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MSM Blood Ban

MSM Blood Ban

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FAQ

Frequently Asked Questions about Lifting the Lifetime Ban on Blood Donation by Gay and Bisexual Men

Is it really true that gay and bisexual men are banned from donating blood?

Why was the ban implemented?

Isn’t it possible to test donated blood for HIV?

How are individuals currently screened before they can donate blood?

Are all high-risk donors treated equally?

Will lifting the lifetime MSM blood ban increase the risk of contracting HIV through blood transfusion?

What do blood safety and medical professional organizations believe about the lifetime MSM blood ban?

What are the consequences of the lifetime MSM blood ban?

How does the lifetime MSM blood ban in the US compare to blood donation policies in other countries?

What are GMHC’s recommendations for updating U.S. blood donation policies?



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Is it really true that gay and bisexual men are banned from donating blood?
Yes. Under the current policy, men who have had sex with other men (MSM), even once, since 1977, are permanently barred from donating blood. This includes MSM who are HIV-negative, consistently practice safe sex, or who are in a monogamous relationship. (Top)

Why was the ban implemented?
In 1983, at the onset of the HIV epidemic, the Food and Drug Administration (FDA) implemented the ban to help prevent inadvertent transmission of HIV through blood transfusions. At that time, HIV/AIDS was largely not understood by doctors, scientists, and the general public, and the technology and procedures used to test donated blood for HIV were extremely limited. (Top)

Isn’t it possible to test donated blood for HIV?
In the decades since the FDA implemented the MSM blood ban, vast improvements have been made in technology that can test donated blood for communicable diseases. Nucleic Acid Amplification Testing (NAT) can detect HIV in a unit of blood within a 9 to 11 day window period of the donor becoming infected. When combined with best practices that screen prospective donors for high-risk behavior, regardless of sexual orientation, NAT renders the lifetime MSM blood ban scientifically obsolete and unnecessary. (Top)

How are individuals currently screened before they can donate blood?
The FDA requires blood donation organizations to screen potential donors for risk factors related to HIV and other infectious diseases. Most administer a Donor History Questionnaire (Questionnaire), which asks about a donor’s current health, medical history, blood donation history, sexual practices, drug use, and other behaviors. Donors deemed to be high risk based on responses to the Questionnaire are deferred from donating blood for varying periods of time into the future.  (Top)

Are all high-risk donors treated equally?
No. The Questionnaire does not ask whether prospective donors have engaged in specific high-risk practices, such as unprotected sex, sex with multiple partners, or sex with a partner whose HIV status was unknown to the prospective donor. This leads to deferrals that focus on donors’ identity rather than high-risk behavior. For example, the one year deferral period mandated for a heterosexual donor who had sex with a partner known to be HIV-positive is shorter than the permanent deferral for a gay or bisexual male donor, regardless of his partner’s HIV status.   (Top)

Will lifting the lifetime MSM blood ban increase the risk of contracting HIV through blood transfusion?

  • Available research indicates that lifting the lifetime ban on MSM blood donation would cause little risk to the blood supply. In 2006, research presented at a meeting of the FDA’s Blood Products Advisory Committee (BPAC) found that the implementation of technology like NAT and other “operational improvements” has reduced risk of releasing infected, donated blood into the supply, and that replacing the lifetime MSM blood ban with a one-year deferral could increase the risk of HIV by one in 46 million, or one case every 33 years. 
  • A study published in 2013 that assessed proposed changes in blood donation policies in England found that “[t]here appears to be only a small increase in risk between a 12-month deferral compared with a permanent exclusion.”  (Top)

What do blood safety and medical professional organizations believe about the lifetime MSM blood ban?

  • A joint statement released in 2006 by the American Association of Blood Banks (AABB), the Red Cross, and America’s Blood Centers, characterized the lifetime MSM blood ban as “medically and scientifically unwarranted,” and urged the FDA to modify blood donation policies so that they are “comparable with criteria for other groups at increased risk of sexual transmission of transfusion transmitted infections.” 
  • In a statement released in June, 2013, the American Medical Association (AMA) declared that “the lifetime ban on blood donation for men who have sex with men is discriminatory and not based on sound science”  (Top)

What are the consequences of the lifetime MSM blood ban?

  • It supports a false perception that heterosexual people are at low risk for HIV infection, while allowing individuals who participate in high-risk behavior, but who do not identify as gay or bisexual, to donate blood. 
  • It reduces the availability of blood across the country by preventing, according to one estimate, over 130,000 gay and bisexual men from donating over 219,000 pints of blood annually. 
  • There is strong opposition to blood drives at many colleges, which only serves to reduce the blood supply. For example, San Jose State University does not allow blood drives on campus because the ban violates the university’s nondiscrimination policies.
  • It reinforces negative stereotypes about gay and bisexual people, which is especially problematic because the majority of blood donations occur at blood drives in workplaces or schools, where gay and bisexual donors may worry about employment or social ramifications of not donating. (Top)

How does the lifetime MSM blood ban in the US compare to blood donation policies in other countries?

  • As of July, 2013, 21 countries have replaced lifetime MSM blood bans with deferral periods for MSM that vary in length from six months to five years.
  • Spain and Italy have adopted deferral policies based on comprehensive assessments that ask all prospective donors, regardless of sexual orientation, specific questions about high-risk practices. (Top)

What are GMHC’s recommendations for updating U.S. blood donation policies?

  • The FDA should update the Donor History Questionnaire so that all potential donors are screened for high-risk behavior, regardless of sexual orientation. Only prospective donors determined to be at high-risk should be subject to deferral periods. 
  • The ban should be replaced with a policy that defers high-risk gay and bisexual men, while permitting low-risk gay and bisexual men to donate blood. The risk assessment for gay and bisexual men should also include whether the donor engaged in low-risk sexual practices like condom usage or monogamy. 
  • The highest-risk members of the MSM population, such as those who fall into several risk categories (e.g., IV drug users, commercial sex workers) or who report unprotected sex with partner(s) with HIV or with unknown HIV status, may justifiably be subject to lengthy or permanent deferrals. (Top)