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Repeat, Sorry, Dr!
Aug 1, 2008

Hi, Dr. Bob.

My apologies for posing a repeat question, as I didn't see a response; I realize how many inquires you must get! To repeat: Last month, I became sexually active with a lady friend I've been seeing for a while. She's of Nigerian decent, having moved here when she was 9 years old (she's in her mid-20's now). Condoms have been used consistently and correct, with no breakages ever noticed. We've also performed unprotected oral sex on one another.

Having read the wealth of information on this site, I know that my risk of contracting HIV from fellatio is almost non-existent, and the risk of contraction from offering cunnilingus is negligible at best. Got it!

Fast forward to a couple of weeks back. When trying to give blood recently, one of the questions asked was, "Have you had sex with anyone from the following countries," one of which was Nigeria. I was immediately denied the opportunity to give. Now to my point:

When I asked the nurse why I was denied, she replied that Nigeria is an HIV "hot spot," hence anyone in contact with is automatically rejected. She also went on to say that I was now at an "abnormally high risk" of contracting the disease, and as such should test immediately not only at the 3 month but 6 month mark, too.

Now to my question: Is this nurse justified in now increasing my paranoia ten-fold, or should I just relax and test annually as I do now? As a side note, my friend assures me she's clean, but also admits it's been over a years since she's been tested. So that said, I have to say she's right now of unknown status.

Thanks again, Dr. I admire the work you do and the wisdom you dispense.

Take care.

Response from Dr. Frascino

Hi,

So you showed up with all good intentions to donate blood and were rejected for an unscientific and unjustifiable reason? Join the club! Any man who admits to having had sex with another man is also permanently barred. (See below.) I certainly agree with taking every reasonable precaution to protect the blood supply, but rules like blocking all gay men or people who "have had sex with anyone from the following countries . . ." really makes absolutely no sense. Your exposure was to a Nigerian woman who moved here when she was nine years old! Frevinsakes!

I'm also amazed the "nurse" advised you that you were now at "abnormally high risk" for HIV!!!! It seems clear to me you understand HIV risk far more clearly than she does. Did her nurse nametag happen to read "Nurse Ratchet"??

My advice is to relax and continue to test annually. You're fine. It's Nurse Ratchet who's confused. We have a whole chapter devoted to blood donations questions in the archives. If you want additional information or need additional reassurance, have a look.

Dr. Bob

Blood donation discrimination question Feb 8, 2008

Hi. I am a medical student, and I wanted to have your input about the whole blood donation issue. I am a completely pro-equality straight married woman, and the idea that gay men can't donate blood has always disturbed me. Recently a university decided it was no longer holding blood drives on campus for this reason. This kind of disturbs me too! People (gay, straight, HIV negative, positive, whatever!) need these donations! What is your opinion and why?

As I read more about the whole issue, I am seeing how gut-wrenchingly complex it is, so I wanted to know if you had any suggestions for what the blood donation regulations SHOULD be. While the vast majority of gay men are HIV negative, they are more likely to be positive than the general population. Although blood is screened for HIV, there is inevitably going to be some donations that passes testing. The FDA gives that as a reason (excuse?) for why gay men shouldn't donate, despite the blood screening. But then should the FDA just bar everyone who had unprotected sex in the last six months, gay or straight, but allow gay people who had unprotected sex before then to donate? Basically what is the best way to protect the blood supply, make sure it's not so restrictive that many fewer people can donate, AND AVOID DISCRIMINATION?

THANKS! AC

Response from Dr. Frascino

Hello AC,

This is not a difficult or complex issue. Common sense is all that's required. The rules should apply equally to gays as well as straights. Exclude blood donors who have had potentially risky exposures within the past three months. Personally I'd rather get a transfusion from a gay monogamously coupled male than a 20-year-old heterosexual horndog college kid who knows nothing about STD protection, because all he's been exposed to is Dubya's disastrous abstinence-only till marriage sex-education initiative. These kids often are having risky sex with multiple partners and may not even realize it. Half of all new HIV infections in the U.S. are in young adults aged 13-24. Yet these heterosexuals are welcomed to donate. Go figure! When Bush is finally run out of town with his legacy of a failed presidency, hopefully Barrack or Hillary will bring common sense and science back to the FDA and all of America for that matter.

Dr. Bob



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