The Gay Men’s Health Crisis, the NYC-based AIDS research and support group, this week released “Drive For Change,” a study on how the Food and Drug Administration’s ban on blood donations from gay men — one which the American Red Cross hopes to reform — isn’t just discriminatory, but harmful to the health of Americans. But what alternatives are there? Good ones, actually.
The ban prohibits donations from any man who has had sex with another man, even once, since 1977. The policy is based on assumed risk, not the fact that all blood is screened for HIV and other blood-based diseases before it is used, and not the fact that the spread of HIV is increasingly a “heterosexual problem” (to put it bluntly, and stupidly). There are some reforms on the table: Reduce the “sex window” from “anytime since 1977” to five years, or one year, or six months.
But as GMHC’s report (full PDF here; summary here) and Captain Obvious notes, those options do little to formidably increase the blood donor supply and still discriminate against gay men. Or at least gay men who are not celibate. “Neither the current policy nor any of the proposed temporary deferral
policies adequately distinguish between low-risk and high-risk sexual practices by MSM donors or others,” the report concludes. “Any policy in which a male donor is deferred because he answers that he has “had sex” with another man during a certain time period, whether since 1977, in the last five years, in the last one year, or otherwise, fails to address the fact that both MSM and non-MSM donors engage in low-risk sexual behavior (e.g., protected sex, monogamous sex with an HIV-negative partner, oral sex) and high-risk sexual behavior (e.g., unprotected anal sex, sex with multiple partners, sex with new partners, sex with HIV-positive partners or partners of unknown HIV status).”
Fine. So what does GMHC recommend? Aside from obvious things like “expanding research,” there’s this: “Screen all donors for high-risk behavior” by modifying the donor questionnaire. And “Only defer prospective donors determined to be at high-risk. The permanent deferral for men who have had sex with men since 1977 should be replaced with a policy that defers high-risk MSMs, as defined by recent sexual history, for a period of time carefully tailored to known window periods, while permitting low-risk MSM donors to donate blood. An MSM donor’s risk should not be measured solely in terms of the date of the donor’s sexual encounters, but also in terms of whether the donor engaged in low-risk sexual practices like condom usage or monogamy. The highest-risk members of the MSM population, such as those who fall into several risk categories (e.g., IV drug users, commercial sex workers) or who report unprotected sex with partner(s) with HIV or with unknown HIV status, may justifiably be subject to lengthy or permanent deferrals.”
Indeed. If a donor’s questionnaire reveals a man has had eighty partners in the past year and uses condoms “sometimes,” then sure, defer the guy. Even if he is heterosexual! But for men who always use condoms and are in monogamous relationships, or have just a handful of sexual partners, and are not drug users, and are not prostitutes, then hey, strap them to a gurney and suck the cells out of their arm this minute.