Blood Donor Eligibility: Safety or Discrimination?

Kate Harsh

In 1983, the FDA enacted a law that any man who has had sexual activity with another man, even once, since the beginning of the AIDS epidemic in 1977 is ineligible to donate blood for life [1]. In 1983, the logic behind the blanket ban was reasonable: statistically, men who have sex with other men (MSM) have an HIV prevalence 60 times higher than the general population and 800 times higher than first-time blood donors [1]. Additionally, in the 1980s, tests for HIV were much less reliable. As ensuring the safety of donated blood is paramount, the ban on MSM donors was a safety measure. However, 30 years after the ban was enacted, many believe that the ban is outdated, discriminatory, and impractical given the constant need for blood.

The biggest argument against the policy is that it is does not reflect today’s scientific realities, for HIV testing has become much more accurate. When the blanket ban was enacted, people did not now how HIV spread, and there was no accurate test for HIV. Scientists only knew that the blood supply was polluted with HIV-containing blood and that “a disproportionate number of gay men were affected by the virus” [2], but poorly understood the specifics. However, today’s advanced HIV/AIDS blood tests are able to detect HIV within 10-21 days after exposure [3], and their failure rate is less than one in a million [1]. According to the FDA, however, a one in a million failure rate becomes significant when over 20 million transfusions of blood, plasma, platelets, or red cell concentrates occur annually [1]. In response, the American Red Cross, America’s Blood Centers, and the American Association of Blood Banks released a joint statement saying that “the data regarding quarantine release errors…[does not justify] a different deferral period for MSM than that for individuals with similar high-risk sexual behavior” [4].

Many believe that a lifelong ban for MSMs is “medically and scientifically unwarranted” [3]. As most of the other deferral periods regarding donating blood are for only one year [5], banning MSM for life is arguably discrimination, as the detection window for HIV falls well within the one-year period. Martin Algaze, the spokesman for Gay Men’s Health Crisis, said that “The existing policy is archaic and discriminatory because it falsely assumes that all gay men are HIV-positive regardless of their sexual behavior. At the same time, it allows heterosexuals to donate blood even if they have participated in risky sexual or drug-use behavior” [6]. The policies fail to address the legitimate risks and instead prohibit many would-be donors from giving healthy blood, so it does not really accomplish its goal. This past September, a panel of scientists from the FDA voted 7-6 to keep the ban intact, but the ban is continuously under review [6].

The American Red Cross has a constant need for donated blood, as “many life-saving medical treatments and procedures would not be possible without a safe and reliable blood supply” [7]. Although more than 44,000 blood donations are needed every day, less than 38 percent of the U.S. population is eligible to give blood [8]. By restricting sexually active gay men from donating blood, the Red Cross turns away over 50,000 healthy men who want to donate [2]. Many believe that while the ban was once based in science, it is now rooted in discrimination and politics [6]. While the safety of the blood supply is of course the top priority of the Red Cross, FDA, and other associated organizations, political or discriminatory beliefs should not get in the way of saving lives with healthy blood, and policymakers must keep this in mind in future discussions of potential reforms.










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