FDA's 12-month deferral plan would still require gay and bisexual men to be celibate for a full year before they are allowed to donate blood, regardless of marital status and safe-sex practices. Heterosexuals are given no such restrictions, even if their sexual behavior places them at high risk for HIV. In practice, the new policy is still a continuation of the lifetime ban and ignores the modern science of HIV-testing technology while perpetuating the stereotype that all gay and bisexual men are inherently dangerous. Blood donation policies should be based on science, not stigma.

"The United States government has to stop reacting to HIV like it is the early 1980s. Other countries have implemented risk-based deferral systems that reflect modern science and screen all donors for behavior that could lead to HIV transmission. Since Italy implemented this type of system in 2001, transfusion-related infections have actually decreased.

"It is time for the FDA to implement a policy that is truly based on science, not blanket bans on certain groups of people. GMHC is optimistic that we can and should get to a policy that will treat gay people who want to donate blood with the dignity and respect they deserve."

Responding to the criticism, the FDA's Goodin said the new deferral policy "is a behavior-based policy, not one based upon sexual orientation." She contended that "male-to-male sexual contact was associated with a 62-fold increased risk for being HIV positive, whereas the increase in risk for a history of multiple sexual partners of the opposite sex in the last year was 2.3-fold." Goodin twice referenced the new deferral as similar to the policies in Australia, "a country with HIV epidemiology and blood screening systems similar to the United States."

Goodin did emphasize that the latest policy is not forever set in stone and "the FDA will continue to review its donor deferral policies to ensure they reflect the most up-to-date scientific knowledge."

Tags: Health, HIV
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