Wednesday, November 25, 2015

Gay men should be allowed to donate blood

As gay individuals fight for the right to marry, there is another struggle for gay rights that deserves more attention than it is receiving. And this one may be a matter of life and death. It is the fight to abolish the ban on gay male blood donation.

Gay men should be allowed to donate blood


As gay individuals fight for the right to marry, there is another struggle for gay rights that deserves more attention than it is receiving. And this one may be a matter of life and death. It is the fight to abolish the ban on gay male blood donation.

At the start of the AIDS crisis in 1985, the Food and Drug Administration (FDA) issued regulations that prohibit any man who has had sex with another man even once since 1977 – the year the FDA considers the start of the AIDS epidemic – from ever donating blood. The goal was to screen out potential donors who had the highest risk of being HIV-positive. While the rule may have successfully prevented a few donations from HIV-positive individuals, it has blocked needed donations from many healthy individuals as well.

Gay men are not the only ones at heightened risk of infection. Studies show that male circumcision decreases the transmission of HIV from women to men by 60 percent. Are uncircumcised men prohibited from donating? No. And African American women have a higher rate of HIV infection than white women. Are African American women prohibited from donating? No. Then why are gay men prohibited from donating? 

While men who have had sex with men still are affected disproportionately by HIV and AIDS, it is a person's actual behavior, not his sexual orientation, that puts him at risk say health experts. Any type of sex without a condom, whether between a man and a woman or between a man and a man, carries a risk of HIV transmission.

A heterosexual man or a woman who has had sex with an HIV-positive partner is restricted from giving blood only for one year from the date of that contact. Why are gay men banned for the rest of their lives – especially when labs can screen for HIV within days of infection?

The nation's blood banks have called a lifetime ban “medically and scientifically unwarranted,” and numerous attempts have been made over the years to lift it. In June 2010, a federal court upheld the ban citing a lack of sufficient scientific evidence to justify lifting it. In July 2011, the federal Department of Health and Human Services (HHS) announced that it would have to study four critical issues before reconsidering whether the ban should stay in place. In June 2012, a group of 64 U.S. Senators sent a letter to HHS encouraging it to move forward with the study; however, it is yet to be completed and the ban remains in effect.

In the meantime, this past summer, the Red Cross reported that the nation’s blood supply dropped to its lowest level in 15 years. But as the blood supply dwindles and hospitals issue pleas for donors due to critical shortages, our nation’s blood banks continue to turn away healthy, willing donors because of the ban.

The Red Cross and other blood banks support a one-year deferral on blood donation after a man has sexual contact with another man, which should alleviate concerns of possible HIV or AIDS transmission. While this policy would still prohibit men who recently have had sex with other men from donating, it would significantly increase the number of eligible donors.

A study conducted by the Williams Institute at the University of California Los Angeles School of Law found that implementation of a one-year deferral period on blood donations by men who have had sex with another man, rather than a lifetime ban, would yield an estimated 89,000 additional pints of blood each year.

Of course, the safety of patients who receive blood and other biological products should always be of utmost concern. But even with the most stringent testing, errors can occur and illnesses can go undetected. This occurred recently when a man died after receiving a rabies-infected kidney.

While it is essential to reduce risks as much as possible, we should not turn away healthy donors simply due to their sexual orientation. If the goal is to eliminate all risks, the FDA should also prohibit other groups at high risk from donating. There is no reason to single out men who have had sex with men for special treatment.

The only reasonable solution is to lift the lifetime ban on gay male blood donations. Patients and donors would both benefit.

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Robert I. Field, Ph.D., J.D., M.P.H. Professor, Drexel University Kline School of Law & Dornsife School of Public Health
Jeffrey Brenner, MD Founder of the Camden Coalition of Healthcare Providers, Medical Director of the Urban Health Institute at Cooper University Healthcare
Andy Carter President & CEO, The Hospital & Healthsystem Assoc. of Pa.
Robert B. Doherty Senior Vice President of Governmental Affairs & Public Policy American College of Physicians
David Grande, MD, MPA Assistant Professor of Medicine at the University of Pennsylvania
Tine Hansen-Turton Chief Strategy Officer of Public Health Management Corporation
Drew A. Harris, DPM, MPH Director of Health Policy Program at the Jefferson College of Population Health
Antoinette Kraus Director of the Pennsylvania Health Access Network
Laval Miller-Wilson Executive Director of the Pennsylvania Health Law Project
David B. Nash, MD, MBA Founding Dean of the Jefferson College of Population Health
Mark V. Pauly, Ph.D. Professor of Health Care Management, Business Economics and Public Policy at The Wharton School
Howard J. Peterson, MHA Managing Partner of TRG Healthcare, a national healthcare consulting firm
Paula L. Stillman, MD, MBA Healthcare consultant with special expertise in population health and disease management
Elizabeth A. W. Williams Senior Vice President & Chief Communications Officer for Independence Blue Cross
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