In 1983, more than 10,000 transfusion recipients were infected with HIV from tainted blood. In response, the FDA instituted a lifelong ban on blood donations from any man who'd had sexual contact with another man ("MSM" for short). There are no exceptions, even for celibate men who have tested negative for HIV.
Last month, U.K. Department of Health, acting on recommendation in a report from the the U.K. Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO), lifted their similar law banning MSM blood donations -- provided the men haven't had sex in at least one year. Restrictions have been relaxed in Australia, Japan, Sweden, South Africa and New Zealand. Some think the US should follow suit, but others believe the ban should remain to protect transfusion recipients.
Why a one-year deferral?
The SaBTO report looked at data regarding HIV and related diseases and "additional infectious agents" in the donor population as well as the UK overall population. What SaBTO found is that these diseases can be reliably screened for at the time of donation -- if the donor is not in an "early window infection" stage. This window is between nine days and 12 months, depending on the disease. During the window, test results could be unreliable -a false negative might appear in donors who'd recently engaged in high-risk behavior, who could then transmit the disease to a recipient.
The SaBTO recommended deferring gay males for either one or five years from their last sexual encounter to ensure the window had been exceeded. The UK chose the one-year deferral.
Should the US follow suit and institute a deferral system rather than an outright ban on donations from gay men?
In favor of maintaining the lifetime ban
In 2009, the Center for Disease Control "estimate[d] MSM represent approximately 2% of the US population, but accounted for more than 50% of all new HIV infections annually from 2006 to 2009." This data is the most heavily cited in ban-lifting opponents, who say this creates an increased risk to recipients.
Dr. Jay P. Brooks, a professor of pathology and the director of blood banking and transfusion medicine at University Hospital in San Antonio, says the risk is too great to lift the ban:
The FDA agrees: a petition put forth from the American Red Cross in 2006 called the ban "medically and scientifically unwarranted," but the FDA maintained that the increased risk of HIV infection in the general population was too great to assume.
In favor of lifting the lifetime ban
The American Red Cross continues to advocate a repeal of the MSM donor ban in favor of a deferral system, as does Dr. James P. AuBuchon, president of the American Association of Blood Banks. "Given the sensitivity of the tests we now have available, there is no detectable increased risk of HIV entering the blood supply by allowing gay and bisexual men to donate. . . [U]nits of blood are typically destroyed quickly if they're identified as unsuitable, and blood collectors have a robust protocols — including computer systems approved by the FDA — to prevent erroneous releases."
What the FDA should focus on, says Joel Ginsberg, head of the Gay and Lesbian Medical Association, are "behavioral risks rather than belonging to a particular group" by reworking the donor questionnaire about sexual activity and lifestyle behaviors, regardless of demographic.
There are opponents to this tactic, though--primarily, SaBTO. They felt that "the introduction of extensive donor health check questionnaires regarding sexual history will lead to a loss of existing donors," when presenting their data to the UK Dept. of Health. So there's the dilemma: do you lose part of your current donor base to admit the (very few) celibate homosexual men who could then donate under the new, fairer screening process? That gamble is not likely to be accepted in the U.S. The most viable option for lifting the ban appears to be the one-year deferral adopted in 12 other industrialized nations.
OK, Neatoramanauts: If it were on a ballot, would you vote to keep the blood donation ban for gay men intact, or vote to implement a deferral system?
Sources:
Pro/Con: Two views of U.S. prohibiting gay men's blood donation
American Red Cross Fights Ban On Gays' Blood
Bloody Personal
Britain Lifts Ban on Gay Men Donating Blood. Could the U.S. Be Far Behind?
SaBTO Donor Criteria Selection Review (April 2011) [PDF]
HIV Incidence Report, CDC 2009
Last month, U.K. Department of Health, acting on recommendation in a report from the the U.K. Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO), lifted their similar law banning MSM blood donations -- provided the men haven't had sex in at least one year. Restrictions have been relaxed in Australia, Japan, Sweden, South Africa and New Zealand. Some think the US should follow suit, but others believe the ban should remain to protect transfusion recipients.
Why a one-year deferral?
