So I also fall under the mad cow ban, having lived in England 85-87. Thing is, they didn’t pass that rule banning donations for years after I started donating. I have donated gallons of blood in multiple states!
Kind of like closing the barn door after the horse escaped, isn’t it? And why is it a lifetime ban? I thought if you made it 20 years or so it was a good sign you were clear? Or do I still have to worry about not only myself, but all the people who might have gotten my blood in the late 80s and early-mid 90s?
“Kind of like closing the barn door after the horse escaped, isn’t it? And why is it a lifetime ban? I thought if you made it 20 years or so it was a good sign you were clear?”
Risks get reassessed depending on what we currently know about the disease, including the causes and routes of transmission. For instance, a CJD-linked mutation was not discovered until 1990:
Yes, some people still get the smallpox vaccine. But, in the US, almost all people age 45 or older will answer yes to that question (because they themselves had the smallpox vaccine as children), and even most younger people have contact with people age 45 or older more than once every 8 weeks. So almost everyone in the US should answer “yes” to the question about being in contact in the last 8 weeks with someone who had a smallpox vaccination.
just because one partner is monogamous and believes thst his or her partner is monogamous does not mean that the person is, in fact, in a mutually monogamous relationship. Public health decisions should not depend on a person’s being able to answer the question, “Is your partner monogamous?” accurately.
Of course, many of the questions do depend on knowing or guessing things about your sexual partner or some other person (e.g. questions 10, 17, 19, 21, 22, 23 in the questions linked from reply #19). So if your sexual partner or other person has not told you about these things, you may not be able to answer the questions correctly.
Exactly, ucbalumnus. With respect to question 21, after all, if you follow the logic of the preceding comment, no woman who has ever had sexual contact with a male should be allowed to donate blood, because how can she ever be sure that he hasn’t, in turn, had sex with men?
I am fairly sure that most people who haven’t studied this issue drastically overestimate the risk of HIV transmission from a single sexual act (including sex between two men), where one of them is HIV-positive, even when safe sex is not being practiced. That risk is lowered even further when safe sex is practiced, or when one of two men having sex is doing PrEP such as taking Truvada daily.
(From everything I’ve heard, the risk of transmission from two men having oral sex – either giving or receiving – is essentially zero, and there may never have been even one documented case of such transmission.)
Those risks are reduced further when precautions are taken:
So, given the fact that the risk from gay men having oral sex alone is effectively zero even without protection, is it still justified to have a ban for gay men who’ve had any sexual contact within one year? Or to ban a man who’s had other forms of sex with men within the last year, if it’s always been safe sex and the man takes Truvada every day? Yes, I know they might not be telling the truth about themselves, but that’s true of anyone. The policies are based on an assumption that people answer the questions truthfully. After all, how would anyone necessarily know if someone is gay in the first place unless they disclose it? Gaydar is not exactly scientifically accurate!
And why do I read about these things? It actually has nothing to do with blood donations; it’s because I have a 25-year old gay son, and I worry. I find statistics like this – and his own assurances, even though I resist being a stereotypical “Jewish mother” and nagging him about safe sex! – reassuring.
“There are absolutely risky behaviors and they should not be limited to certain populations. Anyone who has had, for example, unprotected vaginal or anal sex should wait for X period before donating regardless of sex/gender/sexuality”
But, but…I have had monogamous unprotected sex with my husband only, for 27 years (as has he), should I be in the same category as sex workers, and non-monogamous gay men? I may have tainted blood because of exposures to hazardous materials or infections from other countries, but HIV-no.
My mom lived in Europe for 3 months in the early 90’s, and mostly ate top ramen there as a college student. Now she can never give blood. Seems like a massive waste of perfectly good blood they could be accepting.
No, you are missing my point entirely. My point is that it is a stupid screening question because people cannot know what their partners are up to. And, by the way, plenty of nuns have sex.
“My point is that it is a stupid screening question because people cannot know what their partners are up to. And, by the way, plenty of nuns have sex.” Using that logic, all the screening questions are stupid, because it also assumes that people are telling the truth on them. The point is that the screening questions only have meaning if people tell the truth. For example, I think Busdriver11 mentioned that she and her husband have unprotected sex but are monogamous, and according to the screening rules she can donate blood, as can her husband…but a gay couple wouldn’t have that same option. Yet I could argue, as you have, that there is the risk that mr. Busdriver might be having sex on the down low, or shooting drugs or other risky behavior that she doesn’t know about.
