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This blog is the work of an educated civilian, not of an expert in the fields discussed.

Saturday, December 26, 2015

Update of the Gay Donor Policy

A 2010 study by the University of California at Los Angeles found that lifting the long-standing ban could increase the total annual supply of donated blood by between 2 and 4 percent, adding as many as 615,000 pints per year. A shift from the full ban to a 12-month deferral that FDA opted for on Monday could add about 317,000 pints a year, the study found.
I regularly give blood and we take a questionnaire with about thirty (maybe more like fifty though a few of them might not be asked) questions that is used to winnow out those with risk factors of some blood problem though the blood is still tested.  People who give blood might generally be nice and honest sorts, but they are not totally so and might also make errors and/or be confused by some of the questions.  Few probably don't think much of it.

Some do.  For instance, I once did not give blood for a year because of a tattoo (N.Y. underregulates by their standards), a rule that in fact applies to ear piercing. People who have traveled to certain countries (someone I know) or lived in the U.K. for a few months or more (from 1980-1996) are not allowed to donate.  There are rules for those in prison, pregnant, who had sex with a prostitute in the last year and so on.  But, a particularly striking one was for gay men -- have sex even once since 1977? BANNED! Given the level of care given -- ear piercing? -- this was understandable in the early days.  This is so even though it burdens gays in particular. Some of the other rules burden certain groups, but the breadth of the ban here is still notable. 

Much less so now.  As noted in the article linked at the top, the antiquated standard has been subject to dissent for years by now. Note, e.g., that Australia put such a standard in place in 2000.  The old policy was seen as rank discrimination, a sort of mark of Cain, by gay men and those who support them. When Andy Humm on Facebook, e.g., referenced the new policy, there was some vitriol even now. One person felt it sent a message that gay men were subhuman and had to be eunuchs to give blood. Personally, given the other rules in place, find that a tad excessive. Change happens in installments and this one was rational:
Peter Marks, deputy director of FDA’s Center for Biologics Evaluation and Research, told reporters Monday that the agency considered a range of approaches, but ultimately settled on the 12-month deferral window because it was backed by the most scientific evidence, and other large countries had adopted a similar approach. But he also called the change a "first step," saying the FDA will continue to conduct research and evaluate new data that emerges after the new approach goes into effect.
Put aside the reality of the situation -- as seen by other comments on Facebook that thought this move (again, blood is tested anyway and to be quite honest, some gay men who had sex since 1977 have already give blood) was dangerous. It would have been more appropriate to do this a long time ago, to over time decrease the ban period.  The article notes some think at best the ban should be a month given testing protocols in place. I guess that's possible -- if people actually take the test before giving blood. Perhaps, that would move up all the other things too. But, the rules are purposely REAL careful.  Just a case of two that falls between the cracks will be a gigantic black mark, a public relations nightmare and endanger people.  Can't stop everything, but that's the mentality.

Some point out that a monogamous gay man is safer than a promiscuous person though we aren't talking about VD alone here.  I don't know really if that is true (a "monogamous" person of any sexuality might not have a "monogamous" partner ... something gay men tragically discovered and many non-gay people too) specifically in regards to blood issues here.  Finally, there is a general sentiment this change is meaningless -- who doesn't have sex for a year?  The study cited at the top suggests the change is far from meaningless even on the basic level of the amount of blood that can be obtained.  Overall, pushing up the ban date THIRTY SEVEN years to me is far from trivial. 

The old policy originally probably made sense but lingered on out of inertia and some degree of homophobia. (How much of the latter, however, is unclear to me, to be honest, but unnecessary disparate impact here does matter a lot too.)  Objectively, in a basic scientific way, it makes perfect sense to me to phase it out.  Better late than never here.  I would be far from surprised that -- once the die was cast and with so much improved concerns about gay rights -- the ban will be decreased even further in a few years.  This is so even if a year is too long -- we have to deal with the long term practices in place and the fact there isn't a "gay question" and nothing else involved here.  There are a range of risk factors that for many people will be very small but still are applied to ban blood donation.  This should be underlined.

The change is a big step even if only a first one.

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