The SaBTO report looked at data regarding HIV and related diseases and "additional infectious agents" in the donor population as well as the UK overall population. What SaBTO found is that these diseases can be reliably screened for at the time of donation -- if the donor is not in an "early window infection" stage. This window is between nine days and 12 months, depending on the disease. During the window, test results could be unreliable -a false negative might appear in donors who'd recently engaged in high-risk behavior, who could then transmit the disease to a recipient.
The SaBTO recommended deferring gay males for either one or five years from their last sexual encounter to ensure the window had been exceeded. The UK chose the one-year deferral.
Should the US follow suit and institute a deferral system rather than an outright ban on donations from gay men?
In favor of maintaining the lifetime ban
In 2009, the Center for Disease Control "estimate[d] MSM represent approximately 2% of the US population, but accounted for more than 50% of all new HIV infections annually from 2006 to 2009." This data is the most heavily cited in ban-lifting opponents, who say this creates an increased risk to recipients.
Dr. Jay P. Brooks, a professor of pathology and the director of blood banking and transfusion medicine at University Hospital in San Antonio, says the risk is too great to lift the ban:
"If the current policy is changed or eliminated, we just don't know what the increased risk to the blood supply will be. We could have one additional HIV-positive unit released every 10 years, every 20 years — or one per year. . . But if the policy is changed to relieve the stigma, you have a risk that has been transferred to a completely different group — the recipients — and I think that is an unfair situation."
The FDA agrees: a petition put forth from the American Red Cross in 2006 called the ban "medically and scientifically unwarranted," but the FDA maintained that the increased risk of HIV infection in the general population was too great to assume.
In favor of lifting the lifetime ban
The American Red Cross continues to advocate a repeal of the MSM donor ban in favor of a deferral system, as does Dr. James P. AuBuchon, president of the American Association of Blood Banks. "Given the sensitivity of the tests we now have available, there is no detectable increased risk of HIV entering the blood supply by allowing gay and bisexual men to donate. . . [U]nits of blood are typically destroyed quickly if they're identified as unsuitable, and blood collectors have a robust protocols — including computer systems approved by the FDA — to prevent erroneous releases."
What the FDA should focus on, says Joel Ginsberg, head of the Gay and Lesbian Medical Association, are "behavioral risks rather than belonging to a particular group" by reworking the donor questionnaire about sexual activity and lifestyle behaviors, regardless of demographic.
There are opponents to this tactic, though--primarily, SaBTO. They felt that "the introduction of extensive donor health check questionnaires regarding sexual history will lead to a loss of existing donors," when presenting their data to the UK Dept. of Health. So there's the dilemma: do you lose part of your current donor base to admit the (very few) celibate homosexual men who could then donate under the new, fairer screening process? That gamble is not likely to be accepted in the U.S. The most viable option for lifting the ban appears to be the one-year deferral adopted in 12 other industrialized nations.
OK, Neatoramanauts: If it were on a ballot, would you vote to keep the blood donation ban for gay men intact, or vote to implement a deferral system?
Sources:
Pro/Con: Two views of U.S. prohibiting gay men's blood donation
American Red Cross Fights Ban On Gays' Blood
Bloody Personal
Britain Lifts Ban on Gay Men Donating Blood. Could the U.S. Be Far Behind?
SaBTO Donor Criteria Selection Review (April 2011) [PDF]
HIV Incidence Report, CDC 2009
Have you had sex in the last year with anyone who has been to eastern Europe?
Have you had sex in the last year with anyone who has been to Africa?
Have you had sex with anyone who uses IV drugs?
I could see another thirty or so questions like that, so I said, "Look, I haven't had sex with ANYONE in the last year! Can we skip all that?"
She looked at me sympathetically and said, "No. We have to ask each question individually. Regulations."
I believe we should maintain the present ban. People need to have confidence in the safety of the blood supply. This isn't a question of 'rights' it is a question of public health.
On the other hand, if the experts in charge of the tests say that the tests only work maybe 99.9% of the time, than the numbers of deaths by disease should be compared to those by lack of blood stock.
Just work the numbers and minimize the deaths.
