For several decades, the Food and Drug Administration (FDA) has refused to accept any blood donations whatsoever from "men who have sex with men (MSM)" - in other words, gay and bisexual men. Amidst the growing criticism of this ethically and scientifically unjustifiable ban, the FDA recently released a proposal to modify it. Yet this proposal, which would allow only celibate MSM to donate blood, is essentially just as bad as the original policy.
Fortunately, the same public activism that drove the marriage equality movement can move us towards blood donation equality as well. Proponents of LGBT rights can advance this cause, for example, by submitting a public comment on the FDA's proposal by July 14.
I am writing to express concern about the proposed revision to your blood donor deferral criteria for gay and bisexual men (MSM). Our knowledge of HIV transmission and the experience of other countries in adopting safe, reliable, and nondiscriminatory donor eligibility criteria indicate that a one-year deferral, while marginally better than the lifetime deferral currently in place, would continue to stigmatize gay men without improving the safety of the blood supply.
While the prevalence of HIV is higher among MSM than among the general population, an individual's risk of contracting HIV from sexual contact depends both on the probability that a sexual partner has HIV and the probability that HIV will be transmitted through a given type of sexual contact. As a result, many individuals who engage in unprotected heterosexual intercourse with multiple partners have a greater risk of contracting HIV than gay or bisexual men who use protection, especially if those gay or bisexual men are in committed relationships.
In fact, the BloodDROPS study you commissioned found rates of HIV prevalence among MSM blood donors lower than rates of HIV prevalence seen in the general population. These results suggest that MSM who engage in riskier sexual behaviors already abstain from donation, and that they would continue to do so if provided with a more appropriately-constructed questionnaire.
I strongly urge you to strike items IX and X from your recommendations for an updated donor history questionnaire. I also urge you to strike the footnote that puts "anal, oral, or vaginal sex, regardless of whether or not a condom or other protection is used," into the same category. Those items could be replaced with the following recommendations for deferral in the DHQ:
1. A history in the past twelve months of anal sex with multiple partners or of unprotected anal sex,
2. A history in the past twelve months of unprotected vaginal sex with multiple partners.
Making this change would not require new resources. It would preserve blood safety, end the FDA's discrimination against gay and bisexual men, and improve the educational value of donor education material. And it would also bring the US policy in line with policies in place in Mexico, Spain, and Italy. A recent study of Italy's policy, instituted in 2001, found that the country maintained the integrity of its blood supply after it discarded its ban on MSM in favor of unprejudiced deferral criteria.
I believe ending deferral based on sexual orientation entirely is the only way to simultaneously avoid discrimination, preserve the safety of the blood supply, and maintain the FDA's credibility. Thank you very much in advance for considering my proposed revision.