This is an excerpt from There is Hope: Learning to Live with HIV, 2nd Edition, written by Janice Ferri, with Richard R. Roose and Jill Schwendeman, a publication of The HIV Coalition.

Our company has very aggressive blood drives. The woman who used to run them, after about the third year of my refusing them, came by and said, "Should I even bother asking you this year?" I told her, "No, there's no point in asking me, ever. I'd love to, but I can't." Finally, I just explained that I'd had hepatitis several years before and couldn't ever donate. But hepatitis is already kind of pushing it, because most people don't get hepatitis in this country. Here, it's primarily homosexuals and IV drug users. You've got to be careful what you say, because you can tip your hand either way.

-- Charlie

To avoid passing the virus along to others, HIV-infected people must never allow their blood to be used for transfusion purposes. You'll see this expressed in warnings such as "Do not donate blood or blood products." In reality, there are times when some people living with HIV may find themselves in the awkward and ironic position of having to go through the blood donation process in order to hide their medical condition. Church- and company-sponsored blood drives are a prime example. You may feel pressured by co-workers, friends, or persons in authority to give blood. If the people in charge of rounding up donors won't take "no" for an answer (or if you don't feel you can decline to donate without arousing suspicion), you have three choices:

1. If you are a skillful "actor," you might try explaining you can't donate blood for some relatively innocuous health reason, such as chronic anemia (if you're slender), kidney trouble, or a particular medication you're taking. However, this can lead to further unwanted probing and you'll have to be careful to keep your story straight.
   
2. The day of the blood drive, call in sick. Or if that's not possible and you feel you must keep your donation appointment, tell the screening nurse from the collection service you feel nauseated or have the flu, that your allergies are acting up--or simply that you don't feel it's appropriate that you donate blood today. Blood service personnel are trained to be very discreet, and will excuse you without any questions. That should take you off the hook with your colleagues.
   
3. If the screening area is not sufficiently private, or if you don't feel you can avoid "going through the motions" without others noticing, go ahead and give blood--but make sure to alert the blood bank people that your blood is not safe for transfusion.

There are several ways you can do this. On the questionnaire you fill out before donating, there will be a statement that reads something like, "I believe my blood is safe for transfusion." Check the "no" box. Alternatively, some collection services will give you a bar-coded sticker to give to the person drawing your blood. The sticker will discreetly let the service know whether you consider your blood "safe" or "not safe" for use. Choose the "not safe" sticker. Either way, no one from the blood service will ask for details.

If all else fails, you can call up the blood collection agency later that day and request that they discard your blood as unsafe. Again, they will do it with no questions asked.

Going through these gymnastics may seem rather extreme, but they are necessary to protect the blood supply--and your privacy. If you fail to let the blood collection service know of your blood's unsafe status, they will test it for HIV anyway, just as they test all donated blood. Assuming the test comes out positive, your name will go into a computerized donor deferral registry. While only blood banks are supposed to have access to these records, you don't want to have your name placed on file in connection with a blood disorder if you can possibly avoid it.