Should Gay Men Be Allowed To Give Blood?
The lifetime ban on blood donations from men who have sex with men was put in place in the 1980s when little was known about HIV. But is this ban still justified? Experts debate the issue on bmj.com today.
Jay Brooks, Professor of Pathology at the University of Texas believes that the ban should remain because the risk of transmission of infection is too great. He argues that the right of recipients to receive safe blood should trump the asserted rights of donors to give blood.
Men who have had sex with men since 1977 have an HIV prevalence 60 times higher than the general population, 800 times higher than first time blood donors, and 8000 times higher than repeat blood donors, he writes. Although testing is better than it has ever been, infections can be transmitted during the window period – the period between infection and its detection.
He also points to evidence from the United Kingdom that moving to a one year deferral policy would increase the risk of HIV in the blood supply by 60%, while dropping the ban entirely would result in a 500% rise.
He concludes: Those who propose a change to policy should provide evidence that there would be no extra risk to transfusion recipients whatsoever.
But Bob Roehr argues that the lifetime ban has no scientific justification, particularly when other high risk groups are not similarly excluded.
A biomedical journalist based in Washington DC, he points to research which estimates that relaxing the criteria to 12 months from when the last sex took place with a new partner would result in only one more unit of HIV positive blood among the 15 million units a year processed in the United States.
He also argues that the ban is unfairly discriminatory as, in the US, people who fall into other categories of risky behaviour – for example, injecting drug users and female sex workers – are allowed to donate blood after a year’s deferral from the last risky activity.
Roehr calls for change in policy in line with Australia, which has had a one year deferral policy for all risk categories since 1992, and a record of one case of probable HIV transmission by transfusion since 1985. He also points out that the American Association of Blood Banks has supported harmonisation to a 12 month deferral for all risk categories since 1997, and the American Red Cross adopted that position in 2006.
An accompanying feature asks why some developed countries now accept blood donations from men who have sex with men, but most do not. It reviews arguments for and against the ban and concludes: “It seems unlikely that lifelong deferral of men who have sex with men is a sustainable policy, but whether a finite period will appease opponents remains to be seen.”
Jay Brooks, Professor of Pathology, University of Texas Health Science Center, San Antonio, Texas, USA.