Ethical for me to lie to donate blood?

In My Humble Opinion
61

I didn’t realize they screened based on sexual preference. At the United Blood Services outlet here (we don’t have a Red Cross station for collecting blood…) they don’t have that on the questionnaire. The questions are all gender neutral and basically ask things like “Have you had sex with an intraveinous drug user since 1970?” or “Have you had unprotected sex with more than 4 people in the last year?” Also things like drug use, past and present. If you smoked meth, they don’t care as much if you’re clean, as if you shot it up. Obviously, current drug use would render you unable to donate.

I haven’t donated in a long time. Dunno if I even can anymore. I should go check.

~Tasha

62

As a gay man who came of age after AIDS was a factor and who- without giving TMI- has NEVER had a sexual experience that would put him at risk for AIDS, I don’t mind the fact that I am excluded so much as I mind the people who ARE at much higher risk who AREN’T excluded. Nowhere does it ask “have you ever had unprotected sex with a stranger, gay or straight?” or “have you ever had unprotected sexual intercourse with numerous partners within a 2 year period” or anything remotely like that.

Personally I would make a new list of all high risk activities from drug use to blood transfusions to unprotected sex (preferably explicit) and ask “Have you done any of the following activities or ever had sex with someone who has?”

63

Well, so far I don’t see anyone providing any evidence that making the changes proposed would make the blood supply any safer. Or even keep it as safe as it already is.

Lacking such evidence, I find it difficult to buy into the concept of reforming the current screening system.

Folks, I practiced medicine when the blood supply was dangerous! It was not nice! HIV and Hepatitis C were all too often the side-effect of necessary transfusions. People continue to die from those diseases daily, despite improved therapies.

But infection from blood transfusion is not nearly so common anymore. The risk of getting a blood-borne disease is far, far lower these days, in no small part thanks to the screening process that people are complaining about here.

So, as someone who prescribes blood products to patients, if you want to convince me that things should be done differently, I need evidence.

64

I agree that no one has a “right” to be a blood donor, and I would definitely be in favor of stricter guidelines disallowing donations by people who have had multiple partners and/or unprotected sex within a certain timeframe (say, long enough that you’re sure the diseases you’re screening out would have shown up on their blood test by then). Similarly, disallowing vegans from the UK seems silly.

[QUOTE=RickJay]
In Canada, that is certainly not true. The questions about sexual history don’t ask if you’re gay or straight.
[/QUOTE]
What you’re saying is technically true… from a certain point of view.

Canadian Blood Services says you can’t donate if you are a male who has had sex with another male since 1977. So technically they aren’t saying gay males can’t donate. Just any gay males who have ever had sex. Regardless of how safe they were, regardless of the number of sexual partners, regardless of when theylast had a negative test for HIV.

And I think, if they really strictly interpreted the rules, very few people would be able to donate blood. How many women who’ve had even only a few partners can definitively state that no man they’ve had sex with has slept with another man since 1977?

Link to PDF of the pamphlet Canadian Blood Services gives to blood donors:

And the page before that, it says:

65

[QUOTE=Qadgop the Mercotan]
So, as someone who prescribes blood products to patients, if you want to convince me that things should be done differently, I need evidence.
[/QUOTE]

Do you deny that a gay man who practices {very} safe sex but has had sex {as some would define it} with a man since 1977 is at lower risk than a promiscuous heterosexual who can currently pass the screening? Or do you believe that protected non-penetrative gay sex is intrinsically more dangerous by it’s nature than unprotected penetrative straight sex?

66

[QUOTE=Sampiro]
Do you deny that a gay man who practices {very} safe sex but has had sex {as some would define it} with a man since 1977 is at lower risk than a promiscuous heterosexual who can currently pass the screening? Or do you believe that protected non-penetrative gay sex is intrinsically more dangerous by it’s nature than unprotected penetrative straight sex?
[/QUOTE]

Give me evidence that changing the screening process to allow such folks to donate doesn’t increase risk.

67

[QUOTE=Qadgop the Mercotan]
Give me evidence that changing the screening process to allow such folks to donate doesn’t increase risk.
[/QUOTE]

I made no such argument, so no I won’t. But give me evidence that not allowing them to donate WHILE STILL ALLOWING PROMISCUOUS HETEROSEXUALS TO DONATE (emphasis not to be construed as shouting but to echo my point above, which was

[QUOTE=Sampiro]
I don’t mind the fact that I am excluded so much as I mind the people who ARE at much higher risk who AREN’T excluded.
[/QUOTE]

Is it in the best interest to accept blood from promiscuous heterosexuals rather than run short, or is there evidence that promiscuous heterosexuals are less risky as blood donors than gays who practice safe sex? Divorcing sexual orientation, is the blood of a promiscuous unsafe heterosexual not generally more likely to endanger someone than the blood of somebody who was in England in 1983? If they are indeed a higher risk than either of these candidates (and please provide cites if you say they are not as risky) and if the whole purpose of the screening and exclusion is to decrease risk, then why, other than prejudice and outdated criteria, should promiscuous heterosexuals (who have never done IV drugs or had sex for money since 1977 [if they quit whoring as a New Year’s Resolution in 1976 then supposedly they’re much safer than if they relapsed the next day] or other things that violate the criteria) also not excluded? This seems negligent, stupid, and arguably bigoted.

