Gays giving blood, what is the problem?

Great Debates
1

Link

1977???

Hey, I’m all for being cautious. It just seems that 26 years might be a bit of overkill, seeing that the blood banks are generally pretty desperate for people to donate. I would bet that there aren’t too many people out there, gay or straight, that haven’t had sex in 26 years. The time limit seems to be a way of saying “Gay men cannot give blood”, without actually saying it.

Being that straight people can and do develop HIV, why isn’t there the same amount of concern? I would assume that all donated blood is screened. Is this screening just not reliable enough? It just seems to me that saving lives is important enough of a cause that, if there is such a shortage of blood, maybe this policy should be examined a little more closely to see if it is based on fear or actual data.

Also worth mentioning is the fact that there is no way to prove when the last time someone has had sex. They are basically taking peoples word for it. According to the story, there are gay people that lie about their sexual history so that they may be able to donate. The current system is obviously far from infallable. It seems to me that it would make more sense to require everyone to be tested for a period of 5 years before they are allowed to give blood. That would at least be more effective.

What do you think? Should these requirements be changed or are they, in your opinion, justified?

2

http://www.aegis.com/pubs/gmhc/2000/GM141101.html

This has some pretty good info on the why’s and how’s. Basically what it said is that being as there are so few gay men, and the risks of HIV and other diseases being so pronounced in gay men, that the benefits of allowing “clean” gay men donate does not offset the risks of getting the dirty blood.

To me, this is a health issue, and not a discrimination one. IN the article it states that the FDA had considered changing the ban because a “lifetime ban” is pretty aggregious considering what we know of aids today. The the subject of other transmitted diseases that where pronounced in gay men came up and they decided not to change it.

In that light, I feel that the doctors should do the doctoring. They are the experts. The strict restrictions they have on blood donations disriminate a hell of allot. (read the article). And if the exoerts tell me that it is more likely that I would get some disease from a blood donation so that we do not discriminate gainst gay men, I agree with the status quo.

My wife is Thai. If the FDA decided to ban all blood donation from anyone who ever slept with someone from that country, I would not be offended. I may want to know why, but my feelings should have no say in the matter.

3

I fail to see why people are flipping out. Discrimination is not, in itself, a bad thing. We discriminate every day. By choosing chicken salad over tuna, we’ve discriminated against the tuna. It becomes bad when it turns into irrational discrimination. Gay men, last I checked, made up 40% of people living with AIDS (or was that newly-diagnosed cases? can’t recall). At most, we make up 10% of the male population. I would place the percentage at less than that. Figuring liberally, that still places us at risks far above the average heterosexual’s.

4

You have to apply statistics to the problem. When you take the probabilty of a carrier, times the probability of a blood test failure, you get some idea of the risk involved.

It’s common sense, you wouldn’t accept any blood from China at the moment. As time passes, it won’t matter, but on this day in history, you risk getting SARS.

5

The restrictions on giving blood are wide ranging, it’s not just gay men who can’t give:

living in Africa
living in Great Britan
living in Europe
cocaine use
illegal steroid use
tattoos
prostitution

This is but a small sample of the things that can disqualify you from giving blood. It’s all about risk vs. return, statistically the risk is higher when these things are true, and they’re not taking any chances.

6

I have heard that the restrictions on blood donations for anyone ever resident in Great Britain are due to the implied risk of the blood being contaminated by CJD.
However, people who live in GB donate their blood and the place is hardly riddled with death from a plague of CJD

I am sure, that in time, the restrictions on GB and Chinese residents donating blood in the US will be lifted.

One thing I do wonder about though, is a policy that I have heard of in the States.
Is it really true that you are paid for your blood?
I can only speak for the UK and Ireland, where I have donated blood. It is a gift, donated by the individual for no payment. People donate their blood, not sell it. That is why the people who do it are called blood donors, not blood sellers.

Surely the greatest risk to the safety of the national blood supply is putting a price on a donation?
If you were absolutely desperate for cash and could get a few quid from selling your blood, surely the temptation to lie on the questionnaire would be enormous.

7

For the most part, no. You can get paid for selling plasma, but this can be done more often than once every eight weeks.

I believe most blood in the US is donated, not sold. I have donated several gallons of blood over my lifetime, and have never been offered money for donating whole blood.

Regards,
Shodan

8

We had a raging debate about this over the Canadian system’s rules just a few months ago.

