We hope the report will encourage the FDA to revise its guidelines to be more in step with current technology and to avoid reinforcing stigma.
The Food and Drug Administration (FDA) currently bans any man who had sex with another man (MSM), even once, since 1977 from donating blood. The policy does not consider the potential donor's HIV status, frequency or risk of sexual activity, or if he is in a monogamous relationship. Today, Gay Men's Health Crisis (GMHC) released a report, A Drive for Change: Reforming U.S. Blood Donation Policies, detailing the history of the policy, efforts towards revision, and analysis of alternative donation criteria.
Advances in HIV screening of blood supplies since the 1980s make the chance of receiving a unit of HIV infected blood one in 1.5 million. Guidance, for most donors, takes into account the "window period," the short period after HIV infection whereby a HIV screening would not detect infection.
Current FDA guidance includes a questionnaire of potential blood donors that asks 48 questions about current health status, medical history, blood donation history, sexual practices, drug use, and other behaviors. But risk factors are not uniformly applied. A heterosexual donor who has had sex with a knowingly HIV-positive partner 366 days ago would be eligible for donation. By contrast, a man who has had sex with another man, regardless of the frequency, safe sex practices involved, or duration since the episode, is denied for life.
"Across the country, we experience critical shortfalls of blood supplies on a consistent basis," said Janet Weinberg, Chief Operating Officer at GMHC. "Yet only five percent (or less) of Americans that are able to donate blood do so. We call on the FDA to re-examine discriminatory policies that categorically exclude potential blood donors, including gay and bisexual men," added Weinberg.
The report analyzes alternative recommendations for blood donation by gay and bisexual men using a comprehensive framework to assess actual risk of HIV transmission and increased availability of blood supplies. The framework, called "DONATE," provides a way to understand how the use of advanced technology and objective screening standards can decrease the risk faced by recipients of blood products, while at the same time reducing the discriminatory impact on MSM, expanding the pool of blood donors (thereby reducing the potential for blood shortages), and raising awareness of HIV/AIDS risk among donors in general, regardless of sexual orientation or gender.
GMHC thanks Davis Polk & Wardwell LLP (Davis Polk) for their immense contribution in researching and writing this report. "We believe it is important to help GMHC highlight the current challenges with FDA blood donation guidelines," said Joseph Wardenski, a former Davis Polk associate and primary author of the report. "We hope the report will encourage the FDA to revise its guidelines to be more in step with current technology and to avoid reinforcing stigma," added Wardenski.
Click here for the report.