68

[QUOTE=Sampiro]
Is it in the best interest to accept blood from promiscuous heterosexuals rather than run short, or is there evidence that promiscuous heterosexuals are less risky as blood donors than gays who practice safe sex?
[/QUOTE]

How would you phrase the questionnaire to ensure getting the safest blood supply? What would you ask that promiscuous folks (straight and gay) would answer correctly and remove themselves from the donors list?

69

The current screening system has worked to cut the rate of disease transmission due to blood products down tremendously. This screening system has been designed by epidemiologists, infectious disease specialists, and public health experts. Some arbitrary lines are drawn to make the system easier to apply, but there is a body of evidence supporting the reasons for the current screening system. That evidence includes statistics on relative risks of promiscuous heterosexual donation vs. monogamous homosexual donation.

Essentially, 8% of the male US homosexual population is HIV positive, while less than 0.1% of the heterosexual population is positive, and most of them who have HIV used illicit IV drugs, or if female, had sex with men who either used IV drugs or also had sex other men. Get the facts about sexual health and HIV | Be in the KNOW

Combine that with the fact that folks tend to underreport their own promiscuity, or outright lie about it, and one of the easiest ways to ensure reduced risk is to just exclude the high risk groups. By doing so, you also include some low-risk subgroups in the high risk group, and you don’t manage to screen all the high-risk subgroups out of the low risk groups either, but it makes for a fairly straightforward, cost-effective screening process.

I’m sure that not all of the evidence is of the highest quality, and arguments can be made for making changes.

But if someone wants to change the system, it’s up to them to provide cites, and demonstrate that the changes will make the system better at doing what it has to do: Provide adequate amounts of safe blood products. The system is doing that pretty well now, but if one can show that banning promiscuous heterosexual donation and/or allowing monogamous homosexual donation will do it better, I’ll be for it.

70

This is all information I received while in training for my job (I draw blood for a blood bank).

[QUOTE=Sal Ammoniac I read in the NY Times that there are 400 commercial plasma collection centers in the U.S., and I have to wonder how many of the people out there selling their blood are as scrupulous as the people on this board. How does that knowledge weigh against the fact that the risk in my donating is, objectively, exceedingly low?[/QUOTE]

Plasma “donated” to plasma centers is used for research only. Blood that is paid for cannot be transfused, due to peoples propensity to lie about their risk factors. Cheezy t-shirts are not considered payment.

[QUOTE=CalMeacham]

Or they ask me if I’ve had sex for money even once since 1977. Does it count if I pay my wife?

[/QUOTE]

Only if she’s a whore.

Har-dee-har-har. (Guess who’s a bit tired of that joke)

[QUOTE=Miller]
Hey, don’t apologize to me. I’m perfectly happy to have an automatic out when someone asks if they can stick a huge fucking needle in me. Just don’t come complaining to me when you hit a shortage. You had your shot at my platelets, and turned up your nose at them. Too bad for you, too bad for the people you’re trying to help. Works out just fine for me, though.
[/QUOTE]

** I ** won’t be complaining to you. That would be rude of me. Also, I’m sure I have never turned up my nose at your platelets. Not only do I personally not draw platelets, I work for a company governed by the FDA and CDC. At no point did either organization ask “lynne_kilii, how do you feel about our antiquated, bigoted questions targeting homosexual men?”

[QUOTE=cbawlmer]

My sister is moving to England for 18 months (or longer) for her job. Will this make her ineligible to donate blood in the future, or is the Mad Cow crisis over now?
[/QUOTE]

She can call the blood center in her area to find out specifics for that blood bank. Unless it is five years total or more since 1980, that would not be a deferral through our blood bank.

[QUOTE=tashabot]
Just as an aside, did you know that if you smoke marijuana on a regular basis, your liver enzymes wind up kinda wonky in a way that might make a screener think you have hepatitis?

My mom found out and is now barred from donating blood. Fun times.
~Tasha
[/QUOTE]

When did she get tested last? Tests evolve all the time, and at least at our blood bank, we no longer screen liver enzymes with the broad brush we used to (if at all, I don’t know), and a lot of donors once deferred are eligible again.

71

I’ve argued before that part of the screening process is in place, in part, to put people at ease about the safety of the blood supply. Whether or not this is sufficent reason to exclude homosexuals is the big question I suppose. I’d like to see some reliable data on the percentage of homosexuals with HIV/AIDS versus heterosexuals before I decide. Anyone got the information?

