A Personal Case for Gay Blood Donation

12 06 2010

Blood. It courses through 60,000 miles of my ventricles in less than a minute. It supplies vital oxygen from the tip of my big toe to the swirl of hair on my head. It saves lives.

Well, at least yours does.

Last month, as a three-day series of campus blood drives came to a close, a small group of Northwestern students protested the Food and Drug Administration’s policy that prevents sexually-active gay men from giving blood.

The students were not protesting the blood drives. Rather, they actively encouraged people to donate. But they were also raising awareness about an issue that has bothered me since I came out in high school and first confronted that check box, biding it’s time one-third of the way down on the right hand side of the self-deferral questionnaire, asking if I was a man who had ever had sex with a man (MSM) since 1977.

The answer then was ‘no.’ So I rolled up my sleeve, clenched the stress ball and lay staring at the ceiling for ten minutes while I gave a pint of warm, ruby blood that might have saved up to three lives.

When I fill out the form now, I have to lie. I have given blood more than ten times in the past three years. I am a repeat donor, the type organizations such as the American Red Cross send specialized holiday cards every December.

And why shouldn’t I be? I practice safe sex, I have been tested for HIV and I always ask my partners about their serostatus.

The policy, implemented in 1983 during the height of the AIDS crisis, recently made news when Senator John Kerry (D-Mass) led 17 other Senators, including Illinois Senators Dick Durbin and Roland Burris, in asking the FDA to repeal the ban.

Scientifically, a repeal makes sense. Testing has evolved to the point where scientists can limit the “window” period between contraction of HIV and manifestation in the blood stream to less than two weeks. The American Red Cross, America’s Blood Centers and the AABB all agreed in a 2006 review of the policy, calling the ban on donation “medically and scientifically unwarranted.”

Repealing the gay blood ban is a matter of civil rights. Yes, the recipient’s right to clean blood always supersedes the donor’s right to give. But restrictions on donation are applied unevenly. Consider: If you’ve had sex with a heterosexual prostitute or a heterosexual partner infected with HIV, you only have to wait a year before donating.

The empirical case for repeal was made in the June 2009 issue of the scientific journal Transfusions. A special type of donation, pooled whole blood-derived platelets (PLTs) have a four- to six-fold higher risk of transmitting infection to patients because they combine blood from multiple donors.

Pooled PLTs meet 12.5 percent of American patients’ needs, resulting in the release of one HIV-infectious unit every 2.13 years. A “very conservative” estimate of the risk increase if MSM deferral were reduced to 12 months would result in the addition of one additional HIV-infectious unit in the U.S. every 18.5 years. The difference is that pooled PLTs do not have the stigma of homosexuality.

In a defense this week of the ban, the FDA pointed to the disproportionate prevalence of HIV among MSM – 60 times higher than the normal population. Yet if the FDA is waiting for the HIV-infectious risk for blood to be “statistically insignificant and unpreventable,” then why do they permit pooled PLTs?

Were the ban to be lifted, evidence exists suggesting blood banks might receive an even larger boost to dwindling stocks than expected. In January, the free gay dating website ManCentral.com polled users and found 77 percent of respondents said they would donate if permitted. Obviously it’s not the best poll in the world, but a desire to give clearly exists.

Every two seconds, someone in the U.S. needs blood, according to the American Red Cross. Because blood is perishable and must be used within a 4-day period, banks are in constant need of donors. Shortages are frequent and frightening; just a few weeks ago the United Blood Services in West Texas reported a “critical” shortage after a series of accidents left them with near-zero levels of O negative blood, the universal donor type. This is an endemic problem that we can and want to help solve.

On June 10 and 11 at meetings in Rockville, Ma., the Federal Advisory Committee on Blood Safety and Availability will consider the blood ban and make recommendations to the Department of Health and Human Services Secretary Kathleen Sebelius about its continuance.

We cannot save lives by fighting abroad. We cannot save lives by adopting. We cannot save lives by giving blood. The Obama administration has made progress on rectifying the first two injustices. Let’s urge Secretary Sebelius to face the facts, reduce the ban on MSM donors to 12 months and make sure men like me never have to lie again.