FDA Sustains Gay Stereotypes, HIV Stigma in Blood Donor Policy Change, Advocates Say
December 23, 2014
It may have been the day before Christmas Eve, when many were preparing for a long holiday, but HIV/AIDS and LGBT advocates reacted swiftly to the announcement that the U.S. Food and Drug Administration (FDA) planned to impose a one-year celibacy requirement for gay men, other men who have sex with men and some transgender people who want to donate blood. If implemented, the move would replace the existing lifetime ban on blood donations by men who have ever had sex with a man.
In a press statement, GMHC said the change was "offensive and harmful," calling on the FDA and Health and Human Services Secretary Sylvia Mathews Burwell to implement "a risk-based blood donation policy, regardless of sexual orientation or gender identity, and to stop perpetuating the stigma and discrimination driving the HIV/AIDS epidemic."
"This new policy does not require heterosexual blood donors to be celibate for one year. Some may believe this is a step forward, but in reality, requiring celibacy for a year is a de facto lifetime ban," GMHC explained in its statement. "Since the first days of epidemic [sic], GMHC has witnessed first-hand how fear, stigma, and discrimination have fueled the spread of HIV. By implementing this policy, the FDA will continue to fan the flames of the outdated stereotype that HIV is only a 'gay disease.'"
"Within 45 days of exposure, currently required blood donation testing detects all known serious blood-borne pathogens, including HIV. Therefore, a deferral of more than two months -- for anyone -- is not necessary and does not noticeably enhance the safety of the blood supply," he stressed.
Adaora Adimora, M.D., M.P.H., chair of the HIV Medicine Association (HIVMA), which represents more than 5,000 medical providers and researchers, said in a statement that her organization is "concerned that the new policy retains an unnecessary and unique exclusion of men who have sex with men from donating blood for one year.
"HIVMA recommends adoption of screening procedures based on a review commissioned by the Australian Red Cross in 2012, in which would-be donors would be asked to hold back if in the past six months they had tested positive for HIV, engaged in unprotected sex with a partner with HIV or unknown HIV status, or used a syringe not prescribed by a physician."
Many advocates asserted that the headline of The New York Times story on the planned change, which read "F.D.A. Lifting Ban on Gay Blood Donors," was inaccurate; the continuing (albeit shorter-term) celibacy requirement will undoubtedly ban many HIV-negative men from donating, they said -- including those at low or no risk of infection who are in long-term monogamous relationships with uninfected partners, those on pre-exposure prophylaxis (PrEP) and those whose partners have undetectable HIV viral load.
As Mark Joseph Stern writes in Slate:
The one-year deferral policy is still rooted in an outdated, insulting vision of gay men as diseased, promiscuous lechers. A gay man in a decades-long monogamous relationship with his husband will be forbidden from donating blood. So, too, will any gay or bisexual man who consistently practices safe sex. Meanwhile, straight people who routinely have sex with multiple opposite-sex partners -- whether or not they use condoms -- face no deferral at all. A straight man can donate blood the morning after participating in an unprotected, anonymous orgy. A married gay man cannot donate blood at all.
In addition, writer Parker Marie Molloy cautions that the proposed change may also maintain the inaccurate labeling and exclusion of many transgender women. She explains that:
Essentially, the ban applies to anyone who was assigned male at birth who has had sex with another person who was assigned male at birth anytime since 1977. Examples of individuals banned from donating blood include:
- Gay cisgender men who sleep with other gay cisgender men.
- Straight or bi cisgender men who sleep with bi or straight trans women.
- Straight or bi transgender women who sleep with straight cisgender men.
- Gay transgender women who sleep with other gay trans women.
- Transgender women who sleep with non-binary people assigned male at birth.
- Non-binary people assigned male at birth who sleep with trans women.
- Non-binary people assigned male at birth who sleep with other non-binary people assigned male at birth.
The list could go on, but you get the point. With exception of the first example, none of those are "men who have sex with men."
GMHC explained that the American Medical Association, the Red Cross, America's Blood Centers, and the Association of Blood Banks all believe that the lifetime ban is unnecessary and discriminatory. GMHC -- which has been a leader in advocacy on this issue -- believes that the FDA should use a system of evaluating all donors on the basis of high-risk practices that could lead to HIV infection.
"After all, HIV is transmitted by what you do, not who you are," GMHC noted.
In the Lambda Legal statement, Schoettes concurred, adding that "[t]o base deferrals primarily on prevalence within certain communities rather than behavior could serve to disqualify other segments of the population based on race, sex and where they reside -- a very slippery slope toward more easily recognizable forms of illegal discrimination. If we are serious about a policy that is truly most protective of the blood supply, it will treat all potential donors the same and base any deferrals on the conduct of those potential donors within a scientifically justified 'window period' prior to donation."
As noted by BuzzFeed, the FDA said it will submit the policy change to the Federal Register in 2015 to receive and consider public comments. It did not say when the policy change would become final.
Julie "JD" Davids is the managing editor for TheBody.com and TheBodyPRO.com.
Follow JD on Twitter: @JDAtTheBody.
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