Continue Ban On Gay Blood Donors?

by winemama

Should the Red Cross change its stance on blood donations from gay men in light of the Supreme Court’s decision on gay marriage and other recent events? Safety is the main factor, but I would think they could ensure safety without such a strict rule (male who has had sexual contact with another male, even once, since 1977). It seems like it is based on an out-of date stereotype.

Currently this is the rule:

You should not give blood if you have AIDS or have ever had a positive HIV test, or if you have done something that puts you at risk for becoming infected with HIV.

You are at risk for getting infected if you:
  • have ever used needles to take drugs, steroids, or anything not prescribed by your doctor
  • are a male who has had sexual contact with another male, even once, since 1977
  • have ever taken money, drugs or other payment for sex since 1977
  • have had sexual contact in the past 12 months with anyone described above
  • received clotting factor concentrates for a bleeding disorder such as hemophilia

Panel Recommends U.S. Keep Ban on Gay Blood Donors

Joint Statement Regarding National Gay Blood Drive

Blood Donor Eligibility: Medications & Health | American Red Cross

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47 thoughts on “Continue Ban On Gay Blood Donors?

  1. Obviously they aren’t taking anyone word that they aren’t gay or a junkie, so why ask?

  2. I remember back in the Bay Area in ’83 or ’84 they asked me if I even KNEW any gay people. I said something like, “This is San Francisco. Of course I know gay people. Everyone knows gay people”. The gal got really mad at me.

  3. Dr. Ada says most people don’t lie about important medical stuff. It’s just hard to tell the difference.

    I have gotten into this a bit with routine testing of young (12-14) girls for pregnancy. Parents say, “They said they aren’t sexually active, and I know they aren’t, they don’t need.” i usually blame “policy”. Easier to defer to “policy” than to try to explain good medical decision making. I find a truly surprise pregnancy every few years, and in a few instances it is causing a life threatening condition. For example, a patient who presents with an episode of fainting after transient abdominal pain (on her way to the bathroom) and has no findings that put her at high risk for heart or neuro complications – good vital signs, can follow up as outpatient. Add a positive pregnancy test, and then you consider that the transient pain could have been an ectopic pregnancy and the fainting could be related. A discharge home with outpatient follow up woutl be a lethal decision.

    I would say my surprise preg positive rate is probably 1/1000, but it is enough.

  4. Here is the best science (I don’t think there is anything more recent).

    Transfusion. 2003;43(1):25.

    RESULTS: The revised policy for MSM would potentially result in one HIV-contaminated unit for every 136,000 additional donations (95% CI, 1 in 69,000 to 1 in 268,000), for an overall increase in HIV risk estimated at 8 percent. The number of donations would increase by 1.3 percent (95% CI, 0.9%-1.7%). The risk-benefit ratio of currently accepting female partners of MSM is approximately five times lower.
    CONCLUSION: The risk increment of accepting 12-month abstinent MSM would be very small but not zero. From a risk-benefit perspective, the current deferral policy for MSM is more efficient compared to an analogous hypothetical criterion for female partners of MSM.

  5. My take: it is not true that every type of sexual encounter and every type of partner has the same risks. Monogamous women have lived with HIV+ male partners for decades without contracting the illness. Not so true of men with HIV+ partners.

    Consider, also, that the normal patient receiving blood is not getting 1 exposure. They often are getting 10-100 units over the acute illness. One of my snowflakes was acutely ill a few years ago and had dozens of small blood transfusion, blood exposure to prime a dialysis machine, and a few rounds of plasmaphoresis (with pooled plasma of 10s of people). I would suspect she had exposure to at least 100 different people. I try not to think too hard about it.

    An 8% increase in risk exposure is significant. Unless someone has better data, I can’t see why you would change the rules.

  6. Initially, the donor declined repeated contacts by MDHSS to be interviewed. In April 2009, he agreed to a brief interview with MDHSS, and an OraQuick rapid HIV test (OraSure Technologies, Bethlehem, Pennsylvania) was performed. This test was reactive and confirmed by a positive Western blot at MDHSS. During his interview, the donor reported he was married but had sex with both men and women outside of his marriage, including just before his June 2008 donation. He indicated that the sex often was anonymous and occurred while he was intoxicated.

