FRIDAY, July 25, 2014 (HealthDay News) -- The United States
should repeal a 30-year policy that bans blood donations from gay
and bisexual men, according to a team of medical and legal experts
writing this week in the
Journal of the American Medical Association.
Currently, a man who has ever had sex with another man cannot
donate blood in the United States -- a lifetime ban that has been
in place since 1983.
The U.S. Food and Drug Administration adopted this policy at the
dawn of the AIDS crisis. However, changing times and technological
advances have rendered the decades-old ban obsolete, said
JAMAarticle co-author Glenn Cohen, who directs Harvard Law
School's Petrie-Flom Center for Health Law Policy, Biotechnology
"We think it's time for the FDA to take a serious look at its policy, because it's out of step with peer countries, it's out of step with modern medicine, it's out of step with public opinion, and we feel it may be legally problematic," said Cohen, who co-wrote the article with Jeremy Feigenbaum of Harvard Law School and Dr. Eli Adashi of Brown University's medical school.
The lifetime ban for gay or bisexual men stands in contradiction
to other FDA policies regarding people considered high-risk donors
due to their sexual behavior, Cohen noted.
For example, there currently is a maximum one-year ban in the
United States for blood donations by men who have had sex with an
HIV-positive woman or commercial sex workers. The same goes for
women who have had sex with HIV-positive men.
By implementing a lifetime ban on donation from sexually active
gay or bisexual males, "you're giving a 'scarlet letter' of sorts
to these men," Cohen said.
The policy also stands in stark contrast to recent advances in
gay rights, and could be open to a legal challenge, given that the
U.S. Supreme Court struck down the Defense of Marriage Act in 2013,
Other countries have already moved to limit their bans on blood
donations from gay men in recent years. Canada has changed its
policy to a five-year ban, there's a one-year ban in place in the
United Kingdom and a six-month ban in South Africa.
None of these countries has experienced any increase in
HIV-positive blood donations, noted Dr. Steven Kleinman, a senior
medical advisor to the AABB, an international non-profit blood bank
Current technology allows accurate detection of HIV in the
bloodstream within weeks of exposure, Kleinman said. Changing the
ban to six months or a year remains a conservative approach that
still allows officials to prevent contamination of the blood
supply, he said.
"It's correct to say that countries have made changes and so far we haven't seen any adverse effects," Kleinman added.
FDA spokeswoman Jennifer Rodriguez said that the agency is open
to changing the lifetime ban and is awaiting the results of new
research that will provide additional evidence.
An advisory committee to the FDA in 2010 voted in favor of
retaining the existing policy. But it also found that the ban might
be keeping some low-risk donors from contributing to the nation's
blood supply, she said.
The committee also recommended looking at the results of studies
that have been undertaken by the U.S. Department of Health and
Human Services (HHS). The studies are aimed at reviewing rates of
transfusion-transmitted infections and investigating whether
another screening strategy for gay men could maintain the safety of
the nation's blood supply, the HHS said.
Officials at HHS said the results of this research should be
available by the end of 2014.
"When the results and data from the studies are available and potential policy revisions are brought forward for consideration, HHS intends to provide opportunities for discussion in a public forum," Rodriguez said.
The American Red Cross and the AABB both advocate changing the
U.S. policy on donations by gay men to a one-year ban -- on par
with donation policies for other high-risk groups.
But Cohen wants to go further, advocating an "assess and test"
approach, in which restrictions are placed on potential blood
donors based on their personal sexual practices.
Italy adopted such an approach in 2001, and "Italian data
suggests there's no disproportionate increase in the number of
HIV-positive donors getting into the blood supply," he said.
The AABB does not support that approach at this time, although
even a one-year ban amounts to a requirement that gay men abstain
from sex to be eligible to donate, Kleinman said.
"We're not requiring anyone else to be abstinent from their sexual partners of choice," he said, noting that lesbians can donate freely. "But we still find that the risk factor that accounts for the greatest proportion of cases are males who have sex with other males. That's an epidemiological fact at this point."
For more on the U.S. policy on blood donations from gay men,
U.S. Food and Drug Administration.
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