Officials question why FDA continues to restrict gay blood donors

key takeaways

  • A group of senators is calling on the FDA to reverse a ban on men who have sex with men from donating blood.
  • Current rules state that men who have sex with men must wait three months after their last sex before they can donate blood.
  • Doctors say the rule is outdated.

A group of U.S. senators is asking the U.S. Food and Drug Administration (FDA) to lift a ban on men who have sex with men (MSM) donating blood.

In a letter to the FDA, the senators, led by Sen. Tammy Baldwin of Wisconsin, said they are reaching out “to express our warnings about the national shortage of blood and blood products that puts patient care and safety at risk.” in danger.”

The group is urging the FDA to “act quickly based on the best available science and update its outdated and discriminatory blood donor deferral policy for men who have sex with men, a long-overdue step that will significantly increase eligibility blood donor base.”

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The group wrote the letter just days after the American Red Cross (ARC) announced it was experiencing a blood shortage. The ARC said on January 11, 2022, that the organization was facing “the worst blood shortage in more than a decade”, which poses “an alarming risk to patient care”.

“During this crisis, physicians are being forced to make difficult decisions about who receives blood transfusions and who needs to wait until more products become available,” ARC said. “We urgently need blood and platelet donations to help prevent further delays in vital medical care. ”

The Red Cross cited a massive wave of COVID-19 infections due to the Omicron variant as one reason for the shortage. Other issues include low donor turnout since the start of the pandemic, canceled blood drives and staffing restrictions.

Pampee Young, MD, chief medical officer of the Red Cross, said in a statement. “We need the help of the American people.”

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The Red Cross, which supplies 40 percent of the country’s blood, recently had to limit blood distribution to hospitals. The ARC said some hospitals may receive less than a quarter of the blood products they request.

“The FDA has the ability to take simple, science-based steps to significantly increase the donor base and help address this crisis,” the senators wrote. FDA officials did not respond publicly or say they would make changes.

Current U.S. Rules Regarding Blood Donation

Current FDA guidelines are very specific about who can and cannot donate blood in the U.S.

According to the guidelines, people who meet one of the following criteria should not donate blood:

  • Anyone who has ever tested positive for HIV
  • Patients with hemophilia or related factor deficiencies requiring treatment with factor concentrates

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Those who meet one of the following criteria should not donate for three months:

  • people who exchange sex for money or drugs
  • people who engage in over-the-counter drug use
  • Anyone who has sex with someone who has tested positive for HIV
  • Having sex with someone who has exchanged sex for money or drugs in the past three months, or using an over-the-counter injectable drug in the past three months
  • People who have had a blood transfusion in the past three months
  • Anyone who has had a tattoo, ear or body piercing within the past three months, unless done with a disposable device
  • People who have been treated for syphilis or gonorrhea within the past three months
  • Men who have had sex with men in the past three months
  • Women who have sex with men who have had sex with men in the past three months

Previous guidance said MSM would need to delay blood donations by 12 months from the time they last had sex — shortened to three months in March 2020. Before the 12-month ruling, there was a lifetime injunction preventing MSM from donating blood. This was cancelled in 2015.

what does this mean to you

Current regulations require men who have sex with men to wait three months after their last sexual encounter before donating blood. However, legislators and doctors support an outright repeal of the ruling. However, so far, these regulations are still in effect.

Doctors say the guidelines are outdated

The guideline was originally motivated by concerns that MSM had a higher risk of contracting the human immunodeficiency virus (HIV) than the general population. In the United States, the estimated lifetime risk of HIV infection in MSM is one in six. This compares to a 1 in 524 risk for heterosexual men and 1 in 253 for heterosexual women.

The three-month mark is now in place “because people think that’s enough time to wait for HIV antibodies to develop in a newly infected person,” Richard Watkins, MD, an infectious disease physician and professor of internal medicine at Northeastern Ohio Medical University, told VigorTip. He explained that if a MSM is newly infected with HIV and waits three months to donate blood from a previous sexual encounter, the test should be able to detect the virus by then.

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But “all blood donations are tested not only for blood and Rh type, but also for evidence of myriad infectious pathogens, including HIV and hepatitis B and C,” said Kristen D. Krause, Ph.D., Instructor, Public Health, Rutgers School of Public Health. The Master of Health and Deputy Director of the Center for Health, Identity, Behavior and Prevention told VigorTip.

Meaning, if the blood donor happens to have HIV and doesn’t know it, the test should take it out of the blood bank.

“These unreasonable restrictions are a holdover from an era when HIV was a major fear,” Amesh A. Adalja, MD, senior scholar at the Johns Hopkins Center for Health Security, told VigorTip. There is a significant risk of contaminating the blood supply in the 1990s. To maintain this policy is to continue to stigmatize HIV in an unfounded way in 2022.”

It’s time to end restrictions on MSM blood donors, Krause said.

“This policy is absolutely outdated and continues to stigmatize gay, bisexual and other men who have sex with men,” she said. “In particular, this policy highlights significant structural inequalities in the United States, even now There is no blood shortage, and it should be abolished. The rest of the world, including Italy, Spain, and Argentina, has removed any rules that may have historically prevented gay men from donating blood, and the U.S. has caught up much longer than that.”