    I think a show like House but with CDC investigators would make for an awesome TV show. Sort of like Bones but at the CDC dealing with disease vs. at The Jefferson dealing with crime.

    http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5941a3.htm

  7. I spent just barely too much time in the UK in the 80s to be eligible to donate. That’s another one where I wonder why they still have it on. If I haven’t gotten mad cow yet, is it really likely to be present in my blood, lurking, lurking?

  8. Ada – I assume there is a protocol currently in place for testing for HIV and Hep C, etc., in donated blood? Is that testing not 100%?

    I don’t donate because of my clotting factor; apparently (according to my physician relative) I would be a good candidate to donate plasma, but it’s never been something I wanted to do anyway.

  9. I’m a universal donor and they also told me recently that I had the kind of blood they give to sick babies , I can’t remember what they called it, maybe one of the health professionals knows what I’m talking about, I think only about 20% of the population

  10. “f you are CMV-Negative, we encourage you to donate as often as possible as your blood can help many of our patients with weakened immune systems!
    One out of every five people in the greater Los Angeles area is CMV-Negative, meaning their blood has never been exposed to cytomegalovirus (CMV).
    CMV is a common virus, harmless to most people, but can cause severe infections for patients with weak immune systems.
    As our hospital provides care for children who are going through Bone Marrow Transplant therapy or have weakened immune systems due to receiving aggressive chemotherapy treatment, blood donations that are CMV-Negative are particularly valuable to the recovery of many children throughout Los Angeles County and beyond.
    We encourage you to call the Blood Donor Center to schedule an appointment to give.”

  11. What is CMV (Cytomegalovirus [sigh‐to‐MEG‐uh‐lo‐vi‐rus])?
    Source: Centers for Disease Control; http://www.cdc.gov
    Cytomegalovirus (CMV) is one of the herpes viruses. This group of viruses includes the herpes
    simplex viruses, varicella‐zoster virus (which causes chickenpox and shingles), and Epstein‐Barr
    virus (which causes infectious mononucleosis, also known as mono). CMV is a common
    infection that is usually harmless. Once CMV is in a person’s body, it stays there for life. Among
    every 100 adults in the United States, 50–80 are infected with CMV by the time they are 40
    years old.
    Most healthy children and adults infected with CMV have no symptoms and may not even
    know that they have been infected. Others may develop a mild illness when they get infected
    and have the following symptoms: fever, sore throat, fatigue, and swollen glands. But since
    these are also symptoms of other illnesses, most people don’t realize that they have been
    infected with CMV.
    Why does blood for pediatric transfusion have to be negative for CMV?
    Scientific studies have shown blood lacking this virus (CMV negative blood) is safer for pediatric
    patients, particularly infants whose immune system isn’t fully developed.

  12. Yes, blood is tested for HIV, Hep C. However, the tests look for RNA, not the virus itself (if I remember correctly). Therefore, there is a lag from exposure to positive test — much better than it used to be, but a few units slip through all the time.

    Pro Tip: You really, really don’t want a blood transfusion if at all possible. Not because of the viral risk, but there are other big downsides.

  13. “it is not true that every type of sexual encounter and every type of partner has the same risks.”

    I’ve read that certain acts involve a much higher risk of transmission, including a certain act apparently more common in male-male liaisons than in heterosexual liaisons, and largely impossible for female-female liaisons (perhaps not totally impossible as the male/female line is increasingly blurred by recognition that gender is a continuum, not binary).

  14. One of the standard questions I’ve been asked many times is whether I’m giving blood so my blood will be tested for HIV.

  15. Ada, does receiving gamma globulin come with risks similar to receiving blood transfusions, e.g., HIV transmission? At least in theory, could hepatitis be transmitted that way?

  16. “Pro Tip: You really, really don’t want a blood transfusion if at all possible. Not because of the viral risk, but there are other big downsides.”

    I believe obviating the need for transfusions is one use for epogen, in addition to improving the performance of endurance athletes.

  17. “Not because of the viral risk, but there are other big downsides.”

    What other big downsides?

    I hate the idea of having to have anything done, certainly of having to check into the hospital. I know, I’m a bit paranoid, but that’s what prevents me from having any elective cosmetic procedure.

