Tainted Blood

I came across an interesting story in the San Jose Mercury News yesterday about how the President of San Jose State University has suspended all blood drives on campus because the FDA’s lifetime ban on blood donations from gay men conflicts with the university’s nondiscrimination policy.

This is apparently the first time that a university president has taken such a dramatic step to protest the ban. Unsurprisingly, the story reported highly negative reactions from blood banks.

I found the story interesting because this ban has always bothered me:despite my pathological fear of needles and propensity to nearly pass out whenever I have blood drawn. Moreover, I don’t think that many people are really aware of the existence of the ban or, if they are, of its apparent breadth.

According to the FDA’s web site,”[m]en who have had sex with other men, at any time since 1977 (the beginning of the AIDS epidemic in the United States) are currently deferred as blood donors.”It’s worth taking a few moments to pull this sentence apart:

First, I find the choice to use the word”deferred”rather than”banned”(or even the oxymoron”permanently deferred”that I found on some blood bank web sites) rather interesting. It makes a lifetime ban that began in 1983 sound as if it were only temporary (like the 12-month deferral for someone who has gotten a tattoo, had sex with a prostitute, or in the case of a woman, who has had sex with a man who has had sex with a man since 1977, all as mentioned here). Indeed, the FDA reconsidered this temporary-sounding”deferral”in May 2007 and decided to leave it in place.

Second, the phrase”men who have had sex with other men”invites questions about how broad the term”sex”is for this purpose: Does it cover anal sex, oral sex, mutual masturbation, etc.? Obviously, not all same-sex sexual practices involve the same risk of transmitting HIV. Nonetheless, I didn’t encounter any sort of definition on the FDA’s web site dealing with this issue.

Third, the words”at any time since 1977″should prevent a man who has had even a single sexual encounter with another man in the past 30 years from donating blood.

Given these last two points:that is, the apparent breadth of the ban and the lack of a definition of”sex”: I wonder how many straight men who neither identify as gay or bisexual:but who have had at least one same-sex sexual experience, whether in high school, college, or later:would answer this question”yes”when they go to donate blood. I suspect that very few, if any, would.

But even beyond the questionable practicability of the standard, I wonder why it is that the FDA feels the need to stereotype and taint an entire community when it could couple screening blood for HIV with an individualized assessment of risk factors. To me, the FDA’s assertion that”to date, no donor eligibility questions have been shown to reliably identify a subset of [men who have sex with men] (e.g., based on monogamy or safe sexual practices) who do not still have a substantially increased rate of HIV infection compared to the general population or currently accepted blood donors”rings quite hollow. This seems especially true when you realize that heterosexuals who have had sex with multiple partners are permitted to donate blood so long as they are not themselves prostitutes or have had sex with a prostitute during the past year.

-Anthony C. Infanti