FDA Considers Lifting Ban on Gay Men Donating Blood

By Mina Kim and Peter Shuler

The Food and Drug Administration (FDA) will consider Tuesday lifting a 31-year-old ban on blood donations from gay men.

Originally fueled by fear and little understanding of AIDS, federal regulators in 1983 banned donations from men who have sex with men. Now a federal health advisory committee recommends that the FDA ease that ban, saying that men who have not had sex with another man for a year may donate blood.

Hank Greely is a professor of law and medicine at Stanford and directs the Center for Law and the Biosciences. He reminded listeners of how little we knew about AIDS when the ban was first put in place. "No one really knew what caused AIDS" at that time, he said. "They did know people were getting the disease from transfusions, and that gay men were one of the groups that had the highest incidence of the disease."

But pretty quickly, the HIV virus was identified and tests were developed to see if donated blood contained antibodies to the virus -- indicating the donor was infected with HIV. Originally, Greely said, that process took a couple months, but over the intervening years that window has shrunk to 11 days.

Greely says that, in theory, the waiting period for a man who has had sex with another man to be eligible to donate blood could be shrunk to two weeks. "A year seems a little strong," Greely said, "but the idea of a waiting period is not crazy. It’s an idea to try to prevent undetected and undetectable HIV-contaminated blood from getting into the blood transfusion system."

Ryan James Yezak with the National Gay Blood Drive thinks any ban is discriminatory, but agrees that the change is a step in the right direction. "People who need blood don’t care whether it’s straight blood or gay blood," he said. "Blood is blood. They want safe blood, and that is something our community has to offer."

Some advocates are pushing for a behavior-based risk assessment. such as banning anyone who has recently had unsafe sex. Italy has such a ban in place. Greely said moving to this kind of assessment might be the next step.

"But it’s important to remember, in blood donation, there are a lot of categories that are excluded or at least deferred," said Greely, who pointed out that people who have gotten a tattoo may not donate for a year. People who were in Great Britain during the time of the mad cow disease outbreak are banned for life.

"There are a variety of these exclusions," he said. "What makes this one particularly sensitive is that it’s an exclusion that taps into a preexisting group that has a history of being discriminated against."

Greely said he thinks the change would be "clearly better" than the status quo. And that the one-year deferral could be "cut down from a safety perspective to something shorter."

But he also said that the concern about diseases being transmitted through blood is "a real one and has had some tragic consequences."

"About half of the hemophiliacs alive in the United States in 1982 contracted AIDS as a result of blood product transfusions that were contaminated with HIV," he said. "Thousands of people got AIDS through transfusions, so the recommendations coming out about blood transfusions are based on an appropriate desire to maximize the safety of those transfusions."

Whether the U.S. should move to a behavior-based risk assessment is a good question, he said. "But it is beyond question that the proposed move is a lot better than the status quo."