TEL AVIV, ISRAEL - SEPTEMBER 18: Israeli nurse Gina Eshkol (R) has a blood sample drawn before being vaccinated against smallpox September 18, 2002 at Tel Aviv's Ichilov Hospital in Tel Aviv, Israel. Health and emergency workers are being innoculated against the disease in case of an Iraqi biological weapon attack. Israeli officials say the Jewish State has more than double the Smallpox vaccine needed for the whole population. Baghdad launched 39 Scud missiles against Israel during the 1991 Gulf War. (Photo by David Silverman/Getty Images)
Should gay men be allowed to donate blood? A government health committee is re-examining that question today.
A regulation created at the height of the 1980s' AIDS epidemic banned men who have had sex with another man since 1977 from ever giving blood.
Advocacy groups, blood-collection organizations and some members of Congress are calling for the Food and Drug Administration to revise the lifetime ban, which has been reviewed twice in the past 10 years, but left unchanged.
Groups advocating lifting the ban point to frequent shortages in the blood supply. A new study by the Williams Institute at the UCLA School of Law estimated that if the ban on gay men ended, 219,000 additional pints of blood would be donated annually.
Gay rights organizations say the regulation discriminates against gay and bisexual men. They point out that heterosexual men who have had sex with an HIV-positive partner or a prostitute are barred from donating blood for only 12 months after that contact.
“We’re asking the FDA to look at alternative policies [that also] protect the safety of the blood supply,’’ says Sean Cahill, managing director of the Gay Men’s Health Crisis, an HIV/AIDS organization.
The Red Cross and other blood-collection organizations recommend a one-year ”deferral,” or waiting period, on donations after male-to-male sex, saying the current lifetime ban, established in 1985, is scientifically unwarranted. The policies “should be applied fairly and consistently among donors who engage in similar risk activities,” the Red Cross says.
A one-year deferral period on blood donation by a man who has had sex with another man would produce an estimated 89,000 additional pints, according to the Williams Institute study.
Weighing the HIV risk
The Health and Human Services advisory committee reviewing the policy will hear testimony today and Friday and issue recommendations. The final call, though, will be made by the FDA, experts say.
The FDA, explaining the current policy, points out that men who have had sex with men since 1977 have an HIV prevalence that’s 60 times higher than the general population. The agency contends its first obligation is to ensure the safety of the blood supply.
Still, a group of U.S. senators and representatives, led by Sen. John Kerry of Massachusetts and Rep. Mike Quigley of Illinois, this week asked the FDA to end its “discriminatory” ban.
Earlier this year, the U.S. lifted a travel ban on HIV-positive individuals from entering the country. The Obama administration is basing policies “solely on science,” not stigma and stereotypes, says Brian Moulton, chief legislative counsel for the Human Rights Campaign, an advocacy group.
Kimberly Hagen of the Center for AIDS Research at Emory University says that “from a public health perspective [the ban] no longer makes sense. The ability to screen the blood supply for HIV has become much better.’’ A one-year deferral “makes tremendous sense,’’ she says, making the donor pool as large as possible.
The National Hemophilia Foundation, though, will argue at the meeting for the continuation of current policy, pending further research. “We want the science to dictate the choice,’’ says CEO Val Bias. “We don’t want it to be an emotional issue.’’
The FDA cites the “window period” between HIV infection and the ability to detect the disease as a crucial testing challenge. The current ban, the agency says, reduces the chance that a person would unknowingly donate blood during that period, considered roughly nine days.
The risk of getting HIV from a unit of blood has been lowered to about one per 2 million units transfused under existing policy, the agency says.
Yet federal donor restrictions are inconsistent. Gay men have a five-year deferral period on tissue donations, and no strict rules on organ donations, notes Gary Gates, co-author of the Williams Institute report.
A one-year wait period for gay men should have a negligible or no effect on blood safety, says Dr. Steven Kleinman, senior medical adviser for AABB, a transfusion medicine accreditation organization that supports a one-year deferral
Italy, Spain and France now screen donors for high-risk sexual behavior, not sexual orientation, while Argentina, Australia and Japan have a one-year deferral period, says the Gay Men’s Health Crisis.
Gay men are often stigmatized at blood drives at their companies and schools, and many would like to donate, Cahill says.
Andy Miller is an Atlanta-based freelance journalist. His work has been published by WebMD, AOL's WalletPop and AARP. He was a longtime staff writer at the Atlanta Journal-Constitution.