The one year window is necessary since the test looks for antibodies. If one just got infected, the test would miss it, since it takes a while to develop antibodies. Therefore the one year windows ensures that no one slips through who is in fact infected with HIV.
btw:
I traveled in Europe, so couldn't give blood.
They were right to suspect me of mad cow disease, though.
I didn't get BSE from a burger in the UK; it's hereditary and comes from having gentecially-bonkers family.
Off to resume playing piano with a watermelon and a carney sledgehammer, cyz!
Of course, if this did end up on a ballot at some point, I'm sure the wording would be intentionally misleading: "Do you agree to a law that would make it easier for homosexual men to possibly put HIV in your blood?
No offense to America, but I encourage any MSM who hasn't had sex in over a year to go ahead and donate blood and screw the ban. Saving a life is worth more than laws based on fear and discrimination.
It's an issue microcosmically analogous to the much more tiresome issue of homosexual marriage; in both cases, the proponents are doggedly pursuing 'rights' with an unabashed disregard for the welfare of the institution itself. One is a /tradition/ whose participation in which is pursued doggedly by a community overwhelmingly disdainful of tradition, a tradition rooted in the virtue of community agreement of a couple's fitness to bear children, which, when coupled with social stigma against out-of-wedlock childbirth, certainly had a statistical impact on phenomena such as fatherless teenagers and -let's face it- congenital stupidity. (It's worth mentioning that /every single child/ raised by homosexual couples is denied the statistically enormous advantage of being raised by both of its biological parents). The other is a clinical procedure so bereft of any ceremonial trappings beyond a Chiquita-sized back-patting sticker that one is hard-pressed to keep a straight face to be told that submitting to it is a "right" of emotional import to those citizens so brutally excluded.
We can no more legislate /actual/ equivalence ("equality") of individual talents, dispositions, tendencies or circumstances than we can legislate millions upon millions of firearms out of the hands of criminals. I'm beginning to think that when public schools apparently dropped English and mathematics to make room for K-12th WWII Holocaust and southern US slavery indoctrination, they might have thought to squeeze in some instruction about how life on planet earth IS NOT FAIR.
(Those of you who say "do away with this ban and simply TEST the blood" are either really bad at everyday 'head math' or just so hasty to reflexively voice off in the direction our Universities and Murray Rothstein's MTV train us to that you didn't stop to think it through. I invite you to re-examine the 'dilemma' and comment again)
*google Jared Taylor's excellent THE COLOR OF CRIME, free as .pdf
There just does not seem, given the information presented here, any reason that gay men should be singled out.
JohnJ's point about risky behavior is made nicely by Ginsberg in the interview linked in the article: If a monogamous gay couple who test negative for HIV are banned from donating blood, why then is a woman who was exposed to HIV over 12 months prior allowed to donate? The deferral makes sense, and a continued ban on donations for a risk that can easily be tested for is simply discriminatory.
When you speculate that homosexuals would be "far more likely" to submit to frequent HIV tests, I'm guessing you're thinking of the quintessential 'gay neighborhood' resident or visitor, a white guy with rainbow stickers on his Mazda Miata. The seemingly silly term "men who have sex with men," or "MSM," surfaced to account for the millions and millions of black and Mestizo men who consider themselves to be straight, but who nevertheless... 'have sex with men.' These bisexuals (just don't call them that in their presence) are the principal vectors of HIV into non-intravenous-drug abusing heterosexual women, BTW, and simply put, they overwhelmingly DO NOT CARE about things like conscientious HIV testing. Consequently, the taxpayer-funded effort to reverse this has generated a cottage industry producing ghetto-speak commercials, publishing pamphlets, "protect the blood" bumper stickers with African nationalist colors and symbols, and my favorite: Ebonics-language comic books that indeed have a comic value all their own. Like most bottomless-pit urban social programs, it a 'urinating in the wind' effort. Not gonna change a thing. If our mandatory state religion is correct that "diversity" is the supreme virtue, our future definitely looks bright!
You were one of those guys taking pre-algebra in 12th grade, weren't you?