The reality is that the blood supply these days is protected primarily by the tests they do on the blood supply, and that is why we are protected, the questions they have, because they focus on specific demographics groups rather than behavior, and worse based on self reporting. Right now they allow a married woman to donate blood, even though there is the chance her husband is not monogamous (or she could be having an affair and have gotten infected), and given the sheer number of people who donate blood, odds are such scenarios have played out, the blood was tainted, and screening tests pulled it out.
Put it this way, a question that asks about risky behavior ie unprotected sex with people you don’t know the status of and/or are not monogamous with, is as effective as the questions they have today, and doesn’t stigmatize anyone and also would allow more people to donate blood. The questions will filter out some percent of people, then the testing will take out the rest.
First of all, it was not called a “lifetime ban.” It is called “indefinite deference” because the FDA does not discount the fact that with new research, the risk will be reviewed, just like it happened with MSM. They just don’t know when this data will come up… Therefore, the term “indefinite.” Second, the 12 month deferral is now aligned with the deferral for other high risk groups, such as people coming into contact with blood etc.
^^If you start asking questions that look like prying into personal, intimate details (unprotected sex? how often? anal? etc.), much higher percentage will not answer honestly. It will also turn away many folks who otherwise would be perfect candidates. Who wants to divulge such intimate details to a blood center tech?
We do not pay money to blood donors in the USA in order to encourage people to be honest when answering the screening questions. Doubt people donate just for the free cookies.
One still has to register and answer the questions as the sex they were born.
People from Europe have not come down with Mad Cow, YET. People with a history of cancer also have deferral periods. Recipients of blood are often immunocompromised
If 10 donors show up within 10 minutes of each other, how many are going to stick around for a rapid HIV test to be run on each person. It takes long enough to answer the questions and donate.
The questions are not directed just to gay men. People who have sex with needle using drug addicts, prostitutes, folks with hepatitis are also deferred.
If we deferred everyone who had unprotected sex, there would be a shortage of blood.
Being exposed to some one who had a recent small pox vaccination is not a definite deferral.
12 months is somewhat arbitrary, but do you remember if the unprotected sex you had was 3 months, 6 months 12 months ago? Memory is fickle and a year is a good time span for picking up potential exposures.
All donations are tested for HIV 1/2 Ab, HBC Ab, HBS Ag, HCV Ab, HIV/HBV/HCV by NAT, WNV by NAT, HTLV Ab, T. Cruzi, syphilis.
Speaking of AA women, the hemoglobin requirement for all donors is 12.5. AAs typically have lower HGB than Caucasians and could safely donate at 11.5. 12.5 is low for all men, and the HGB should probably be 13 for them, but as someone said above this is about risk mitigation and doing the best to ensure donor and blood product safety while maintaining an adequate supply to meet demand.
Busyparent, I still don’t see the justification – given the statistics I cited above – for banning all gay men who’ve had sexual contact of any kind (even within the last 12 months), rather than simply banning those who’ve had unprotected sex or even protected receptive anal sex. (Which – news bulletin! – not all gay men ever even engage in.)
Register as the sex you were born? Where is that in writing? – just curious. Of course, even apart from my objection to that dubious terminology (“born” vs. “assigned at birth”), I can’t imagine any trans woman who is legally female and isn’t obviously and visibly trans agreeing to do so. Not that I would ever try to donate blood in the first place given my general health issues, including anemia, but I certainly wouldn’t ever be willing to “register” as male for anything, for any reason. Even if I had ever had sex with men.
If the purpose of the questions is to reduce the amount of wasted collection (i.e. collecting blood from high risk donors, then discarding it due to finding blood-borne diseases), then perhaps the sexual activity related questions can be condensed to:
“Within the last [time period 1], have you had any sexual contact with someone other than a spouse or partner with whom you have been mutually monogamous with over [time period 2], and who does not have any of [sexually-transmitted diseases of concern]?”
where [time period 1] is the length of time between infection and detectability for the [sexually-transmitted diseases of concern], plus a safety buffer, and [time period 2] is something longer.
Of course, some people may answer “no” even though their spouse or partner has been cheating on them or has a sexually-transmitted disease that is not known, so that would not cover all cases. But that is why all blood donations are supposed to be tested.
Although, given the widespread and longstanding reports of a blanket ban on transgender donors at many places (regardless of whether they report a history of having sex with men since 1977) – based on the staggeringly ignorant assumption that all trans women have sex with men – I don’t expect for one moment that the new guidelines will be generally respected.