History of the Blood Ban: A summary timeline

1981: first patients with HIV described in the medical literature

1983: Test for HIV arrives; 1986: FDA institutes blood donation ban for gay and bisexual men

1997: FDA changes langage from lifetime ban to “indefinitely deferred” (we’re underwhelmed by that too…)

2014: FDA changed the policies to a 12 month deferral, which is an actual deferral. So no sex for one year to give blood.The FDA’s reasoning here.

You’re talking about blood but you keep saying plasma?

Fair point. Blood has two main components. Plasma is the watery part that also has some blood borne diseases and carries antibodies. This information applies to any type of blood or plasma donation.

What’s scientifically based vs discirimation?

Advocacy orgs: like behavior should be treated alike

Meaning: those screening for blood borne illnesses should use individualized risk assessment on questionnaires 

Meaning: don’t equate gay and bisexual men and “risky sex”, anyone who has penetrative rectal intercourse (ie the behavior) should be asked about it

Meaning: identity is not a scientific substitute for health behaviors, thinking so sets you up for discrimination and stigma

Public service announcement: oral sex, aka blow jobs, aka head - very low risk for HIV (<1% per the CDC, “theoretical” to others) - should not be considered a behavior for which to defer blood donation 

What’s the risk of getting HIV from a blood transfusion?

Same risk as getting into a plane (that crashes) or getting hit by lightning in a thunderstorm (stay inside folks!)

Some numbers: risk estimates range from:

1 in 2,135,000 (the higher estimate)

1 in 909,000 – 5,500,000 (the lower estimate)

Advocates want a three month deferral for gay and bisexual men - where does that number come from?

Window period! AKA the amount of time it takes for the test to be able to detect the virus once it's inside someone's body.

Explain! There is a lag time between when the virus enters someone's blood to when it has copied itself enough to be detected by medical testing.

The most up to date testing can see HIV in someone’s blood 5 to 11 days after acquisition. 

Q: So….why three months if the test works in about a week?

A: HIV isn't the only thing we test for. And testing exactly at the threshold of our best test is cutting it too close for the regulatory agencies.

Reminder: U=U applies to sexual practices - not to blood donations.

Questioning Questionnaires

It is discriminatory that the questionnaire considers an identity the same thing as a behavior. It sees gay and bisexual identity as the same thing as engaging in anal intercourse. (Just ask high school Sam - not true!)

Another nuance: many gay and bisexual men who don't have anal sex (again, see Sam in high school) and are at less risk than their heterosexual colleagues when giving blood.

What's going on about this: The FDA is (slowly) studying implementing a questionnaire that includes individualized risk assessment and making sure this keeps the blood supply safe.

HURRY UP FDA! Well, Dr. Anani said it best: “It's not their job to consider the feelings of others. It's their job to protect the blood supply. So from their perspective, to hell with the feelings.”

For now...#FeelingsHurt, the future goal being to ask specific questions respectfully to make blood donation and transfusion safe, less biased and less discriminatory.

So is the blood bank going to start calling me when this is all changed?

Not anytime soon. The FDA doesn't make changes without the data behind it and studying this data, studying how well screening questions that ask about specific individual sexual behaviors work is going to take a really long time.

Oh and this: blood centers don't want to scare away straight donors with invasive questions about butt sex. 

Q: Is that a discriminatoy dobule standard that favors straigh people at the risk of stigmatizing queer people donating blood? 

A: YES!

A non-discriminatory future of blood donation is likely a three month deferral period. Meaning - anyone who has anal intercourse would have to wait three months from that to give blood.

This accounts for emerging new diseases that could get into the blood supply that we may not know about.

We test for more than HIV - so just going by HIV’s best test doesn’t cut it.

The FDA wants to make sure asking about butt sex rather than identities associated with it doesn’t scare donors away.