Liquid Gold

"Well you're certainly unique!" my new primary care physician tells me recently, after my first visit to his office.

While my mother and I would like to think this is true across multiple aspects of my life, he was unfortunately just referring to my blood type. "AB with a positive Rh factor," he says approvingly, while reviewing my charts. "You should really consider becoming a routine donor."

I've heard this all before, but I sit patiently, in my hospital gown, and allow him to elaborate anyway.

He explains. While individuals of all blood types are encouraged to donate, those of us with either O negative or AB positive blood are in especially high demand. We are known as "universal donors" since the red blood cells from type O negative blood and the plasma from type AB positive blood can be transfused into individuals with any other blood type. These "universal" blood types are especially important to have on hand in an emergency, when transfusions are urgently needed but an exact blood match can't be readily found.

"Have you ever donated before?" he asks. I sheepishly shake my head no.

It's true. I've never donated blood. Not even once in my life. Before you rush to judge, it isn't because I don't want to become a donor. It's because I'm prohibited from doing so.

In 1983, the Food and Drug Administration (FDA) began forbidding blood and plasma centers from accepting donations from men who have sex with men. At the time, little was known about HIV/AIDS apart from two things: the illness seemed to be transmittable through bodily fluids, like blood, and many gay men were contracting it. With no reliable HIV test during these early days of the epidemic, the FDA made the seemingly sensible decision to forbid all gay and bisexual men from donating blood.

I want to explain all this to my doctor, but by now he is well into his pitch. He goes on. Not only is my blood type coveted for its universality, "It's also quite rare." Only 7% of those living in the United States have O negative blood. Just 3%, meanwhile, share my own blood type, AB positive.

"All this would make people like you very popular at blood banks! So what do you say? Help save some lives?" he concludes, expectantly.

This question, which I've received countless times during blood drives at work or school, or routine trips to the doctor's office, always leads to a slightly awkward exchange. "Sorry, I like boys!" seems a mismatched response to the question, "Care to save a life?" I'd love to do my part. My blood is useful. My blood is rare. Many donation centers even refer to my blood type as "liquid gold." Some blood banks have created entire programs dedicated to reaching out to individuals like me to become regular donors.

"Sorry, I can't," I finally say. I'm a gay man. I'm not qualified. There will be no mining of my liquid gold blood.

"Oh," he says, his turn to be a bit embarrassed.

The donation ban may have made sense within the context of the 1980s. But today, as we celebrate the 26th anniversary of the first World AIDS Day, the prohibition is at best outdated and at worst homophobic. Though HIV prevalence remains high among men who have sex with men-60 times higher than the general population-our ability to test for the presence of HIV in blood has grown exponentially over the last 30 years. The tests are more accurate, and errors exceedingly rare. Due to these advancements in technology, all of the major blood donation organizations, including the American Association of Blood Banks, the American Red Cross, and America's Blood Centers, support ending this lifetime prohibition.

Nonetheless, the FDA continues to justify the ban as a precaution against "high risk behavior." It's unfortunate, but necessary, in order to "protect the blood supply."

The FDA does not, however, consider these behaviors "high risk": If you're a straight man or woman, and have unprotected sex with multiple partners, no worries! Donate away. If you're a straight man and have unprotected sex with a sex worker, just wait a year! You'll be welcomed back into the donor pool with open arms. Meanwhile, a lifetime ban exists for all men who have had even one sexual encounter with another man since 1977.

In the 1980s, at the height of the HIV/AIDS crisis, countries all over the world implemented similar donation bans on gay and bisexual men. Over the last decade, however, many of these countries have significantly relaxed these restrictions. It's time for the United States to follow suit. Ending the ban would increase the donor supply, and decrease the continued misconception of HIV/AIDS being a "gay disease."

It'll also spare me any more awkward trips to the doctor's office.