This is a late World AIDS Day entry that I wanted to put out there. The FDA panel today recommended the one year deferment for gay men to donate blood. No votes were taken, but they will work to issue national guidelines in the future. This post was edited slightly to account for the lag in publishing.
I still remember the days that this was considered a gay disease—not the “that’s so gay”gay, I mean “the faggot deserved it”gay. All throughout high school, my mom would ask me what new gay/AIDS jokes I heard recently; they cheered her up from all the diagnoses and funerals of friends she knew. I walked in numerous AIDS walks (including one in the early 2000’s with my daughter in a stroller), donated money, I even helped design information brochures with the NYC Board of Health. Since those days as AIDS was a death sentence, I’ve seen it become a chronic disease for millions in the US and still a killer on other continents. While he medicinal treatments have evolved, the stigma hasn’t in many ways. I was reminded of this today on World AIDS Day.
On December 2, the Food and Drug Administration had a meeting where they heard testimony to consider a partial lift on banning homosexuals from donating blood. Since 1983—near the height of the epidemic—gay men were banned from donating blood for life. It makes less sense to keep that policy, so the proposal for the meeting tomorrow—endorsed by the American Red Cross among others—is to create a one year deferment of gay men before they can donate. This is a step in the right direction, but not enough.
When I was younger, I used to engage in risky sexual activity by visiting prostitutes (it was low risk but still risky for contracting HIV). With the old policy in place, that means that at my worst risk factor, I would be deferred for one year before I could donate blood, while a monogamous gay couple would be banned for life from donating. Changing the policy would put both of us on the same one year deferment. The problem here is that my risk factor is still higher going from hooker to hooker, than a gay couple practicing safe sex in a monogamous relationship, but the gay couple is treated as if they were the same risk. This is stigmatizing and problematic and wrong. In addition to assuming sexuality between homosexuals is wrong thus shunning it and the people for a certain behavior, you are actually barring life saving donations from people who have the same risk factors as any other sexually active couple engaged in safe sex.
The simple way to solve the issue is do do what Italy did in 2001, and switch from permanent deferment for “men who have sex with men” donating blood to an individual risk assessment of sexual behaviors of donors. According to a study in the National Center for Biotechnology Information, the switch “did not significantly affect either the incidence or prevalence of HIV infection among blood donors.” This means it works as a screening tool minus the irrational stigmatizing of a potential blood donating population. This properly puts the onus of risk, correctly, on the individual behaviors instead of a blanket condemnation of a specific population. It’s also important to note that the majority of those contracting HIV in Italy did so through unprotected HETEROSEXUAL sex both before and after the switch to individual risk assessment.
For the US to switch to risk assessment of each donor instead of a completely barring gay men from donating would be a great stride in erasing the past stigma of this disease, and might even help educate the public about the true causes of contracting the disease. It will also save lives as more people will be able to donate blood and keep blood banks fully stocked.
While the original policy was instituted in a time of fear and ignorance about the disease itself, now that we are more enlightened about the nature of the disease, it is time to operate without fear. The one-year deferment is a decent start; switching to individual risk assessment models would be the best and more important step to take.