I gave blood on Friday. In fact, I've been giving blood regularly since 2003. Every time I donate, I have to check the "I have not have sex with other men since 1977" box.
"I don't like that question," I told the Red Cross worker.
"I know, I don't like it either," he said uncomfortably. He was a young guy with a full beard and a lip ring. I felt sorry for making him sit through my badgering.
"I just feel like I need to register my complaint," I said. "I don't have many options."
It feels sometimes like I'm riding the "whites only" buses - except that buses, unlike blood donations, don't save lives. A boycott is generally the right idea when businesses discriminate against gays. But if we were to launch such a campaign, patients would suffer. So even though I hate checking off that box, I don't know what else to do. Meanwhile, the Red Cross itself diverts responsibility by saying that it just follows the FDA's rule on the matter. Some gay friends of mine won't give blood as a way of protesting the FDA rule, but I don't see how that helps anybody. You can't protest by NOT donating blood that the FDA doesn't want anyway. Someone might say that the FDA might change its policy if a large number of people began boycotting. In fact, a potential decision of Santa Cruz schools might point that way. But while people were boycotting blood drives, how many people will die for lack of transfusable blood? So boycotting is out of the question.
The FDA prohibits men who have had sex with men - even once - since 1977 from donating because: "Studies have shown that men with a history of male to male sex since 1977 may be infected with HIV and/or may have evidence of a lifestyle that potentially exposes them to HIV." Follow the link for more information on the FDA's self-described "conservative" approach.
I searched the medical literature and found a 2003 study (Transfusion 43(1)) that endorses the FDA's screening criteria. The study computed the likely outcome if the FDA changed its rule to only bar men who've had gay sex in the last 12 months. The number of donations would increase by only 1.3 percent, while the number of HIV-contaminated units would increase by 8 percent, from 1 in 150,000 to 1 in 136,000 donations. (By the way, U.S. stats are rather poor compared to Canada, but not when compared to Zambia or other developing countries.) The authors of the study conclude that the gain is not worth the risk. When I discovered this study, my heart sank. It was a lot easier to criticize the FDA when its rule wasn't backed up by reputable evidence.
I'm obviously glad that the FDA takes precautions. A screening process is necessary because just testing the blood is not a fail-proof way of eliminating the HIV risk. But I'm not pleased that we can't be more creative in designing the screening process. The need for blood is expanding as more and more patients require C-sections, organ transplants, joint replacements, and other operations. Donated blood lasts just 42 days, so the nation's blood supply must be constantly replenished - and shortages are very possible. It seems to me that the FDA could safely expand its donor pool by asking people who would otherwise be excluded to present a recent negative HIV test. Or perhaps the FDA could admit men who haven't had gay sex in ten years, instead of thirty, or men in monogamous relationships. The current policy just seems ridiculous. If you acquired HIV in 1977, you'd know it by now. Since no one wants to end up in an ICU without blood, reforming the policy seems like something everyone should favor. Even a homophobe who won't shake hands with a gay person would probably take "gay blood" if the alternative were death.
A question: Suppose for the sake of argument that you (a man) had sex with another man. From repeated testing, you know for certain that you don't have HIV. Should you lie (and perjure yourself) to donate? Lying is generally wrong, but is it worse than withholding blood?
Posts
