FDA Lifts Ban On Blood Donations By Gay And Bisexual Men... kind of

[BunsenBurner]

From the document linked by Donna (emphasis is mine):

e BOTS Working Group reviewed and discussed several different options for the MSM policy:
• no change,
• change to a five-year deferral,
• change to a one-year deferral,
• change to a deferral less than one year,
• pre-testing of potential donors, and
• deferral based upon individual risk assessment.

Although not making a change would maintain the current level of safety of the blood supply, as noted above, there is evidence that the indefinite deferral policy is becoming less effective over time. In addition, the indefinite policy is perceived by some as discriminatory. The data that a five-year deferral would be safer than a one-year deferral are not compelling. However, some have argued that a five-year deferral would, in theory, add a safeguard by allowing time for intervention against an emerging infectious disease that might spread rapidly among MSM and be transmitted through blood transfusion. Sufficient data are not available to assess the effectiveness of selecting MSM with low HIV risk based on deferral times of less than one year since last exposure. **The individual risk-based options were not determined to be viable options for a policy change at this time for a number of reasons: pretesting would be logistically challenging, and would likely also be viewed as discriminatory by some individuals, and individual risk assessment by trained medical professionals would be very difficult to validate and implement in our current blood donor system due to resource constraints. ** Additionally, the available epidemiologic data in the published literature do not support the concept that MSM who report mutual monogamy with a partner or who report routine use of safe sex practices are at low risk for HIV. Specifically, the rate of partner infidelity in ostensibly monogamous heterosexual couples and same-sex male couples is estimated to be about 25%, and condom use is associated with a 1 to 2% failure rate per episode of anal intercourse (Refs. 38, 39, 40, 41). In addition, the prevalence of HIV infection is significantly higher in MSM with multiple male partners compared with individuals who have only multiple opposite sex partners (Ref. 28).

[busyparent]

DonnaL, I will take the wet noodle regarding how trans individuals can now self report. However, SOPs will have to be updated to reflect the new guidance and until then, my statement remains accurate.

I also agree that the questions are not perfect, but I do not conclude the intent is to discriminate against the gay community.

Someone with a history of basal cell carcinoma can donate when the lesion has been removed and is fully healed. Someone with a history of melanoma, with margins suggesting little chance of metastasis, can not donate for years. Are cancer patients being discriminated against?

[Hunt]

Are cancer patients being discriminated against?

Of course they are. The question is whether the discrimination is justified or not. That requires analysis of data in order to quantify risks. If Group A has a higher incidence of HIV than Group B, that isn’t assuming anything about any particular member of Group A. This may be annoying if you are a member of Group A who does not engage in the risky behavior that is more prevalent in Group A than in Group B. And if there’s a workable way to reach the risky behavior other than discriminating against all of Group A, that would be preferable.

[busyparent]

Agree with Hunt

[baseballmom]

Who gets paid for donating blood?

[busdriver11]

“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.”

Zero chance. Now our blood may be full of nasty stuff because of exposure to hazardous materials in our job and what Saddam put out there, but the other stuff, no way. But isn’t it really about narrowing the odds? Without doing complete blood testing for every possibility, there are certain groups that generally are very high risk—and groups that are very low risk, for certain threats. Of course anyone’s individual situation can differ.

[nottelling]

I don’t know enough about these issues to weigh in about how the risks should be managed; I trust the experts for that. But I’m very curious as to how Busdriver comes up with “zero chance” that her husband has had (or will have) an affair. People do out of character things all the time. One might say, “Based on everything I know about this person I’ve spent my life with, I think it is very, very unlikely that he’d ever have an affair because it would be so out of character.” But to assert that there is ZERO chance seems a little naive.

[DonnaL]

Perhaps she has kept Mr. Busdriver locked in the basement for the last 25 years?

More seriously, I’ll just assume that Busdriver knows whereof she speaks. On the other hand, I would never have thought my former spouse would ever have an affair, until I learned eventually that there had been something going on with one particular person since even before we were married. I guess I must have missed the grandfather clause exception in our wedding vows!

[busyparent]

Romani- I like your enthusiasm and am thankful you are helping the community. I want to assure you the intent of the blood donor screening is not to discriminate against any specific group of people. Discrimination might happen but I believe there is not a nefarious reason behind it.

One reason a donor center can not do a quick HIV test is because that doesn’t tell us anything about hepatitis or syphilis. People make antibodies to viruses at different rates, but most everyone has antibodies to the tested agents by 12 months.

People who take some medications for enlarged prostates can not donate because that blood is not safe for pregnant women. It isn’t intended to be discrimination against older men, but protection for the unborn. One has to wait 6 months after the last dose of accutane.

Does this explanation help?

[busyparent]

Let me put in a plug for the NMDP (National Marrow Donor Program). If you are under 61, consider registering to donate stem cells, lymphocytes or bone marrow. Many of the things that disqualify blood donors would not disqualify a stem cell donor i.e.:donors from Europe.