  18. For planned surgery, e.g., cosmetic, can you bank your own blood in advance? Ada, would using your own blood eliminate the downsides to which you refer?

  19. There are a lot of soft reasons that I wouldn’t want blood, if avoidable — probably increased risk of heart attack, increased risk of viral illness, allergic reactions, etc. Then there are specific, uncommon, outcomes: transfusion related lung injury (rate of 1/5000, mortality around 50%), heart failure from fluid overload, iron overload.

    Again, though, snowflake has a history of “massive transfusion”, and is probably completely fine – but there were no other options.

    And Finn – your own blood would eliminate some risks, but not all.

  20. One of my high school classmates died from AIDS after receiving contaminated blood during surgery as a young child in the 1980s.

    I realize intellectually that the statistics show minimal increased risk and that the donations are tested.

    But having watched her slow death over our four years in school together, I would say that one more AIDS case is one too many.

  21. Don’t know if it is a standard operating procedure, but here they always give you two stickers and turn their back. The instructions are to use the sticker on this one paper. The stickers are Yes and No. The question is “Is there any reason you think we should not use your blood?” No matter what sticker you choose, they draw the blood. It seems to be protective of people in environments, like work blood drives, where people are pressured into giving, but know it may not be safe, but also do not want to deal with the response from peers/managers about what was wrong, why they couldn’t give.

  22. Austin, I think that, or something similar, are pretty much SOP. Every time I give blood they ask me that and take my blood, too. I know folks can be pressured into giving blood. When I was in Big Law there was inevitably some rainmaker who was on the board of the local Red Cross or something. A person simply had to donate or have a pretty damn good reason why– and it better not be sex or drug related. It was almost like the required contribution to United Way or, down here, the mandatory contribution to a candidate who deserves life without parole.

    I like that there is a discrete way out.

    Perhaps, ADA can advise better on this. It seems like HIV and other diseases that can be transmitted by blood must have a reasonable incubation period beyond which the likelihood of HIV would manifest itself. 1977 is 38 years ago! I know the implications are dire, but 38 years is a long time for something to lay dormant. Am I wrong or is the risk too great? It seems like they might waste a lot of good blood.

  23. “38 years is a long time for something to lay dormant.”

    Isn’t is common for shingles to dormant for a lot longer than that?

  24. Winemamma – I am also a CMV donor. When I lived in Dallas they called me every 8 weeks, and I gave several times a year. I liked knowing that my blood could be used for tiny babies! When I moved to the west coast and registered at the blood center here, I told them I was a CMV donor but they didn’t seem to make note of it or care.

  25. I watched my Mom donate blood once when I was a kid, watching the plastic bag fill up,with dark red, then I ran outside and threw up.

    The only thing I’ve done is donate a sample to be in the marrow registry, when we had a drive in college for someone with leukemia. No calls yet. I would if someone needed it, and I know that it’s painful. But that would be worth it.

    One more day of Disney parks, I am so, so, so, so, so, so DONE with heat and humidity and lines and crowds. Done.

  26. I would like to donate blood but can’t because I feel light headed even while giving blood for a blood test. I was determined to not let this happen but it has taken all my will power to get to the chairs in the lobby area of the doctor’s office and not crumple to the floor after a blood test. I feel like a wimp.

  27. Pre-kids, I was a regular donor and my partner was a platelets donor. I did the platelets twice, but didn’t feel very well afterward. Post-kids, I have been sporatic. While my employer allows 8 hours a year specifically for blood donation, the locations/hours are not very easy to get to. Two different employers, but not my current one, set up a mobile drive every quarter and for a while it was at my kids school about 3 times a year (not in the summer). When it was on-site, I was good about donating. I am a uncommon, but not rare. If I get a call from the blood center requesting my type, I will go in.

  28. I gave up donating a few years ago. I have difficult veins to stick so most of the time they’d have to stick me a second time to get it. Then I didn’t have great output and I would reach the 15 minute limit before they got a full unit. Most of the time they said it was enough that they could use it, but I got tired of going through the multiple sticks and not getting enough out.

  29. I’ve given several gallons over my lifetime thus far, but it’s been several months since the last time. There haven’t been any convenient blood drives lately.

