July 23, 2022. The Daily Reflector. By Serena Mooney.
The U.S. is experiencing a national blood crisis — the worst blood shortage in over a decade, according to the American Red Cross. They report a 10% decline in the number of people donating blood since the beginning of the pandemic, adding to the demand that the organization already faced in recruiting donors before the pandemic. Since blood cannot be manufactured and relies solely on volunteers, a blood shortage means that health care providers will have to make difficult decisions about the care they provide. Some patients with illnesses that require regular transfusions report having to wait weeks after their appointment to receive blood, debilitating them even further. This scarcity of a vital resource leaves already overburdened hospitals with another challenge to face. In this desperate time, the Red Cross is encouraging all those who can to donate; however, one vital and willing population still faces barriers in donating blood: men who have sex with men (MSM).
Current FDA policy states that MSM must abstain from sex for three months before they are allowed to donate blood. This was a recent revision made in 2020 to the previous policy that required a 12-month abstinence. This rule applies to all MSM and people who have sex with MSM, even if they are HIV negative and practicing safe sex. Jeremy Wang, a GLAAD campus ambassador alum, gives a poignant example, “Under current guidelines, a monogamous gay man on PrEP [pre-exposure prophylaxis] who has had protected sex in the past three months with a long-term male partner would not be able to donate blood while a heterosexual male who has had unprotected sex with multiple female partners in the same time period would be allowed to donate.”
This restriction began during HIV/AIDS crisis in the 1980s, when there was a higher prevalence of HIV and no screening methods available for donated blood. Fast forward more than 40 years and the advancements are significant. We now test every unit of blood for HIV, have prophylactic medication for high-risk groups and most importantly we have dispelled the myth that HIV is a “gay disease.” While 2018 data from the CDC shows that gay and bisexual men accounted for 69% of new HIV diagnoses, sexual orientation is not an inherent risk factor. It is risky behaviors such as unprotected sex, sharing contaminated needles or having another sexually transmitted infection that increases one’s risk, according to the World Health Organization. These risk factors are why one of the leading public health organizations, the American Public Health Association, endorses a risk-based screening protocol that is not reliant on a donor’s sexual orientation or gender identity. Other countries have already revised their deferral period. Great Britain, Italy, Spain, and Portugal have all switched to a screening method that assesses high risk behavior regardless of sexual preference. With this improvement in medical technology and knowledge, why is the U.S. still discriminating against this population?
A 2014 report by the Williams Institute at UCLA found that allowing MSM equal access to donating blood could increase the total annual blood supply by 2% to 4%, which would help save the lives of more than a million people. GLAAD, an LGBTQ+ advocacy group, reports that if the three-month deferral period were lifted, an additional 360,000 people would donate blood. That’s 360,000 more units that could be used for life-saving surgeries, accident victims, cancer patients, and even those hospitalized for COVID-19. In yet another complication of this unprecedented time, it is time for the FDA to put science over stigma and consider revising the MSM deferral period.
Serena Mooney is a student in the ECU Brody School of Medicine’s Class of 2024 and a 2021-22 N.C. Schweitzer Fellow. She is from Greenville, N.C.