Neil
By the way author, Australia still has a complete ban on gay men donating. Ridiculous that I have been in a monogamous 13 year relationship and can't donate while any slapper can pick up an anonymous root at the pub and donate the next day.....
(Paragraph 2, Donor Policy Fact Sheet: http://www.donateblood.com.au/files/images/Male%20to%20male%20sex%20Fact%20Sheet_June%202010.pdf)
Wow.
Why "single out" and ban the entire demographic of high-frequency epileptics from highway automobile operation when anyone can have a seizure?
Why "single out" and ban felons from bank security positions when illegal behavior can be practiced by anyone?
Why "single out" and ban children from voting when more than 90% of the population actually falls for the entire, symbiotic, left/right, democrat/republican, conservative/liberal FARCE?
etc.
etc.
etc.
You might go over to wikipedia or just google and plug in the word 'statistics.' It's fascinating stuff.
Statistically, female sexual partners of MSM are more likely to contract and pass along HIV than a male, yet they are deferred for 12 months from exposure.
Statistically, the incidence of confirmed HIV contamination of donations was not higher after than before the ban was lifted in Australia. The total number of donations were higher, though.
The good thing about the US being behind in this particular area is that we can watch hard data roll in from countries who have loosened the MSM donor restrictions to see if there is evidence of increased public risk. If not, then perpetuating the ban is senselessly limiting the available resources for people who need blood transfusions based on an imaginary risk perpetuated by a willful disregard for evidence against it. Statistically, this would mean that more people will die from a lack of available blood than from contracting HIV from a tainted transfusion.
Any group will represent something statistically that is not true for the group as a whole. So rather than targeting a demographic that represents the highest risk, why not target the source of the problem, which in this case is being in contact with HIV any time in the previous 12 months. Anyone can catch it, anyone can spread it, and anyone can engage in the behavior that encourages both of these things. So ask the questions that determine the individual's risk rather than assuming it exists (or in the case of everyone who isn't a gay or bisexual male, assuming it doesn't exist).
Hundreds (if not thousands) of HIV-neg men who have sex with men donate every year by, you know, lying. Because they know they don't have HIV, and they know it's silly to refrain from donating lifesaving biological matter because of homophobia. I know some of them. As an HIV-neg person who cannot donate blood due to a genetic immune disorder, I would be perfectly happy to accept blood from MSMs.
The regulations make sense if you may have contracted a disease of which you are unaware, as from foreign travel. But you may have been a virgin until marriage, and your cheatin' spouse has been having unprotected sex behind your back, and you're happily donating blood with no knowledge of the risk you're conferring on others. That's why it's tested anyway!
Lift the ban or only accept blood from Vestal Virgins, I say.
You posture in the initial ostensibly impartial post as though you're not politicizing neatorama, but later engage in debate that would appear a lot less dubious if you'd at least clear your principal detractors' purportedly 'robot'-censored comments for posting. I was directly and aggressively (not that I mind) addressed by name by your ideological ally "Vivisection," only to have my my speedy and quite substantial response CENSORED, the first instance of which I've experienced on this otherwise laudable website.
Thanks.
Taking someone's word for it is like asking your casual sex partner, while you're undressing, "You don't have anything, do you?" or trusting that man who says, "We don't need a condom, baby. I've had a vasectome."
Laughable.
The ban is discriminatory because it presumes that ANY male-to-male homosexual contact is inherently more dangerous than SOME TYPES of heterosexual contact.
So, if historically, we have deduced that many terrorists are (INSERT HIGH-RISK GROUP HERE), it would be scientific to discriminate against all (INSERT HIGH-RISK GROUP HERE)s, and keep them off of airplanes altogether. But the only screening done is to ask a person if they're (INSERT HIGH-RISK GROUP HERE) before they board the plane. We won't even screen their luggage, or anyone else's luggage, for that matter. After all, they're not (INSERT HIGH RISK GROUP HERE)s. Because people never lie. That wouldn't be very scientific of them to lie.
I support lifting the ban and testing all the blood. Back then the blood banks were fighting tooth and nail against testing because it was expensive and time consuming; they had only ELISA and Western Blot tests at the time. Now the tests are fast, more accurate, and much less expensive. Let gay people donate.