This week the Department of Health and Human Services published a notice in the Federal Register seeking information to create a study to reevaluate blood donation eligibility criteria for men who have sex with men. The news, first reported in the Washington Blade, is a welcome first step in removing an odious ban that stigmatizes gay and bisexual men and has outlived its purpose.
Gay and bi men have been prohibited since 1985 – the height of the AIDS epidemic – from donating blood. Under current regulations, men who have had sex with other men since 1977, even once, are not eligible blood donors.
Back when AIDS was known as "gay cancer" and there were no HIV tests available, public health officials and blood banks took precautions to ban certain donor profiles after AIDS cases were documented among people who received blood transfusions. But today, more than 30 years after the first reported AIDS cases, more sophisticated testing is available. In recent years, blood banks increasingly support an easing of the ban, citing chronic shortages.
HHS is willing to develop and implement a pilot study under which gay and bi men who meet specific criteria would be permitted to donate blood, "with additional safeguards in place to protect blood recipients during the course of the study," the notice states.
One possible strategy, the Blade reported, is pre-donation testing, in which the donor would have a pre-donation blood sample drawn that is tested prior to the actual donation for HIV/AIDS infection. Keep in mind that blood is already tested three or four times after it is donated, so one more test couldn't hurt.
State Senator Mark Leno (D-San Francisco) has been a proponent of lifting the ban on gay blood donations since he was a supervisor more than a decade ago. Leno, who is gay, recalled receiving a request to donate blood while on the board. But then he noticed a line at the bottom in small print that essentially said that if you're a gay man, don't bother.
"I never knew that before," Leno recalled this week.
Leno correctly pointed out that the blood ban has always been discriminatory and, more importantly, has always been focused on the wrong question: It's not one's sex partner but one's decisions and actions that can be potentially dangerous. A straight man could have sex with numerous partners and not be safe, yet he would never be asked about his sexual history.
Leno, who is HIV-negative, said, "Of course I would be able to give blood."
When Leno was on the Board of Supervisors he met with local blood bank officials, who back then were supportive of his advocacy to do away with the ban. They knew that science had advanced, that testing had improved, and that, at its core, the blood ban is based on homophobia.
As a sign of the times – and this was in 2000, not 1985 – Leno recalled appearing on a right-wing radio show about the issue. The host opened up the phone lines with the question, "If you needed blood and gay blood was the only kind available, would you take it?"
"It's an emotionally charged subject," Leno acknowledged, but the time has come to move forward, however slowly, on changing the policy.
HHS has taken the smallest of steps. The notice is not a request for proposals nor is it soliciting contracts; but HHS is opening up a dialogue and appealing to people for information. And that's a positive development.