The US Food and Drug Administration has confirmed its 1983 policy to refuse blood donation from gay men, or to be more accurate, men who have sex with men, in order to reduce the spread of HIV through blood donation.
The FDA says that as a group, men who have sex with men (MSM), carry an increased risk of HIV, hepatitis B and other infections that can be transmitted by transfusion. They point out this decision not unique to the United States and quote a European Union directive that also concurs with this policy.
As the policy stands, a man who has ever had sex with another man since 1977, even once,is deferred from giving blood for the rest of his life.
The FDA announcement says that:
“Men who have had sex with men since 1977 have an HIV prevalence (the total number of cases of a disease that are present in a population at a specific point in time) 60 times higher than the general population, 800 times higher than first time blood donors and 8000 times higher than repeat blood donors.”
A particular area of concern appears to be the “window period” following a recent infection of HIV when there is not enough of the virus in the blood to guarantee its detection.
In March last year, the Red Cross and other blood groups, in the light of the increasing demand for donated blood, suggested to the FDA that the lifetime ban be replaced by a 12 month period of deferral following MSM sexual contact. This would give time for the window period to elapse, and with the recently improved HIV tests where the virus can be detected inside one month of infection this would remove the need to make the ban for life.
However, the FDA says that it would only change its policy if there was sufficient scientific evidence, and new tests are not 100 per cent accurate. This follows last year’s FDA Workshop on Behavior-Based Donor Deferrals in the NAT Era, where FDA scientists and blood experts discussed the topic of MSM deferral and the evidence for and against it. (NAT stands for nucleic acid testing, which was approved by the FDA in 2001 for screening blood plasma for HIV and hepatitis C.)
There has been a strong reaction to the renewal of this policy, with many people saying that it discriminates against gay men. The FDA says that the policy is not discriminatory, their view is that MSMs present a high risk group compared to others:
“Scientific evidence has not yet been provided to FDA that shows that blood donated by MSM or a subgroup of these potential donors, is as safe as blood from currently accepted donors,” says the FDA website.
They said they remain “willing to consider new approaches to donor screening and testing, provided those approaches assure that blood recipients are not placed at an increased risk of HIV or other transfusion transmitted diseases”.
A lifetime ban is also in place for people who use drugs intravenously and sex workers.
Written by: Catharine Paddock
Writer: Medical News Today