I appreciate that people feel like shit if they’re told “we don’t want your donations,” but you need only look at the Canadian experience to see what blood banks are up against in terms of their legal exposure. The AIDS/Hep-C problem basically destroyed the Canadian Red Cross. If their successors are a little overcautious when accepted blood, it’s quite understandable. People’s lives are at stake, people’s career are at stake, and the simple fact is that their screening questions are specifically directed to identify higher risk donors, and it’s a fact beyond reasonable dispute that in the U.S. and Canada, gay men are much likelier to carry HIV than is true for the population at large; even today the transmission rate among gay men is way, way higher than the general average. The screening questions aren’t perfect, but if you put perfect screening processes into place you couldn’t afford it. They’re not trying to hurt anyone, they’re trying to NOT hurt anyone.

Now, if the blood donor services were to, say, refuse to HIRE someone for being gay, I would be screaming bloody murder. But nobody has a legal or moral right to have a donation accepted.

9

It’s not that I don’t understand the “better safe than sorry” approach. It doesn’t do much good to save someones life if you are going to give them a deadly disease in the process. I guess two things bother me about this…

  1. 26 years still seems awfully excessive. Could you have AIDS for 10 years and not be aware? I would think that a monogomous gay couple, who have both been tested numerous times over the course of 5 years should be considered safe. They are not high risk by any means.

  2. The answers to the questions asked are accepted as truthful but should they be? I saw an interesting article dealing with office blood drives. A person might not want to disclose their orientation at work to their co-workers who pressure everyone to give. Therefore, they might lie rather than admit to homosexuality (or drug use, for that matter). Someone else might lie just because they think they are safe and want to contribute.

Luckily, rather than rely on the honesty of people, all blood that is donated goes through a screening process. I guess my question is, if this safeguard is in place anyway (and it should be) why is it important as to whether a person had sex in the last 26 years. wouldn’t a better question be “Have you had unsafe sex in the past 5 years” and follow it with "If no, have you been tested at least 3 times in the last 3 years.

In another thread, Jillcat, who is quite knowledgable in this area, made the following statement:

If the above is true, and applicants were required to be tested, I see no reason why someone needs to be abstinate for 26 years to give blood. Surely there must be a way to widen the pool of potential donors without increasing the overall risk.

10

You’re absolutely right, musicguy, in that blood does get tested for diseases and so forth. You’re also right in that many people do lie about their past sexual activity. To clarify the last point, the blood centers don’t exactly care about your orientation. Gay men like me (sometimes to my annoyance) who have not had sex with another man are free to donate, and any straight fellow who has fooled around with a guy once since '77 can’t.

However…

  1. Tests foul up. Human error does enter the picture when testing blood, and contaminated blood does end up in the donor pool. Do you really want them to foul up with blood that does have a higher probability of carrying HIV?

  2. Blood that does test positive for various diseases must be destroyed. This means they’ve lost the blood plus the time and money they spent on the tests. Again, it all comes down to probability weighed into investment. Its cold and it hurts, but blood banks have limited funds that they can not afford to waste.

  3. a) In regards to all the gray areas you draw, they’re all true. However, how would you like your local blood bank to investigate them? How can they know that your partner really is being monogamous? Is he lying to you and sleeping around with another guy, thus dumping both of you back into the inflated probability range?

b) Yes there have been cases of people carrying the HIV virus for long periods of time with no treatment and no AIDS symptoms. They’re being studied to find out why they seem to be resisting so well.

  1. Two problems with testing folks for HIV

a) I believe court cases have established that no one can force you into getting an HIV test. For someone like Hoxworth to begin mandating it for donations would be treading on murky legal grounds. Probably kosher doesn’t cut it when you’re suddenly paying a lawyer outrageous sums of money to defend you against a lawsuit.

b) How do you know someone hasn’t slept with another guy under the six month window? HIV tests are can yield false negatives in those cases.

It all comes down to lines. Paperwork and institutions can’t handle gray areas, much as we would like them to. So it all comes down to a fine line and where you draw it.

11

[QUOTE]
*Originally posted by musicguy *

The Red Cross has a way around this. There are two bar coded stickers which appear virtually identical on the questionnaire. The person processing you makes a point of looking away while you apply the sticker. Using the stickers you can (non-verbally) tell them not to use your blood. They also give you a phone number you can call after the donation.

12

Well, there you go; you’d have to require applicants be tested - an impossible logistical task. The blood services organizations don’t have the time or inclination to test you or put in an additional administrative process to handle accepting notarized copies of your own blood tests. The marginal value in added blood supply simply ain’t worth it.

