Healthy Choices

Decades-old ban on blood donation by gay men draws scrutiny

A blood transportation box rests on a table at a community blood drive last month in Texas.
A blood transportation box rests on a table at a community blood drive last month in Texas. AP

When Patrick O’Reilly heard about American River College’s fall blood drive a few weeks ago, he knew there was no point in showing up.

O’Reilly was turned away from a similar event in June because he checked a box confirming that he has sex with men. A blood drive staffer explained that the U.S. Food and Drug Administration does not allow blood from gay men to enter their system. Under the current policy, which dates back to 1983, O’Reilly is banned for life.

With a free BloodSource T-shirt in hand, the 30-year-old theater major was sent out the way he came in – telling friends he couldn’t donate because he’d recently traveled to Mexico.

“It was pretty odd,” he said earlier this month. “I’d never really declared I was gay to anyone. So when I finally said I’d do it, I got discriminated against. ... This was really terrible, to be turned down because of who you are – especially by the government.”

The FDA bans any man who has had sex with another man even once since 1977 from donating blood. The policy, which has remained largely unchanged since its creation during the AIDS epidemic, has been under fire from gay rights groups in recent months and will be up for discussion at a U.S. Department of Health and Human Services meeting in November.

The American Red Cross, AABB (formerly American Association of Blood Banks) and America’s Blood Centers released a joint statement in 2006, and again in 2010, in which they called the current policy “medically and scientifically unwarranted” and recommended reducing the length of the ban to 12 months to better align with the waiting period for other at-risk groups.

The organizations urged that the policy be updated to reflect new screening technology, which can now detect HIV in blood approximately 10 days after infection. The first blood test for HIV antibodies was developed in 1985, but the method was considered imperfect because immune response can take a minimum of several weeks after infection to show up. Now donor centers use nucleic acid testing, which screens for particles of the virus itself rather than the antibodies, resulting in the faster detection.

The long-standing ban was created when HIV was spreading rapidly throughout the United States, especially among gay men. That group, now about 2 percent of the U.S. population, still accounts for 61 percent of all new HIV infections in the country, according to 2010 FDA data.

Those high transmission rates, combined with potential flaws in screening due to the “window period” during which the virus can go unseen, are the basis of the existing policy, according to the FDA. Officials from the agency and the U.S. Department of Health and Human Services declined to make a representative available to The Sacramento Bee for an interview on the issue.

The administration estimates that the risk of contracting HIV from a blood transfusion has now been reduced to about 1 per 2 million. It was as high as 1 in 100 in New York and San Francisco during the AIDS epidemic, said Dr. Chris Gresens, senior medical director and vice president of global medicine at BloodSource, the premier blood collection agency in Sacramento and the Central Valley.

“This virus is one that awoke the transfusion community to a great risk of disease,” he said. “It caught a lot of good people back in the late ’70s and early ’80s by surprise. Many of these people are still in their careers and they remember. They do not wish to make another mistake with regard to this virus.”

Still, the policy is outdated and discriminatory, said Clarmundo Sullivan, executive director of Golden Rule Services, a nonprofit, minority-based organization that provides a variety of services related to HIV, hepatitis and sexually transmitted diseases.

Sullivan, who is also a member of the Sacramento County STD Prevention Stakeholder Planning Group, said that given the current tools to screen blood for HIV, the risk of infection to blood recipients is low. He points out that a lifelong ban does not exist for other risk groups, such as sex workers and people who have gotten tattoos.

“You can’t single out one community when there are other communities that are also at risk,” he said. “It’s absolutely irritating to me. We know there is a movement that’s going to take place, and we’re going to see something happen real soon.”

San Jose State University prohibited blood drives entirely in 2008, when its president declared that the FDA ban violates its nondiscrimination policy.

In July, representatives from the National Gay Blood Drive, a grass-roots campaign aimed at reforming the ban, staffed a table at BloodSource’s midtown donor center as part of a countrywide protest of the FDA regulation. They encouraged gay and bisexual men to come to the center and “donate” through an eligible surrogate, demonstrating the contributions they could make if the ban were repealed.

BloodSource, like all blood banks in the U.S., is required to follow FDA regulations.

About 3,000 people participated in the drive nationwide, said organizer Ryan James Yezak. He and other advocates will attend the federal government’s November meeting to urge officials to at least reduce the ban, if not eliminate it.

“They should acknowledge that our community has something to give to the blood supply,” he said. “I’d like to think that the benefit outweighs the risk.”

A September study out of the UCLA School of Law calculated that if the ban were lifted, an estimated 360,600 men would likely donate 615,300 additional pints of blood each year, increasing the total annual blood supply in the U.S. by 2 percent to 4 percent and saving about 1.8 million lives. If the deferral were reduced to 12 months, the report estimates that 185,800 additional men are likely to donate 317,000 additional pints of blood each year.

“When we look at the issue in its entirety, the concern is that there’s some kind of discrimination against individuals that in the past may have engaged in certain behaviors,” said Ayako Miyashita, co-author of the report. “It seems to be a question of really looking at this risk in a way that’s accurate and based on current medical science, and reflective of nondiscriminatory regulation that might not categorically dismiss whole groups of people.”

The federal Advisory Committee on Blood and Tissue Safety and Availability last met to discuss the policy in June 2010, ultimately labeling it “suboptimal” but voting to retain the policy until further research could be done.

The committee, which falls under the U.S. Department of Health and Human Services, will revisit the topic with the help of top epidemiologists at a public meeting in Virginia next month and make recommendations to the FDA.

Sullivan, the HIV/AIDS advocate, said the blood ban is a topic of much frustration in his support group for young gay men, who have come back from drives discouraged and confused. He educates them on the issue and suggests ways for them to fight back, such as writing local government officials.

“They want to make sure the blood supply is taken care of, and they’re being told their volunteerism and their interest in doing their part for public health is not appreciated,” he said. “It’s not desired or required.”

Call The Bee’s Sammy Caiola, (916) 321-1636.

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