For decades, homosexuals have been banned from donating blood. In 2015, I was banned for life from loosenedGay men can be donors if they have abstained from sex for at least a year.This was later shortened to Three monthsLast week, the FDA announced new, more comprehensive regulations. plan: Sexually active gay and bisexual people are allowed to donate as long as they haven’t recently had anal sex with a new or multiple partners. Assistant Secretary of Health Rachel Levine, the first confirmed transgender U.S. public official in the Senate, released a statement praising the proposal:Improve equity“We treat everyone the same, regardless of gender or sexual orientation,” she said.
As a member of the small but respectable League of Gay Pathologists, I am more affected than most Americans by these proposed policy changes. They are also responsible for monitoring complications that may arise from blood transfusions. greater risk Get more viruses than members of other groups. But my biggest fear as a doctor is not blood infections.Common bacteria are far more numerous transfusion infection More than any virus in the United States, most of them cause severe or fatal illness. The risk from the virus is very low, and he has not reported a single transfusion-related HIV case in the United States. 2008 onwards— because laboratories now use highly accurate tests to screen all donors to ensure the safety of their blood supply. On the other hand, new directives on anal sex still discriminate against the queer community, like older directives that explicitly target men who have sex with men. . .
Strict precautions made more sense 30 years ago when screening didn’t work as well as it does today. Hemophiliacs, many of whom live on blood products, were a prominent early victim of HIV’s failure to keep it out of its blood supply. One patient who acquired the virus through a blood transfusion new york times In 1993, he had already seen his uncle and cousin die of AIDS. “At that time”shock and denialas Times Thankfully they are behind us. But for older patients, memories of his crisis in the 80’s and early 90’s linger and cause great anxiety.Even those who are ignorant of this historical background fear, threaten, or fear receiving someone else’s blood. sinful.
As a doctor, I have found that patients tend to be more reluctant to take blood transfusions than to take the pill. (For reasons of privacy and practicality, none of these requests can usually be met.) Nevertheless, the same patient may accept drugs with the risk of serious complications. I have. thousands of times higher than the risk of receiving infected blood. Even in the case of blood-borne infections, patients seem to be less concerned about bacterial contamination, which is the greatest danger, than viral infections such as HIV and hepatitis C. However, the risk of HIV transmission through blood transfusions is not only low, it is essentially non-existent.
The feelings of blood donors are also important, and the FDA’s policy towards gay and bisexual men who want to donate has been unfair over the years.Officials are supposed to speak in the objective language of risk and safety, but their selective deployment of concerns suggests a deeper homophobia. scholar said of American Journal of Bioethics Over a decade ago, “the discrimination lies not in the risk itself, but in the FDA response to it.” demographic group Despite the increased risk of contracting HIV, government agencies have not consistently improved exclusion criteria for young people, urban dwellers, or blacks and Hispanics. Federal policy he banned Haitians from donating blood from 1983 to 1991, but activists successfully lobbied for this ban to be repealed. strong slogan ” H. of HIV means humanno HaitianMost people today would consider the idea of refusing blood from a racial group morally abhorrent. Below, the FDA continues to effectively refuse blood from sexual minorities.
The planned update will certainly be an improvement. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, said the unpublished study “a good percentage‘of men who have sex with men can now be donated. However, the plan would likely exclude most even those who wear condoms or are regularly tested for STDs. An FDA spokesperson said in an email: [men who have sex with men] You can donate under the proposed changes. ”
research done in France, Canadaand the EnglandThe adoption of similar policies over the past two years presents a risk. For example, a study on blood donation in France estimated that: 70 percent Percentage of men who had sex with men who had at least one recent partner.and Canadian researchers Queer communities surveyed Montreal, Toronto and Vancouver found that up to 63% are ineligible to donate because they recently had anal sex with a new or multiple partners.just 1 percent Four of the previously eligible donors would have been rejected by similar criteria. Britain is calculation Between 35% and 50% of men who have sex with men become ineligible under policies like the FDA, and only 1.4% of former donors are newly deferred. If sexual men were to shy away from blood centers at many times the rate of heterosexual men, what else could we call it? discriminationUS guidance is supposed to ban lifestyle choices, not identity choices, but that means too many queer men are making the wrong choices. “Anal sex with multiple sexual partners poses a significantly higher risk of HIV infection compared to other sexual exposures, including oral sex and penile and vaginal sex.
If the FDA wants to spy on my sex life, there must be a good reason for it. increased granularity, intimacy The details of these policies, specifying the number of partners, type of gender, give the impression that the stakes are very high. Blood supply can be ruined if the most risky donors are not kept out. But donor screening questions are crude tools for picking needles out of a haystack. 1-2 weeks. thousandsGays and straights across the country are at risk of slipping through our test defenses at any moment. Although no arbitrary questionnaire can completely rule out this possibility, patients and physicians have already accepted other life-threatening transfusion risks that occur at a much higher rate than HIV infection. The phone rang several times each night as I stood by to watch. However, since the last known case of HIV transmission through a blood transfusion, tens of millions of blood transfusions have been performed across the country.
Early data suggest that the overall risk-benefit calculations of receiving blood are unlikely to change. The percentage of donations was already small. remain tinyReal-world results from other countries that have recently adopted sexual orientation-neutral policies will become available in the coming years. Already advocated removing the screening question with 2022 Canadian analysis Our findings suggest that removing all questions about men who have sex with men does not significantly increase the patient’s risk. “Extra behavioral risk questions may not be necessary,” the researchers concluded. (FDA states that its proposed policy “is expected to reduce the likelihood of donations by new or recent HIV-infected individuals who may be in a window period.”) increase.)
As a gay man, I am aware of none other than a brief period of crisis during the coronavirus pandemic. needs my blood.that’s all 6.8 percent of US men identify as gay or bisexual, the potential benefits to overall supply are inherently modest. If you revert to a full ban, the patient will not be harmed. But overturning that ban, both in letter and spirit, would send a vital message. Our governments and health care systems view sexual minorities as more than just vehicles for disease.policy using anal sex as a substitute men having sex with men By disputing one of the main sources of sexual pleasure it only further denounces this group. There is no doubt that queer men who are not monogamous are more likely to contract HIV. But a policy that truly treats all people the same would accept a small amount of risk in return for working with humans.
