The U.S. Meals and Drug Administration introduced on Might 11, 2023, that it has formally dropped restrictions that prohibit homosexual and bisexual males from donating blood below many circumstances on Might 11, 2023. The ban was initially put in place within the early days of the AIDS epidemic, however for years medical professionals and homosexual rights advocates have argued that the ban was not medically justifiable and that it unnecessarily discriminated in opposition to males who’ve intercourse with males.
Ayako Miyashita is a well being coverage researcher on the College of California, Los Angeles, who research HIV therapy and prevention. She explains the historical past of the ban and the reasoning behind its long-awaited reversal.
1. When and why did the ban start?
When the FDA first carried out the blood donation ban in 1983 for males who’ve intercourse with males, there have been good causes for broad rules to make sure the security of the blood provide. Firstly of the AIDS epidemic, public well being officers have been coping with an unknown virus that was unfold by means of unknown means. Researchers formally recognized HIV as the reason for AIDS a 12 months later, in 1984, and it took one other 12 months to approve the primary check to display blood donations for HIV in 1985.
Regardless of the ban on blood donations from males who’ve intercourse with males, there was some small danger that failures in donor screening and blood screening protocols might result in transmission of HIV or different ailments from blood transfusion. However through the years, scientific developments and strict protocols have helped to almost get rid of HIV transmission by means of blood. In reality, the final documented transmission of HIV by means of the a U.S. donor’s blood product occurred almost 15 years in the past.
Beginning in 2013, the U.S. authorities started implementing a nationwide system to observe the security of the U.S. blood provide for a wide range of completely different pathogens, together with HIV.
2. Why carry the ban now?
Whereas the blood donation ban—in addition to many different legal guidelines handed within the Nineteen Eighties concerning HIV publicity and unfold—have been cheap on the time, the science has modified. Researchers and public well being officers have gained a greater understanding of how HIV is transmitted and the dangers related to completely different actions. Given right this moment’s information, many medical specialists consider that the advantages of the ban not outweigh the hit to the blood provide or the hurt brought on by what’s a discriminatory rule.
The FDA has been slowly working towards this modification. In December 2015, the group took a giant step by permitting males who’ve intercourse with males to donate blood in the event that they hadn’t had sexual contact in a single 12 months. That interval was additional diminished to 3 months in April 2020, through the top of the COVID-19 pandemic, to assist battle a vital blood scarcity.
Whereas a step in the precise path, these updates did not change the blunt evaluation by the FDA that males who’ve intercourse with males are performing high-risk sexual behaviors and are themselves high-risk donors. Researchers and homosexual rights advocates have lengthy argued that time-based deferrals lack nuance and fail to realistically contemplate the variations in danger related to the kind of intercourse, kind of relationship, variety of companions and frequency of sexual encounters.
The FDA’s newest draft suggestions go a great distance towards enhancing readability about what makes an individual a high-risk donor and removes the blanket categorization of potential donors primarily based on their gender and sexual orientation alone.
Underneath the brand new pointers, there’s a option to differentiate between people who’re monogamous and those that will not be, in addition to between those that haven’t engaged in anal intercourse within the prior three months and those that have. The advice now means that blood donor historical past questionnaires be used to judge a person’s danger quite than a reliance on broad categorizations. If the evaluation finds a person to be high-risk, then the rules advocate that individual be prevented from donating blood for 3 months.
3. What impact might this have on the blood provide?
The FDA’s newest transfer represents a seismic shift for males who’ve intercourse with males in addition to for the critically low U.S. blood provide.
In keeping with latest analysis, a conservative estimate means that the lifting of the ban will result in a 2% to 4% improve within the blood provide. With the continuing blood scarcity, that improve might assist save greater than one million lives. As well as, eradicating gender and sexual orientation from the chance evaluation for blood donation will take the U.S. one step additional in addressing stigma and discrimination in opposition to males who’ve intercourse with males.
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Homosexual males can now donate blood after FDA modifications decades-old rule—a well being coverage researcher explains the advantages (2023, Might 17)
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