So much for ending government-mandated discrimination. The FDA today eased restrictions on blood donation for gay and bisexual men—but only if they haven't had any sex in the past year. Good try, FDA, but this is still messed up.
The glaringly problematic issue with this new policy is that men in monogamous relationships with other men still cannot donate blood. This policy sends the message that the problem is inherently with being gay, rather than engaging risky sex practices. This is prejudice shining through.
In the dark early days of the AIDS epidemic, testing for HIV could indeed be tricky. Thus the lifetime blood donation ban for any men who have had sex with other men after 1970 became policy in 1983. Three decades later, however, we can now reliably and easily test for the HIV in blood.
Today, donated blood can go through two tests for HIV (among several other blood born diseases). The first, an immunoassay that looks to antibodies against the HIV virus, can detect it within 25 days of infection. The second, an RNA test, can detect HIV within 4-7 days of infection. Against these timelines, the one-year deferral period is overkill.
A study in Italy, which switched from a ban to conducting individual risk assessments for gay men in 2001, found that it did not lead to more HIV-positive men donating blood. An "individual risk assessment" really just means asking questions about lifestyle. This is, after all, how we screen heterosexual donors. Questionnaires for potential donors include questions about having sex with prostitutes and drug users in the past year. Why shouldn't gay and bisexual men be held to the same standard?
Earlier this month, the 17 experts of the FDA's Blood Products Advisory Panel overwhelmingly voted against easing any restrictions at all about gay men donating blood. It's pretty unusual for the FDA to go against the recommendations of its expert panels, so in the small world of bureaucracies, the FDA has actually taken quite a leap here. But in the context of the larger world, which has seen three decades of scientific progress, this is a tiny step. The FDA can do better. The U.S. can do better.
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