  30. DD, I wonder if the 15 min limit is a state thing? The times I donated, I sat there for 30-45 min while the bag filled on the occasions my iron was sufficient. Once I started the pregnancy/lactation cycle, I gave up trying because I was pretty sure my iron was too low to qualify.

  31. I’ve received many compliments on my veins, and the ease of sticking them. And it takes a lot less than 15 minutes for me to fill the bag. I suppose I’m well suited to donate, although I’d be better suited if I was type O.

    Is donated blood really collected from veins, or do they collect from arteries?

  32. Donated blood is really supposed to be collected from veins. It is possible that they hit an artery once in a while, but arteries are so much smaller, it is unlikely.

    Rhett – interesting about the Rh negatives in China. Getting sensitized in childbirth to Rh is not as easy as it sounds. There are people in the US who play the odds – refuse the Rhogam because it is a blood product, and blood products are even worse than vaccines! I did the math once, but if you are an Rh negative person, with an Rh positive partner, the risk of having a baby with hydrops (the really bad outcome) is something like 0% for first baby, 5% for second, 10% for third. A rational person looks at those numbers and says, “Wow, 10% risk of death, avoidable by vaccine? Sign me up!” A different person says – “90% chance I will be fine” – or “I know 8 people who did this without problems.”

    The virus causing shingles lays dormant in the body for decades, usually (VZV- chicken pox), but antibodies are detectable in the serum a realtively short time after infection.

  33. PTM – there are a small handful of HIV positive people who never manifest any symptoms (and don’t progress to AIDS). My understanding is that the ban on men who had sex with men prior to 1977 are banned because they might still be active (though why they would tell the truth about their activity before 1977 and lie about it now, I don’t understand.)

    The longest documented interval between exposure and seroconversion (a positive test) is 230 days – but that was more than a decade ago, so the test is better now.

  34. I give regularly, always have. I have a rarer type and I feel like it is an obligation. You can help save someone’s life AND you get a cookie. What’s not to like!

  35. Dh and I are both Rh negative so there is no chance of us having a Rh positive child. They made me get the shot anyway, I guess because like Dr. House says people lie. A woman could get knocked up by someone other than her boyfriend/husband so they make you do it anyway.

    “My understanding is that the ban on men who had sex with men prior to 1977 are banned because they might still be active (though why they would tell the truth about their activity before 1977 and lie about it now, I don’t understand.)”

    They could be bisexual and married to a woman since after 1977 , but have an affair. Again the people lie thing.

  36. They do blood drives at work several times a year. I hadn’t donated regularly since I was a student and they did blood drives there. So convenient.

  37. @Milo – There should be some sort of badge for fathers who have done Disney in the summer, like boy scout badges. I think even Stalin would approve of that level of torture!

  38. I just had a fun experience.

    Background: The townhome with which we share a wall sold last month. BTW, a similar unit was sold in 2011 for x, this unit sold one year ago (the owner died within 6 months) for 133% of the 2011 price, and last month for 110% of the 2014 price. For the past few days he workers and multiple family members of the young couple were milling around the complex making a mess, making noise into the night, and annoying everyone (including me) by not adhering to parking rules and blocking spaces.

    This morning I go out and all sorts of people are around in full silk traditional Indian dress. The hurried activity and indifference to the rules was because today is the auspicious day for the house warming ceremony. They invited me to join in. I pulled out my nice everyday shalwar khameez (the silk wedding quality one needed pressing) and put on my gold jewelry. Full ceremony with a priest and a fairly large fire on the makeshift altar in the living room (no fireplace or chiminey in our units). I sat on the floor cross legged for an hour. Then the aunties provided tasty, if bland, Bangalore food. (Maybe they held something on for my plate). Sometimes it pays to just live in the moment.

  39. I guess I would qualify for that badge– I did WDW with the family last summer. I did not, however, do it in August, when I assume the humidity is even worse and the parks are even more crowded.

    The best time at the Magic Kingdom was between 11 pm and 1:30 am. We had Extra Magic Hours; IIRC, they were from midnight to 2am.

  40. We sent the kids to Disneyworld with my parents. Lots of fun for both kids and grandparents. Everyone still talks about it.

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