COLORADO SPRINGS — The national blood shortage is sparking calls for the FDA to make changes to who can donate.
Colorado Senator Michael Bennet, along with 21 lawmakers in Congress, is urging the FDA to lift donor restrictions for gay and bisexual men.
Restrictions stem from the height of the AIDS crisis in the 1980s. It started as a ban that eventually eased to allow them to donate if they remained celibate for three months.
"As a gay man, I just found out about it two years ago. A friend of mine, we were talking about donating blood, and he mentioned he couldn't because he was gay and I was like this is absurd," said Brandon Flanery.
He is also gay and was surprised that the policy still existed.
"I couldn't believe it was actually true. I did research and yes it is. As a gay man that is afraid of needles, it doesn't matter to me because I'm not going to give blood but it feels very archaic, especially with technology nowadays," said Flanery.
"I've gone to donate blood, and I've got denied because I'm transgender," said Lauryn Hogan.
Hogan says she was denied because of the hormones needed for her transition.
"It made me feel like I was less than human. That I was discriminated against because of who I was," said Hogan.
"It's another way of othering. It's another way of saying what we do over here is normal but what you do other there is not. What we know from research and studies, there's a 2014 study that showed that policy affects LGBTQ+ mental health. The study was particularly for young people but it's true for adults as well. We see these national conversations, we see these policies that are put into place to allow or disallow us from doing things. That affects how we view ourselves, how the world views us which in turn affects our mental health. We also know there are 76 percent of young people right now who see our current political climate and discussions and that is negatively impacting 76 percent of our LGBTQ+ youth," said Alissa Smith, Inside Out Youth Services.
Smith says all of the blood is tested, and there is no basis for denying gay and bisexual men or people who've had sex with gay and bisexual men to donate blood.
"What I've heard from people in the community is that they want to help when we have a shortage like this or when a tragedy happens. When the Pulse Nightclub shooting happened, so many people wanted to donate blood who were in the LGBTQ+ community but half of us were barred from doing so because of our sexual history. Now there is that rule that you have to be celibate for three months before you can donate but if you're talking about people in committed relationships or even have sex like normal people do, you can't expect three-month celibacy to donate blood," said Smith.
Now lawmakers are calling for an end to the policy. In a letter, they said it discriminates against members of the LGBTQ+ community, and given the advances in blood screening and safety technology it is not scientifically sound. It goes on to say that with the increased uptake of Pre-Exposure Prophylaxis (PrEP), which significantly reduces the likelihood of contracting HIV, many more gay and bisexual men are aware of their HIV status and are taking steps to eliminate their personal risk.
"It is outdated and discriminatory, especially since they do test all blood donations before use. It just really seems like it's time to get rid of that ban, especially since there is such a shortage right now," said Darrel Vigil, Chief Executive Officer of the Colorado Health Network.
The Colorado Health Network has a large HIV prevention program that helps communities prevent the spread of the virus.
"We use rapid tests in our organization, and you get results within one minute. Some of our offices use the Alere test which takes a little longer but it detects HIV one week sooner. Most tests won't detect it if you've just been exposed within days or sometimes a week or more. You really want to make sure you're testing frequently if someone has been exposed or potentially exposed," said Vigil. "I recall back in the early 90s going in for an HIV test myself. They gave you a number because it was anonymous testing and it was a week so all week you were wondering if you were HIV positive or not. Then you would go in the following week and give you your results. We have really come a long way with HIV testing. Today's tests are over 99 percent accurate, about 99. something for the HIV tests that we use today," said Vigil.
Vigil says the policy is preventing a large group of individuals from helping the shortage.
"If someone is in treatment and care and they are HIV positive, they can get their viral load at an undetectable level. I think PREP combined with U=U, which is a federal campaign that means undetectable means untransmittable, it's virtually impossible for HIV transmission to take place. It's important folks get tested regularly, and if they are HIV positive, get into treatment and care right away so they can work on getting that viral load to undetectable," said Vigil.
For more information on prevention resources and services, visit the Colorado Health Network website. LGBTQ+ community members interested in support can email transfigurez@gmail.com.
“Vitalant (‘Vye-TAL-ent’) is dedicated to welcoming as many donors as possible to contribute to a safe blood supply. We are at the forefront of donor eligibility research that informs potential changes to donation policies established by the FDA.
