UK Gay Blood Ban Lifted

The lifelong ban on gay men donating blood has been officially lifted in Great Britain, numerous news sites reported. In its place is a requirement that men who have sex with men wait for one year after a same-sex encounter to donate blood.

For critics, the one-year wait period with no same-gender sex is as bad as the outright ban. But for others, the end of the ban is a step forward.

"We welcome this change, which is based on strong new evidence that all the experts are agreed on," said Nick Partridge, the head of the Terrence Higgins Trust, an AIDS charity. "These regulations will ensure the safety of blood supply for all of us while also being fair and equal in their application."

"The move comes after a review by the Advisory Committee on the Safety of Blood, Tissues and Organs," reported UK gay news site PinkPaper.com on Nov. 7. "It will be implemented across England, Scotland and Wales."

"Our priority as a blood service is to provide a safe and sufficient supply of blood for patients," said Lorna Williamson of the National Health Service. "This change gives us an opportunity to broaden our donor acceptance on the basis of the latest scientific evidence."

Williamson's comments were part of a Press Association story posted at the Huffington Post on Nov. 7.

"The Sabto review concluded that the safety of the blood supply would not be affected by the change and we would like to reassure patients receiving transfusions that the blood supply is as safe as it reasonably can be and amongst the safest in the world," continued Williamson, referring to a study conducted by the Advisory Committee on the Safety of Blood, Tissues and Organs.

"There has been no documented transmission of a blood-borne virus in the UK since 2005, with no HIV transmission since 2002."

The ban was put in place in the 1980s, when relatively little was known about the virus and testing methods were much less sensitive than they are now.

The guidelines for allowing gay men to donate blood are still much stricter than for most heterosexuals.

"Men who have had anal or oral sex with another man in the past 12 months, with or without a condom, will still not be eligible to donate blood," noted the Press Association article.

As EDGE reported in September, critics of the guidelines expressed the opinion that the restrictions that remain in place are still prejudicial and excessive.

Whereas straight men who have sex with prostitutes or use intravenous drugs are also banned for one year from donating blood, gay men who practice safe sex or who are in long-term monogamous relationships are not given the same benefit of the doubt as heterosexual men who conduct themselves in similar fashion.

"A gay man in a monogamous relationship who has only had oral sex will still automatically be unable to give blood but a heterosexual man who has had multiple partners and not worn a condom will not be questioned about his behavior, or even then, excluded," said Ben Summerskill of the British GLBT rights group Stonewall, a Sept. 8 BBC article reported.

In other words, a married straight man who has sex with a prostitute (or in what is deemed a "high risk country") must wait a year -- but a monogamous gay man in a civil partnership cannot donate blood unless he and his husband refrain from sex for a full year.

"Most gay and bisexual men do not have HIV and will never have HIV," noted GLBT rights campaigner Peter Tatchell. "If they always have safe sex with a condom, have only one partner and test HIV negative, their blood is safe to donate. They can and should be allowed to help save lives by becoming donors."

In a Sept. 8 release, Tatchell blasted the revised policy once again.

"Sadly, the blood service's new policy makes no distinction between sex with a condom and sex without one," Tatchell noted. "Any oral or anal sex between men in the previous 12 months -- even with protection -- will be grounds for continuing to refuse a donor under the new rules.

"This is unjustified," Tatchell added. "If a condom is used correctly, it is absolute protection against the transmission and contraction of HIV. Men who use condoms every time without breakages -- and who test HIV negative -- should not be barred from donating blood."

Tatchell also expressed displeasure at the length of the waiting period.

"Protecting the blood supply is the number one priority but ensuring blood safety does not require such a lengthy time span during which gay and bisexual men are barred from donating blood," he asserted.

"The blood service could have opted for a much shorter exclusion period. It should focus on excluding donors who have engaged in risky sexual behavior and those whose HIV status cannot be accurately determined because of the delay between the date of infection and the date when the HIV virus and HIV antibodies manifest and become detectable in an infected person's blood."

Others suggested the original lifetime ban on gay blood donors ban should have been left in place. The Hemophilia Society's Chris James, worried that even though modern testing techniques are sensitive enough to detect minute amounts of HIV in blood, changing the requirements about who may give blood would leave the bloody supply vulnerable to new kinds of pathogens that might emerge in times to come, Manchester radio station KEY-103 reported.

It was unclear why any as-yet unknown blood borne viruses might confine themselves to gay donors.

A Crucial "Lifeline"

"Blood donations are a lifeline, and many of us would not have loved ones with us today if it was not for the selfless act of others," said British Public Health Minister Anne Milton. "Appropriate checks based on robust science must be in place to maintain this safety record and the committee's recommendation reflects this.

