The “Blood Ban”
Author: Soohyun Oh
Data from CDC.gov. According to CDC (2018), among 37,968 newly diagnosed HIV cases, 69% identified as gay, bi+, and MSM. This type of data can be incorrectly interpreted to mean that individuals who identify in these groups are likely to be HIV+, but consider the number of new cases (26,011) framed and graphed relative to the total reported (which is likely underestimated) among marginalized groups discussed here. Only 0.58% of MSM contributed to new HIV cases in this dataset.
In April 2020, the FDA regulation on blood donation eligibility changed due to the shortage of blood supply during the COVID-19 pandemic. This sparked particular attention to the LGBTQ+ community, especially gay and bi+ men, as the new regulation had some significant changes affecting their eligibility to donate blood. Since the HIV/AIDS epidemic in the 1980s, the FDA set a blood donation regulation for individuals with increased risk of transmitting HIV infection.
Prior to the updated regulation, the 2015 FDA blood donation deferral policy was a 12-month abstinence/waiting period for men who have sex with men (MSM) since their most recent sexual intercourse. The updated blood donation regulation policy has shortened the deferral policy for MSM from 12 months to 3 months after seeing no significant increase of safety concerns in the United Kingdom and Canada following the 3-month abstinence policy changes, and the availability of new nucleic acid testing for HIV, HBV, and HCV (able to detect the infection within 3 months) which led to a scientifically supported recommendation of a 3-months abstinence policy.
Although this policy was a step in the right direction for the LGBTQ+ community, bias and stigma around gay and bi+ men is still present. The persistence of this policy seems to be based more on identity, sexual orientation, and fear rather than the scientific facts on the associated risk between HIV infection and gay, bi+ men. According to the Center for Disease Control (CDC) in 2018, among the new 37,968 diagnosed HIV cases 69% (26,011 individuals) were accounted for by gay, bi+, and MSM. This data can be misleading to the public as 69% is a large percentage of the total new HIV cases, creating an idea that the infection rate of HIV is high and concerning especially when it comes to an individual identifying as gay or bi+. However, when the total population statistic of gay and bi+ is taken into account the interpretation can be changed. In 2018, the size estimate for men who have sex with men (MSM) was around 4.5 million in the United States according to the UNAIDS database. Taking the total population of MSM into account, around 0.58% of the MSM population contributed to the new HIV cases.
Although the fear of HIV infection is acknowledged, and there certainly is a possibility of HIV infection through blood donation, creating and continually enforcing a policy because of stigmatization of an individual's sexual orientation can be frustrating for the LGBTQ community and many others in support. Organizations such as The Human Rights Campaign and the Hastings Center are covering bioethics issues in the LGBTQ community, raising awareness of the disparities based on identity, and pushing for a policy change. This policy change was fueled mainly by the blood supply shortage due to the COVID-19 pandemic, but does it take a pandemic to make changes to these kinds of policies? What can we do as a community about these health disparities in our society? We would love to hear from you.
Sources:
● https://www.redcrossblood.org/donate-blood/how-to-donate/eligibility-requirements/lgbtq-donors.html
● https://www.fda.gov/media/92490/download
● https://www.hrc.org/news/hrc-responds-to-the-fdas-updated-policy-on-so-called-blood-ban
● https://www.cdc.gov/hiv/group/msm/index.html
