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Gay men are still barred from donating blood. Is it time to change the rule?

The FDA argues that banning blood donations from men who've had sex with other men has made the nation's blood supply safer. But there's a nationwide shortage of blood, and new science to test for disease.
/ Source: Martin Bashir

The FDA argues that banning blood donations from men who've had sex with other men has made the nation's blood supply safer. But there's a nationwide shortage of blood, and new science to test for disease.

Blood donors fill the stage during a blood drive in Vermont. (Photo by Toby Talbot/AP)

When Evan Low received a letter from the American Red Cross asking him to help organize a blood drive, he felt conflicted. The 30-year-old mayor of Campbell, California, is openly gay, and was aware of the rule.

“My duty is to focus on the well-being of the general welfare of the public,” Low said in an interview with MSNBC. But as a gay man, he knew he was prohibited from donating blood himself.

But the town’s vice mayor, Rich Waterman, thought it was worth an attempt. Although Waterman, too, is gay, he recalled donating blood several years ago in Northern California. “I thought maybe they might’ve changed the policy,” Waterman said, noting that he had been in a monogamous relationship for 19 years.

Low and Waterman signed up, hoping they wouldn’t be turned away from the event they helped organize. But the donor questionnaire asked whether or not they’ve had sex with men; because they said yes, they were both immediately disqualified.

Assessing risk based on behavior vs. sexual orientation

The U.S. Food and Drug Administration imposed the ban on blood donations from men who’ve had sex with men (MSM) in 1983, six years after what is considered to be the start of the AIDS epidemic in the United States. In the years leading up to the ban, the Centers for Disease Control and Prevention studied the origin of the AIDS disease and how it was spread among the population, noting in a March 1983 Morbidity and Mortality Weekly Report that most cases of AIDS were reported among homosexual men with multiple sexual partners, injection drug users, Haitians, and hemophiliacs.

The FDA, an agency of the Department of Health and Human Services, says the ban is based on scientific evidence that shows a higher rates of transmissible diseases among MSM as opposed to individuals who engage in sexual relations only with members of the opposite sex. According to a statement to MSNBC from the FDA, statistics show that MSM accounted for more than half of 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.

In its statement, the FDA argues their policy extends beyond the MSM population and is not meant to target one group over another. “The FDA defers other donors when they present similarly high risks for exposure to transfusion transmissible infections, whether through behavior, medical conditions, or geographical exposures.”

But opponents of the FDA’s policy say the ban is discriminatory, and that the FDA’s explanations about why the ban is still in place don’t hold up anymore.

“The ban was imposed at a time when we didn’t have any way of knowing someone was infected,” Chris Collins, vice president and director of public policy at amFAR, said in an interview. “The problem is that the current ban has not been updated with the new technology for testing. It treats different populations of people differently. It bases deferral of the ability to donate blood based on someone’s identity, rather than what their behavior has been.”

Collins argues that the behavior of every individual giving blood should be examined, rather than basing a policy off of the assumption that men who’ve had sex with men engage in higher-risk behavior than others.

amFAR, along with organizations including the American Red Cross, the American Association of Blood Banks (AABB), and the Human Rights Campaign, urged the FDA in 2010 to reconsider its policy. In a joint statement from AABB, America’s Blood Centers, and the Red Cross, the organizations said they “strongly support[ed] the use of rational, scientifically-based deferral periods that are applied fairly and consistently among blood donors who engage in similar risk activities.”

But after a review of evidence and testimony, a government health committee recommended in 2010 that the policy stay in place, though the committee encouraged new research to address concerns from organizations that supported a reversal of the ban. ”Although scientific evidence has not yet demonstrated that blood donated by MSM or a subgroup of these potential donors does not have a substantially increased rate of HIV infection compared to currently accepted blood donors, the FDA remains willing to consider new approaches to donor screening and testing,” the FDA added in its statement.

A representative from the Red Cross told MSNBC that the Red Cross intends to continue working through the AABB to press for a deferral policy that treats everyone equally. Additionally, advocates for a change in the policy say the FDA has ignored scientific progress around the world that has provided sufficient evidence to reverse the ban. In 2011, the UK announced it would change its lifetime ban to a ban only on men who’ve had sex with men in the previous year;  this past May, Canada moved from a lifetime ban to a ban on men who’ve had sex with men in the last five years.

Blood shortage warrants a second look at lifetime ban, advocates argue

As the debate continues in the medical world, the issue has become political, drawing support from both Democrats and Republicans.

Earlier this month, a bipartisan group of 84 members of Congress signed a letter urging the Department of Health and Human Services to reconsider its ban. Among the signers is Massachusetts Sen. Elizabeth Warren. She said in a press release on her website that she was inspired to add her name to the growing list of people who supported a reversal of the FDA’s ban after hearing from a constituent who tried to donate blood after the Boston Marathon bombings–when it was badly needed–but was turned away because he is gay.

“Current policies are contrary to science,” Warren said. “They promote discrimination and don’t make the system any safer. It’s long past time for HHS to make blood donation policies fairer and more effective.”

The issue of changing the policy is increasingly urgent, as the Red Cross faces a shortage in blood donations. The organization has reached out to cities around the country to organize blood drives—from Philadelphia, Pa., to Davenport, Iowa, to Evan Low’s city of Campbell, Calif.

“When we talk about donation of blood, it’s not an equally-applied policy,” Low said. “There’s a communal need for blood, and that’s why this is important…This is something we can all rally behind.”

Low is taking his fight to a larger stage: a petition he started after his attempt to donate was denied has gained more than 18,000 signatures. “Although I support blood drives, I will always stay committed to the fight for the rights of all people,” Low writes. “Members of the Lesbian, Gay, Bisexual, and Transgender community simply want to be in recognized and committed loving relationships, be able to defend our country in the armed forces to fight for the freedoms that we value, [and] to be able to sacrifice of themselves and give blood to save another’s life.”

In a statement, GLAAD national spokesperson Wilson Cruz writes, “How many people in need will go without blood donations because the FDA is stuck on discriminating against gay and bisexual men? It’s time for the FDA to use modern technology and knowledge to create a blood donation policy that both respects gay and bisexual men and helps those in need.”