Fighting the FDA's Antiquated Policy on Blood Donation

On July 12, 2013, documentarian Ryan James Yezak championed the first National Gay Blood Drive in order to combat the outdated and antiquated FDA guidance document that has banned men who have sex with men (MSM) -- and women who have sex with MSM -- from donating blood for life.
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On July 12, 2013, documentarian Ryan James Yezak championed the first National Gay Blood Drive in order to combat the outdated and antiquated Food and Drug Administration (FDA) guidance document that has banned men who have sex with men (MSM) -- and women who have sex with MSM -- from donating blood for life. Such stipulations mean that bisexual individuals are greatly affected by this rule, as well as gay men and the partners of bisexuals, among others.

Reading about Yezak's campaign, I was instantly reminded of a similar venture that several college friends and I set out on during my junior year at Dickinson College. Run by the school's gay-straight alliance, Spectrum, The Fight to Give Life was a simple campaign to bring together college campuses all over the nation with a petition that called on the FDA to end the ban. We asked college students to come together on 04/05/06 and attempt to donate blood, bringing petitions to their local blood banks in anticipation of being denied.

We were successful enough in getting our message out that members of the American Red Cross, American Blood Banks and America's Blood Centers contacted us. They agreed that the rule was outdated and needed to change, but their hands were tied. Once the FDA got wind of our campaign, we were invited to D.C. to meet with FDA representatives, as well as with members of the aforementioned blood banks. Unfortunately, we were told that there was still too much testing that needed to happen to ensure that MSM didn't pose an additional risk when donating blood.

The 1980s AIDS Scare

A result of the AIDS scare in the 1980s, the FDA rule that was implemented in 1983 specifying that MSM cannot donate blood continues to further the idea that HIV/AIDS is primarily a "gay" disease. Some may recall that it was first known as "gay cancer" in the early days. According to FDA.gov:

Men who have had sex with other men (MSM), at any time since 1977 (the beginning of the AIDS epidemic in the United States) are currently deferred as blood donors. This is because MSM are, as a group, at increased risk for HIV, hepatitis B and certain other infections that can be transmitted by transfusion.

Most opponents see this as stigmatizing, especially when paired with the fact that women who have knowingly engaged in intercourse with an HIV-positive individual must wait only 12 months before donating again. Yezak himself writes in a press release:

The ban is outdated, and as a result, countless otherwise eligible gay and bisexual men are unable to contribute to the nation's blood supply and help save lives. Especially [at] a time when blood shortages are increasingly common. Not only that, but the ban perpetuates negative stereotypes and stigma. Whether intentional or not, it is discrimination based on sexual orientation.

Bisexuals Speak Out

Bisexual activist and blogger Patrick RichardsFink is one individual whom this policy directly impacts. He told told Bi Magazine:

It is utterly ridiculous that in the 21st century, over 20 years after my last sexual experience with anyone other than my partner, both she and I are banned from giving blood (or selling plasma, a common extra job for college students). People have told us to just lie on the application, but all that does is force me back into the closet -- and make her a criminal for loving a bi guy.

To that point, Yezak's focus on gay and bisexual men in this campaign leaves out the countless women impacted by the ban as well. Bisexual activist Lisa Jacobs said:

The MSM exclusion also excludes women who've had sex with an MSM. When I first tried to give blood, I was denied because I had a bisexual boyfriend with whom I'd had sex in the past year. It was quite a shock to me at the time.

Fellow bisexual activist, writer and speaker Dr. Loraine Hutchins echoed Jacobs, saying:

It is not just men who have sex with men; it's anyone who has sex with men who have sex with men, so many bi women and men are affected and always have been. I haven't been able to give blood for years because I've had sex with gay and bi men, and they never asked if it was protected sex or not.

A Stigmatizing "Ban"

What many may not realize is that this disallowance is not an actual "ban" per se. Lauren Beach, J.D., an HIV researcher, explained to Bi Magazine:

There is no federal statute in the U.S.A. banning MSM from donating blood. Rather, the source of the ban comes from [the aforementioned] FDA guidance document. Although they are not legally binding, FDA guidance documents often wind up having the "force of law," because no industry representatives want to go against them and face repercussions from the agency.

Beach also noted that a single blood donation is usually split into multiple blood products that can span the nation in their distribution; that being the case, a single blood donation infected with HIV or any other blood-borne, transmittable disease could potentially infect not one but many recipients.

This is a fraught issue, to say the least. On one side of the proverbial fence, we have the need to stop stigmatizing a part of the population that has been decried for too long. Paul Nocera, a lead facilitator at BiRequest, a New York City bisexual discussion group, added:

The blood donor screening practice is a longstanding policy that has stigmatized gay and bisexual men who are actually honest about their practices. These are most likely the same men who take extra-safe precautions in the bedroom so that they keep a clear conscience. Meanwhile, we should really be worried about those who are less than truthful about their practices in the bedroom; living under a cloud of shame hurts every effort to be honest and communicative when it comes to keeping their bodies and their blood safe from infection. So aside from being a hurtful policy practice, it's also hugely ineffectual.

What the Statistics Say

On the other side of the fence are the statistics in relation to public safety. Going back to FDA.gov:

In 2010, MSM accounted for at least 61% of all new HIV infections in the U.S. and an estimated 77% of diagnosed HIV infections among males were attributed to male-to-male sexual contact. Between 2008 and 2010, the estimated overall incidence of HIV was stable in the U.S. However the incidence in MSM increased 12%, while it decreased in other populations. The largest increase was a 22% increase in MSM aged 13 to 24 years. Since younger individuals are more likely to donate blood, the implications of this increase in incidence need to be further evaluated.

Nevertheless, contracting HIV from a blood donation is incredibly rare. The FDA's website states:

HIV tests currently in use are highly accurate, but still cannot detect HIV 100% of the time. It is estimated that the HIV risk from a unit of blood has been reduced to about 1 per 2 million in the USA, almost exclusively from so called "window period" donations. The "window period" exists very early after infection, where even current HIV testing methods cannot detect all infections.

In an underreported story from the end of June 2013, the American Medical Association (AMA) voted and denounced the FDA ban. AMA board member Dr. William Kobler said in a statement, "The lifetime ban on blood donation for men who have sex with men is discriminatory and not based on sound science." He continued to state that new federal policy is warranted "to ensure blood donation bans or deferrals are applied to donors according to their individual level of risk and are not based on sexual orientation alone."

Furthermore, in an interview on ABC News, Martin Algaze, spokesman for the HIV/AIDS advocacy group Gay Men's Health Crisis (GMHC), said, "The existing policy is archaic and discriminatory because it falsely assumes that all gay [and bi] men are HIV-positive regardless of their sexual behavior."

GMHC policy analyst Robert Valadez added, "Our technology has advanced to the point where ... it is antiquated to keep this policy in place and to keep those units of blood from entering the blood supply."

Looking Abroad

Another influential point is the fact that several other countries have policies in place allowing MSM to donate blood. In Chile and Mexico there is no ban in place; in South Africa, MSM are eligible to donate after six months of sexual abstinence; in Argentina, Australia, Brazil, the Czech Republic, Hungary, Japan, Sweden and the UK it's one year; in Canada it's five years. The aforementioned countries have taken massive steps up from complete lifetime bans. Perhaps the United States will soon follow suit.

If you are interested in learning more about the first National Gay Blood Drive, the "peaceful nation-wide demonstration," visit www.gayblooddrive.com.

A version of this blog post originally appeared in Bi Magazine.

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