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By Ian Lyons
April 15, 2014
Credit : AP/Patrick Sison.

In the late 1970s, a mysterious immune disorder was taking root in the United States. Authorities knew little, only that it was a blood-borne disease due to its prevalence in hemophiliacs, who receive blood transfusions routinely.

However, mysteriously the disease was inflicting a heavy toll on gay men.

Previously healthy young gay men were succumbing to rare infections caused by the disease’s ravaging of their immune systems. There was no reliable test for the disease, which at the time did not even have a name. Today, we now know it as H.I.V./A.I.D.S. In 1983, the United States Food and Drug Administration instituted a ban on blood donations from “men who have sex with men” (MSM) to minimize H.I.V.’s spread.

Though few Millennials will recall these events, we still feel their effects today—gay and bisexual men are still barred from donating.  Despite huge leaps in testing, screening, and treating H.I.V./A.I.D.S. Due to advances in screening, the risk of contracting H.I.V. from a blood transfusion now stands at one in 2 million, as opposed to one in 450,000 to 600,000 in 1995. In fact, the last reported H.I.V. transmission from a blood transfusion was in 2008—the first instance of its kind since 2002.

All donated blood is tested for H.I.V. and other blood-borne illnesses before it is used.

New drugs like pre-exposure prophylaxis (PreP) offer preventative help to people who are at risk of contracting H.I.V. The PreP pill is taken regularly and is used along with other prevention options. In recent studies, those who reported that they took the PreP pill daily had a 90 percent reduced risk of H.I.V. infection. H.I.V./A.I.D.S. has gone from a death sentence to a treatable, largely outpatient disease.

Anti-retroviral therapy (ART) has reduced mortality drastically and improved quality of life among H.I.V./A.I.D.S. patients. New breakthroughs seem inevitable, and President Obama last year announced a boost for funding to H.I.V./A.I.D.S. research—pledging last year up to $5 billion to support an international effort to fight H.I.V./A.I.D.S. Yet, the ban on blood transfusions remains. 

Various members of the medical and donor community support changing the FDA’s MSM deferral policy. This past year, the American Medical Association (AMA) and the American Osteopathic Association came out in opposition of the ban. The AABB (formerly the American Association of Blood Banks), America’s Blood Centers, and the American Red Cross issued a joint statement last June stating that the lifetime ban for MSM should be changed.

The Human Rights Campaign (HRC) has consistently opposed it. The Department of Health and Human Services (HHS) last discussed the policy in 2010, agreeing unanimously that the ban is “suboptimal” because it prevents a large number of low-risk donations (though they voted 9 to 6 to keep the policy in place).

The FDA defers gay and bisexual donors in a way that it doesn’t for other high-risk groups. A man who last had sex with another man in 1978 is considered too risky, while a person who had heterosexual sex with someone infected with H.I.V. 13 months ago is allowed to give blood.

HRC advocates for a policy that would require asking behavioral questions before blood donation, deferring potential donors who have engaged in risky behavior regardless of sexual orientation. With a need for 41,000 donations per day to keep up with demand and frequent blood shortages, a rule change similar to HRC’s proposal, could allow potentially millions of low-risk donations and save lives as a result.

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