Highly sensitive tests for HIV can now detect the virus as soon as 12 days post-infection. And yet, any man who has ever had sex with another man (MSM) is barred from donating blood for life, out of concern that this population is more likely to be infected with HIV.
The lifetime deferral was enacted nearly three decades ago, when AIDS was considered an epidemic and existing tests could not ensure that donated blood was virus-free. Since contaminated blood would place the recipient at risk of contracting the virus, gay men given the higher prevalence of HIV among them were prohibited from donating blood. (Other populations at high risk for HIV infection, such as those who inject recreational drugs or who have received payment for sex since 1977, are subject to the same prohibition.) According to the FDA, the prevalence of HIV among gay men in the U.S. is currently 60 times higher than in the general population. And according to the Centers for Disease Control and Prevention, out of the almost 1.2 million people in the U.S. infected with HIV, almost half are men who became infected through having sex with other men.
The FDA uses these statistics to support the continuation of their lifetime deferral policy for MSM: Despite a 2010 Department of Health and Human Services advisory to reverse the ban, the agency has upheld its former decision. Yet many see the ban on gay men s blood donations as unnecessary, considering the severity of blood shortages and the greatly improved accuracy of current HIV tests. Indeed, given the current lack of scientific or medical necessity for this ban, some have perceived it as discriminatory against gay men.
According to Richard Benjamin, chief medical officer of the American Red Cross, today s tests are impressively accurate: Their failure rate is fewer than one in a million HIV-infected donors. In fact, since the new testing methods were implemented in 1999, there have been only four known HIV transmissions through blood transfusion.
ACSH s Dr. Josh Bloom explains that the original HIV test measured antibodies to the virus, which can take up to six months to form, following infection. But newer technology makes it possible to measure the genetic material of the virus directly. This makes detection much faster and more sensitive.
For all of these reasons, many advocates are calling for the ban on MSM blood donation to be shortened to a one-year waiting period the same waiting period that applies to men who have had sex with a prostitute or with an HIV-positive woman. But ACSH s Dr. Gilbert Ross thinks that even a one-year waiting period is excessive. Many other countries have shortened the waiting period for men who have sex with men to one year, but this is still overly cautious, he points out. Considering the high accuracy of the tests that blood banks employ for donated blood, such lengthy bans and certainly lifetime bans on donations from this population are unscientific.
It makes no sense that men who have sex with men are singled out for lifetime exclusion from blood donation, while men known to engage in risky behaviors, such as unprotected sex with prostitutes, are not, says Dr. Bloom. We should be consistent in assessing risk, rather than singling out a particular group.