Marc

72

[QUOTE=CalMeacham]
I have to assume they’ve got some statistical key that they use to decide on these cutoff points. a gat guy who’s been in a monogamous relationship is surely a better bet than a guy who has a great many sex partners in the US who come from high-risk AIDS or BSE areas, but he’s the more discriminated against.
[/QUOTE]
I also wonder how often they reassess these risks.

Are we still worried that someone who contracted HIV in 1978 still doesn’t know that they’re HIV+? That’s a 30 year latency.

73

[QUOTE=Sal Ammoniac]

So what do I do here? Lie and give blood, or take the honest route and cop out?
[/QUOTE]

Truth is always the correct thing.

74

[QUOTE=Sal Ammoniac]
But here’s the thing – the chances that I have the virus are basically nil. In the six months I was in Niger (and this is 20 years ago now) I was as abstemious as if I had taken holy orders,
[/QUOTE]
Abstinent, I think.

75

[QUOTE=Qadgop the Mercotan]
Essentially, 8% of the male US homosexual population is HIV positive, while less than 0.1% of the heterosexual population is positive, and most of them who have HIV used illicit IV drugs, or if female, had sex with men who either used IV drugs or also had sex other men.
[/QUOTE]

I would seriously doubt that the 8% number is valid because it’s damned near impossible to get a (no pun intended) head count of homosexual males. Assuming that of the 200,000,000+ U.S. adults half are male and that of that half 10% are gay/bisexual/or otherwise are men who have had sex with another man since 1977. That would equal roughly 10 million adult males. If 8% are HIV+ then that’s 800,000 HIV+ gay/bisexual men in America.

An estimated 67% of HIV/AIDS cases among males are, according to the CDC , from gay sex. This would mean that the other 33% of HIV+ males would number approximately 400,000. Since women account for 25% of HIV/AIDS cases that would mean approximately 400,000 women are infected as well if the number aboves are legitimate, for a total of 1.6 million HIV/AIDS cases, which is 500,000 more US HIV/AIDS cases than are actually believed to exist (CDC cite again) and WAAAAAAY more than the number said to exist a few years ago when the Red Cross sheets were created. There’s some statistical problems all around as ALL information comes from 33 states, but already the numbers don’t quite work.

76

The other thing that’s weird is that by rights, if they’re going to worry about people who have had sex with other men, regardless of circumstances, why don’t they exclude people from Southern Africa, or who’ve lived in Southern Africa or had sex with someone from Southern Africa? The infection rate down there, among heterosexuals, dwarfs the infection rate for gay men in America. The Red Cross guidelines are completely silent on the subject.

77

[QUOTE=Contrapuntal]
Abstinent, I think.
[/QUOTE]

Well, that, too.

78

I believe the zero tolerance the Red Cross shows to many groups who might have a slightly higher risk of disease has to do with legal liability, rather than with a realistic assessment of risk. The Red Cross got in a lot of trouble in Canada and was ultimately replaced as our blood gathering service because they did not jump on HIV testing as aggressively as they could when we were first learning of that disease. Once burned, twice shy and all that.

79

[QUOTE=cbawlmer]
<snip> I do think some of the restrictions are unfair though, since a straight person has just as good a chance at having HIV as a gay person.

<snip>
[/QUOTE]
The CDC statistics suggest otherwise. I tried to paste it here, but it’s HTML and I couldn’t get it to line up right. Scroll down to AIDS Cases by Transmission Category on this page .

80

[QUOTE=Mikemike2]
I believe the zero tolerance the Red Cross shows to many groups who might have a slightly higher risk of disease has to do with legal liability, rather than with a realistic assessment of risk. The Red Cross got in a lot of trouble in Canada and was ultimately replaced as our blood gathering service because they did not jump on HIV testing as aggressively as they could when we were first learning of that disease. Once burned, twice shy and all that.
[/QUOTE]

I can’t imagine that the Red Cross operating in the U.S. didn’t take a very active interest in the billion dollar settlement that was awarded to the people who got hepatitis and HIV from those tainted blood products in Canada, and altered their donation regulations as a result in the U.S. as well.

I think the bottom line, which people have mentioned more than once in this thread already, is that donating blood is like a private club, and they do have the right to restrict who they allow to become members, so to speak. I would agree that the restrictions are discriminatory, but we’re not talking about people being denied medical treatment or basic human rights based on these restrictions, just not being allowed to help even though they would like to, in the way they want to.

Not allowing people with HIV/AIDS to donate is discriminatory, but I think we all agree that this type of discrimination is absolutely for the public good. Not allowing high risk groups to donate is one level less obviously required, but I think it still serves the public good. Not excluding promiscuous heterosexuals does sound odd to me, but the fact remains that normal penetrative heterosexual sex does not transmit HIV as easily as normal, penetrative homosexual sex does.