13

  1. As Priam stated, how does the bloodbank etc; know this about the donor? They do not. And as you said, people lie. As few gay men as there are, they cannot justify the investigation for the few. They have to rely on statistical evidence and discriminate based on that.

  2. That is why there are several checks and “discrimination” processes. Asking the donor their personal history is just one. The screening processes are not fail-safe either. And as was already pointed out, not very cost effective to rely on it to be the only source for weeding out bad blood.

from the link i provided:

And as I stated before, and was provided in my link, if HIV was the only risk that gay men provide, the FDA would have most likely changed the rule.

The link also provided an answer to this. Regarding HHV-8 and stating that the population of gay men versus the risks is not a very big pool of potential donors versus the infected potential pool from that demographic.

This is not a perfect system, and they acknowledged it. Regarding to this spacific descrimination practice, again the link provides some insight.

Honestly, I can understand if someone else participating in your thread passed on my link, but I provided it to answer your questions.

14

It’s Australia I worry for. They ban anyone who has lived in the UK for six months or more, since 1980-something. THOUSANDS of young Australians have spent a year or more doing the backpacking/London/Europe thing. Presumably they are all ineligible to donate. Proportionally, that must be a reasonably significant number of people, removed permanently from the blood donor pool. Given how small Australia’s population is, compared to the US.

15

I understand all of your points. And yes spite, I did read your link. Perhaps any gains by allowing more gay men to donate is so insignificant that it doesn’t outweight the risk. I can buy that. But I also think that if you look at all of the causes that a person could be eliminated as a donor, that number becomes more significant. Having said that, the reason I posted this was to become more informed on the topic and I appreciate all of your input.

Concerning testing, I can understand that any kind of manditory testing would be a burden on the system. I can agree with that too. But…

and…having gay sex, are all circumstances that can ban you from donating blood. I think we would all agree that there is a shortage of donors. One can only wonder how much more blood could be collected if people who fell into any of these groups could prove that they do not carry the HIV virus or any of the others that have been mentioned. If you are willing to make the effort to take the required tests over a period of time, and they conclusively prove that you do not have the virus, you are far safer than someone who does not answer the questions honestly. They are going to give blood anyway and yet the screening is apparently not accurate enough to rule out that their blood is not infected. So how is this “honor system” really protecting anyone. Wouldn’t someone that has been repeatedly tested be far safer than someone who might not admit to having sex with a man, out of embarrasment. Or maybe the person lying would rationalize that " I only had sex with one guy and he told me he was safe. That was many years ago and I’m not sick so I’m an ok donor." I’m not saying that this is an acceptable rationalization, but I’m sure it happens. I am also pretty sure that there are quite a few people that donate blood, that don’t know that they are ,in fact, safe, yet do so anyway. Either the blood screening works or it does not, and if it isn’t effective, do I really want to take someones word for it that they are safe.

Besides, there are a hell of a lot of people out there with tattoos who are not infected and would like to donate but cannot. There are probably a hell of a lot more people out there with tattoos, than who are gay. How many people are being denied here? If you eliminate everyone who has ever done cocaine, lived in Europe, received a tattoo, or had gay sex, not to mention all of the other catagories, you are eliminating a heck of a lot of people.

I guess I just feel that this is important enough of a cause that I would like to see a way that more people, if they aren’t truly a risk, could help out, especially since they are willing.

Another way is to make sure that everyone that is eligible but hasn’t given in the past, consider doing so. That would go a long way to helping this problem as well.

16

I’d like to ask-what about lesbians? Aren’t they the lowest percentage of HIV positive?

So are lesbians banned from donating?

17

Guin, I can tell you from personal experience that when I donate blood to the Central Blood Bank of Pittsburgh I am asked no questions whatsoever about having sex specifically with women.

The only questions regarding sex are whether or not I have had sex with someone who has tested positive, even once, for HIV or hepatitis, whether I have ever been given or given money or drugs in exchange for sex, whether or not I have had sex with someone who has been incarcerated for longer than 72 hours since 1977, or whether or not I have had sex with a man who has had sex with a man since 1977.

18

I’m trying to figure out what this implies exactly. Are they figuring that if you are in prison for more than 72 hours, you are likely going to engage in unsafe sex or use intraveneous drugs? Those are the only two reasons I can think of.

19

not to mention, if you are a female being asked this question, what are the chances of you having sex with any male, let alone one in a high risk group, while incarcerated?

20

Promiscuous, unprotected, anonymous sex. Acting like AIDS isn’t primarily a gay problem is what allowed it to spread as quickly as it did.

To ignore the prevalence of AIDS in the gay community would be to allow political correctness to run amuck.