Imagine getting ready to leave work when you suddenly get a call that your mother has been in a serious car accident and is in the hospital. At the emergency room, the nurses tell you that she has been rushed into surgery. After several hours, her surgeon comes out and tells you that she survived in large part because of blood donations from strangers.
Blood transfusions can mean life or death. As many as 5 million people receive blood transfusions each year for reasons such as surgeries, injuries, cancer, anemia and sickle cell disease. In order to keep up with demand, about 9,667 people would need to donate blood every day.
I recently received an email from University of Chicago Medicine encouraging me to donate amid a critical nationwide blood shortage. I looked up the eligibility requirements and was disappointed, but not surprised, to find that the Food and Drug Administration deferral policy remains outdated and homophobic. It bans blood donations from men who have had sexual contact with men in the past three months.
Restricting millions of people in the U.S. from donating blood based on fear over HIV is unethical and unfair to gay and bisexual men and, most importantly, to the millions of patients who desperately need blood transfusions.
This kind of policy was first introduced amid the early stages of America’s HIV/AIDS epidemic when we knew very little about HIV. In the early 1980s, there was no reliable test for HIV, and scientists were still trying to determine the route of transmission. Thousands died from this devastating disease at the time, and around 12,000 blood transfusion patients contracted HIV.
Though the majority of HIV cases in the U.S. occur in gay or bisexual men, the effectiveness of screening for HIV has improved massively. Current HIV tests have an accuracy of 99 percent to 100 percent, and the risk of acquiring HIV through a blood transfusion is 1 in 1.5 million. Our scientific progress has pushed us past the need for this precaution.
Those who argue that this restriction is based on a concern for safety rather than homophobia need only compare how the FDA treats HIV versus another bloodborne disease: hepatitis B. The tests used to detect HIV in blood donations are effective following a seven- to 10-day window after first exposure to the virus. For hepatitis B, an incurable disease, this window is a full 12 days.
Furthermore, around 67 percent of people with hepatitis B do not know they have it, while only 15 percent of people with HIV are unaware of their positive status. Additionally, about 60 percent of Americans with hepatitis B are Asian, yet the FDA correctly chooses to not place a blanket ban on blood donations based on ethnicity, because of the agency’s ability to accurately screen for this disease.
It becomes clear that some of the criteria that determine blood donation eligibility are rooted in social demographics and anti-LGBTQ attitudes rather than an accurate assessment of risky individual behavior. To put this into perspective, a gay or bisexual man who has sex only with his husband of 10 years is banned from donating blood, while a heterosexual man could engage in sexual behavior with multiple female partners in a week and donate blood freely.
The FDA’s criteria also make it seem as if heterosexual people are immune to contracting HIV, although they made up 23 percent of new U.S. cases in 2019.
The need for blood is more dire than ever, especially amid the pandemic and holiday season. Research has shown that by lifting a blood donation ban for men who have sex with men, an additional 360,600 men would donate, leading to an additional 615,300 pints of blood per year. This is enough blood to save the lives of more than a million people.
Lifting this ban would not only increase the amount of blood available for those in need, but also would help reduce the social stigma on LGBTQ individuals. How can we expect full equality for LGBTQ Americans when we are seen as “less than” in the eyes of the medical community and government?
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