It was long overdue and not enough when the U.S. Food and Drug Administration announced last week that it had issued new guidance for gay and bi men donating blood. On April 3, the FDA said that men who have sex with men can donate blood if they've been celibate for three months. The celibacy requirement had been 12 months and before that it was a lifetime ban. The justification was that in 1983, there wasn't a way to detect antibodies to HIV, the virus that causes AIDS, in blood. Today that is not the case, as antibody tests to detect HIV infection in the bloodstream have existed for decades.
The FDA made the decision because the sharp rise in COVID-19 patients has drained blood bank supplies. Its sudden policy change to address this health emergency revealed the longtime discrimination against gay and bi men blood donors — and the insulting celibacy requirement it clings to. The FDA continues to ignore the science of HIV testing, and, as gay state Senator Scott Wiener (D-San Francisco) noted, "continues to codify irrational, fact-free discrimination against gay and bisexual men who simply want to donate blood to save lives."
"While a three-month celibacy requirement is less awful than a one-year celibacy requirement, it is still awful," Wiener stated. "The celibacy requirement still excludes from blood donation a huge number of healthy, HIV-negative gay and bisexual men."
We have railed against the FDA's discriminatory blood donation policy for years, as have many LGBT political and community leaders. Modern HIV testing technology is so accurate that it can detect any HIV infection that occurred 10-14 days or longer before the donation is made. There is no reason to insist on a three-month (or roughly 90-day) celibacy period for gay and bi men to donate blood. Anyone can have HIV and all blood donations are tested equally.
In addition to changing the celibacy requirement for men who have sex with men, the FDA also revised the deferral period from 12 to three months for female donors who have had sex with a man who had sex with another man, and for anyone with recent tattoos and piercings.
For the agency's part, Dr. Peter Marks, director of the FDA's Center for Biologics Evaluation and Research, acknowledged that maintaining an adequate blood supply is vital to public health. "Blood donors help patients of all ages — accident and burn victims, heart surgery and organ transplant patients, and those battling cancer and other life-threatening conditions." The American Red Cross estimates that every two seconds, someone in the U.S. needs blood. Blood donations have dropped dramatically since most blood drives have been canceled due to stay-at-home and physical distancing orders. But blood banks are considered an essential service, and donations can be made safely within the current public health orders.
Marks stated that the FDA wants to do everything it can to encourage more blood donations. But using outdated science is not the way to accomplish that. The FDA needs to revise its guidance so more gay and bi men who are healthy can donate blood like everyone else. This is not only necessary to save lives jeopardized by the coronavirus pandemic, but also for other uses when the outbreak diminishes. To prepare for future health crises, it's imperative to implement policies and practices learned from the current one.
Blood donation guidelines are set by the federal government. The new guidance should also be reevaluated so that more changes can be made.
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