Beyond the theories, the reality is that there were only four known cases of transfusion-related HIV infection from 1999 to 2007, out of more than 112 million units of blood. In all four cases, the donors had denied having any risk factors. In addition to sexually active gay men, the high-risk groups banned from donating include anyone who was ever an intravenous drug user, people with a history or family history of certain illnesses and anyone who has ever accepted payment for sex. Other groups cannot donate for up to a year -- people who have had acupuncture or body piercings, for instance, or heterosexuals who have engaged in high-risk sexual practices.So, they think the lifetime ban should be lifted, but want to replace it with a 5-10 year ban if you have had sex with another man, as opposed to a year for all other "high risk groups." Still sounds discriminatory to me.
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A 2008 report by the American Medical Assn., which reviewed a host of pertinent studies, concluded that there was a very small but statistically significant increase in risk of transmission of AIDS and other diseases if men who had abstained from sex for one year were allowed to give blood. That risk, small as it might be, is nonetheless too big. The FDA should reject a shift to a one-year abstention policy.
But the agency should seriously consider allowing donations from gay men who have abstained from sexual contact for at least five years. Under that scenario, the AMA found, the risk would be indistinguishable from current levels. The figures are theoretical, of course, based on statistical probabilities. If anything, they are probably conservative. The four transfusion-related HIV cases in recent years were a tiny fraction of what the statistical models predicted. Because not all donors remember exactly how long they have abstained from sex, the FDA should consider adding a buffer of several more years. If it does ease the restrictions, it should require.
No one should be deceived about how meaningful such a change would be. Mostly, it would give a symbolic victory to the gay and lesbian community. The number of gay men who have abstained completely from sex for at least five years is considered to be quite small. Fewer yet would be interested in donating blood. The AMA report predicts that even though changes in risk would be unnoticeable, the number of blood donors would not increase appreciably.
But that's not a valid defense for clinging to what might be outdated guidelines. The country has more effective tests and other safety measures than when these rules were devised. If there is no reason to think the country would see a rise in transfusion- related illness with a five- to 10-year rule, refusal to relax the restriction would indeed be unfairly discriminatory.
What I find bizarre is that there is no mention of safer sex in their analysis. I'd like to see statistical analyses of the difference in probabilities between a gay man who has had sex with a condom a year ago and straight man who has had sex without a condom a year ago. Plus, it must be remembered that all donated blood is tested for HIV antibodies. The very low probability scenario that everyone is trying to avoid is the case of someone who has HIV (and doesn't know it) because they are in a one-month window of when they haven't developed detectable antibodies to the virus but they have donated blood.
Is it really reasonable to tar all gay men with the broad brush of medical hazard to avoid this infinitesimally small event? As the editorial mentions, there were 4 known cases of transmission out of 122 million units of blood donated between 1999 and 2007. Even if the rate were to DOUBLE this would still be a vanishingly small probability, on the order of being struck by lightning.
