Finally, the U.S. Food and Drug Administration (FDA) has taken on board scientific evidence and updated its blood donation policies regarding gay and bisexual men. From now on, men who have sex with men are no longer banned from donating their blood, and can do so one year after they last had sex with another man. While progress is progress, it has been argued that the policy revision is still discriminatory.
Up until now, men who have sex with men (MSM) have been indefinitely deferred, basically banned for life, from giving blood in the U.S. This recommendation was a reaction to the AIDS crisis during the '80s, when HIV rapidly spread through the gay community. Back then, we didn’t have tests for HIV as we knew so little about it, and consequently unscreened blood led to multiple cases of blood recipients becoming infected with the virus.
Although it is still more prevalent in gay and bisexual men, not just in the U.S. but globally, nowadays donated blood is routinely screened for HIV, the tests for which have become remarkably accurate and with a quick turnaround. This, in conjunction with donor education and increases in our understanding of the virus, has led to a drop in transmission rates from blood transfusions from 1 in 2,500 to 1 in 1.47 million, the FDA writes in a statement.
But after reviewing the best available scientific literature and learning from other countries, the FDA has decided to revise its deferral period for MSM from indefinite to 12 months since the last sexual encounter with another man. MSM therefore now have similar restrictions to men and women in other high-risk groups, such as recent blood recipients.
Similar moves have already been made by other countries, like Australia, which did not document any rise in HIV transmission risk from blood transfusions with the shorter deferral. If similar evidence becomes available for smaller time windows, the FDA says it will review this data and make amendments accordingly.
“Ultimately, the 12-month deferral window is supported by the best available scientific evidence, at this point in time, relevant to the U.S. population,” deputy director of the FDA’s Center for Biologics Evaluation and Research, Dr. Peter Marks, said in the statement. “We will continue to actively conduct research in this area and further revise our policy as new data emerge.”
But to ask for year-long abstinence is arguably still discrimination and only further fuels stigmatism against gay and bisexual men. HIV does not discriminate, and blood shortages that risk the lives of those in need should be at the forefront of the minds of policymakers, not outdated, unscientific ideas.
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