"It is important that people comply with all donor selection criteria, which are in place to protect the health of both donors and transfusion recipients," Milton added.

It has been nearly a decade since any known case of HIV transmission took place through the blood supply, the article noted.

The BBC reported that the lifetime ban "had been questioned both on equality and medical grounds." Yearlong bans are also imposed on people who have had tattoos, and a history of certain diseases can also mean a lifetime ban.
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In the United States, the Food and Drug Administration decides who may or may not donate blood. Gay men are banned for life if they have had sex with another man even once since 1977.

The ban on gay, bisexual, and MSM blood donors went into effect in 1985, when testing methods were much less sensitive than they are today. Two members of Congress, Sen. John Kerry (Democrat of Massachusetts) and Rep. Mike Quigley (Democrat of Illinois), have kept up the pressure on the FDA in recent years, noting that the agency's guidelines are blatantly discriminatory toward gays: After a one-year waiting period, heterosexual men may donate even after paying prostitutes for sex, whereas gay men are banned for life under the current policy.

Given the crunch on donated blood supplies, which are frequently inadequate to meet demand, critics of the policy say the ban is indefensible. Kerry, Quigley, and more than 40 members of Congress signed a letter sent last summer to the chair of the Health and Human Services Advisory Committee on Blood Safety and Availability to that effect.

The June 9, 2010, letter read, in part, "We join with medical experts at the American Red Cross, America's Blood Centers, AABB, and the American Medical Association, among others, in calling for a change in policy that better reflects the science of high risk behavior for HIV. The time has clearly come to review and modify this policy to strengthen the safety of the blood supply and remove any needless discriminatory rules from the process.

"In order to improve the integrity of the blood supply, we believe it is imperative that all high risk behaviors be appropriately targeted in the screening process and that similar deferral periods are established for similar risks," the letter added.

"As the policy currently stands, a number of potential oversights and medically unjustifiable double standards seem apparent," continued the letter. "For instance, there is no prescribed consideration of safer sex practices, individuals who routinely practice unsafe heterosexual sex face no deferral period at all while monogamous and married homosexual partners who practice safe sex are banned for life. In fact, a woman who has sexual relations with an HIV positive male is deferred for one year, while a man who has had sexual relations with another man, even a monogamous partner, is deferred for life.

"Even individuals who have paid prostitutes for heterosexual sex face a deferral period of one year while gay men face a lifetime ban," the letter noted. "These do not strike us as scientifically sound conclusions."

The U.S. Department of Health and Human Services (HHS) has looked into the matter and determined that there are several key areas into which further research is warranted, with an eye to retiring the ban in whole or in part.

"We've been working on this a long time in a serious way and I'm glad [HHS] Secretary Sebelius responded with concrete steps to finally remove this policy from the books," Kerry told the media. "HHS is doing their due-diligence and we plan to stay focused on the end game -- a safe blood supply and an end to this discriminatory ban."

But for some, those two things do not sit well in the same sentence. Last year, after a HHS committee acknowledged that the FDA's blood donation policies were far harsher toward gays than to heterosexuals who had engaged in risky sexual conduct, Mark Skinner of the American Plasma Users Coalition told MSNBC that anti-gay discrimination was a price worth paying to keep donated blood free of pathogens.

"Ultimately the end-user bears 100 percent of the risk," noted Skinner, going on to say of the FDA's stance, "The fact that it's discriminatory does not mean it's wrong if it's in the interest of public health."

The FDA website explains the rationale for the ban.

"Men who have had sex with men since 1977 have an HIV prevalence... 60 times higher than the general population, 800 times higher than first time blood donors and 8000 times higher than repeat blood donors," text at the site said.

"Even taking into account that 75% of HIV infected men who have sex with men already know they are HIV positive and would be unlikely to donate blood, the HIV prevalence in potential donors with history of male sex with males is 200 times higher than first time blood donors and 2000 times higher than repeat blood donors," added the text.

"Detection of HIV infection is particularly challenging when very low levels of virus are present in the blood for example during the so-called 'window period,' "the text continued. "The 'window period' is the time between being infected with HIV and the ability of an HIV test to detect HIV in an infected person."

Typically, the "window" period is much less than one year.

"Men who have sex with men also have an increased risk of having other infections that can be transmitted to others by blood transfusion," the site's text notes. "For example, infection with the Hepatitis B virus is about 5-6 times more common and Hepatitis C virus infections are about 2 times more common in men who have sex with other men than in the general population.

"Additionally, men who have sex with men have an increased incidence and prevalence of Human Herpes Virus-8 (HHV-8). HHV-8 causes a cancer called Kaposi's sarcoma in immunocompromised individuals."