Vitalant, OneBlood and the American Red Cross are partnering on the ADVANCE Study, Assessing Donor Variability And New Concepts in Eligibility, focused on the FDA’s donor deferral policy for men who have sex with men – or MSM as it is commonly referred. The current MSM policy prohibits a man who has had sex with another man from donating blood for three months following the most recent sexual contact.
The ADVANCE Study is a first step in providing data that will help the FDA determine if a blood donor history questionnaire based on individual risk would be as effective as a time-based deferral in reducing the risk of HIV. Questions on the donor history questionnaire help to determine a possible recent behavioral exposure that could lead to a ‘window period’ for detection of infection, meaning a potential donor may be in the early stages of infection when the virus is present below detectable levels in the donation. During the ‘window period,’ the infection may not be detectable by laboratory testing but may still be transmitted to others by a blood transfusion.
The ADVANCE Study is designed to assess if new questions related to behaviors are effective in distinguishing between MSM who may have recently become infected with HIV and those who do not have HIV infection. Depending on the findings, the additional questions may be added to the donor history questionnaire in the future.
The study is halfway toward its goal of enrolling 2,000 participants across eight cities: Washington D.C., San Francisco, Orlando, New Orleans/Baton Rouge, Miami, Memphis, Los Angeles, and Atlanta. Gay and bisexual men who are 18 to 39 years old are encouraged to see if they meet the eligibility criteria at ADVANCEstudy.org.”
Dear Secretary Becerra and Acting Commissioner Woodcock,
We write to express our alarm at the nationwide shortage of blood and blood products, which has placed patient care and safety at risk. For the first time, the nation’s leading blood donation organizations, including the Red Cross, have declared a national blood supply crisis due to the continued impact of the COVID-19 pandemic. We urge the Food and Drug Administration (FDA) to quickly act on the best available science and update its outdated and discriminatory blood donor deferral policies for men who have sex with men (MSM), a long overdue step that would dramatically increase the eligible donor base.
It is critical that all patients have access to the health care services they need during this pandemic, and for many, the availability of blood and blood products is a necessary component of care. Unfortunately, a significant drop in the number of donations during the COVID-19 pandemic has resulted in a serious shortage of available blood. The Red Cross, America’s Blood Centers, and AABB, formerly the American Association of Blood Banks, have declared a nationwide blood supply crisis for the first time, as the nation experiences its worst blood shortfall in over a decade.
In recent weeks, hospitals have had less than a single day’s supply of critical blood products, and these organizations have had to limit
distribution to health facilities in need. In fact, the Red Cross has reported that as much as one-quarter of
hospital blood needs are not currently being met.
While no single solution can fully solve these challenges, the FDA has the ability to take a simple and science-based step to dramatically increase the donor base and help address this crisis. In fact, the agency responded to our previous correspondence and took an encouraging step in the right direction during the early days of the pandemic, shortening the deferral period for MSM from 12 months down to three
months in March of 2020.
However, any policy that continues to categorically single out the LGBTQ+ community is discriminatory and wrong. Given advances in blood screening and safety technology, a time-based policy for gay and bisexual men is not scientifically sound, continues to effectively exclude an entire group of people, and does not meet the urgent demands of the moment. And further, with increased uptake of Pre-Exposure Prophylaxis (PrEP), which significantly reduces the likelihood that an HIV-negative individual will acquire HIV, many more gay and bisexual men are aware of their HIV status and are taking steps to
eliminate their personal risk. Instead of the current categorical deferral guidelines, we must adopt evidence-based policies focused on assessment of an individual’s risk, not inaccurate and antiquated stereotypes.
All over the world, other countries have led on this issue by scrapping their discriminatory blood donation policies. In October of last year, Israel removed all restrictions on MSM blood donation.3 And just last month, Canada’s blood regulatory agency proposed removing all screening questions focused on gender and sexuality.
The tide is turning, and the data support this change. In light of the nation’s urgent blood supply crisis and to ensure that Americans have access to life-saving blood transfusions during the pandemic, we urge you to swiftly update your current blood donor deferral policies in favor of ones that are grounded in science, based on individualized risk factors, and allow all potentially eligible donors to do so free of stigma. We also request a briefing in the next 30 days on the agency’s plan to update its MSM blood donation policies.
Thank you for your attention to this important issue.
