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The FDA's Blood Ban Reflects Outdated View of HIV, Gay Men

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COVID-19 has drained millions of healthcare workers, first responders, and ailing Americans of time, energy, and peace of mind. Unfortunately, it’s also sapped America’s already limited blood supply, causing blood banks to scramble for donations. But amid the chaos, a group of good samaritans want to help, but their charitable spirit is being hindered by Uncle Sam: Gay and bisexual men. 

In early April, the Food and Drug Administration announced that it had reduced restrictions for how long sexually-active gay and bisexual men should wait after having sex with a man to donate from one year to three months. The updated recommendations will remain post-pandemic. The policy had been severely criticized, and its reduction praised, by political organizations like the Human Rights Campaign and GLAAD. But, they argue, the change isn’t enough. “We will keep fighting until the deferral period is lifted,” said GLAAD’s President and CEO, Sarah Kate Ellis. They’re right.

Yes, gay men can help replenish the nation’s low blood supply if they swear abstinence for three months. Otherwise? Bad luck for people in need of blood donations.

Even in its revised form, this restriction can’t be allowed to stand. Dated stereotypes and fears have no place in political decision-making, especially when lives are at stake. 

Through the years, the FDA’s reasoning on restricting gay blood donations has been consistent: Sexually-active gay and bisexual men present a high risk of transmitting sexual diseases, paritcularly HIV/AIDS. It certainly was once a very legitimate concern, as these men indeed accounted for 70 percent of all HIV diagnoses in America in 2018. But many experts say the concern is simply outdated. 

For instance, Dr. Amesh Adalja, an infectious diseases physician at the Johns Hopkins Bloomberg School of Public Health, recently told The New York Times that the revision was pretty late in coming. “It’s too bad that it took a pandemic to actually prompt this, because it should have been prompted much earlier when technology was such that we could ensure the safety of our blood supply.” 

And Dr. Jeff Kirchner, chief medical officer at the American Academy of HIV Medicine, said that even people with HIV (note: the rate of new diagnoses annually has declined 11 percent from 2010 to 2017) can take treatment to render their viral load to “undetectable,” meaning they can safely donate blood without infecting the recipient. As of 2017, 49 percent of people infected with HIV are on such treatment and “have it under control,” according to the CDC. 

In Dr. Kirchner’s opinion, there “shouldn’t be any waiting period, per se, based on MSM history.” This, he told me, “was a recent compromise to an antiquated and discriminatory policy from my perspective.” All blood is tested after donation for a variety of infectious diseases now, anyway. So why is there still fear of the “gay sickness”?

The FDA had every reason to re-evaluate its antiquated assertions once antiretroviral medicine became available and diagnostic testing became more sophisticated. But they didn’t. The scientific efficacy of HIV medicines and screening, as well as social attitudes on homosexuality, has long been further along than the FDA’s recommendations. As the tides of social acceptability shifted, the FDA finally followed in 2015 with the 12-month policy, but it took another five long years for their policies to be updated any further. 

In light of this fact, COVID-19 should impart upon the medical community the onus to speak for itself, and treat the FDA’s guidelines as the FDA itself regards them: As something “suggested or recommended, but not required.”

Gay activists must not become complacent after this small achievement. Yes, many gay blood donors will be able to help more quickly than we were before. But if the wait restrictions were lifted altogether, so much more could be done. Stopping the struggle now would be a small victory at best. But while COVID-19 claims hundreds of Americans every day, a small victory is simply not enough.

Christian Watson is a political writer based out of Georgia and a Young Voices contributor. He can be found on Twitter at @OfficialCWatson.

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