Lambda Legal Responds to Proposed Change in Blood Donation Policy with Call for Real Reform

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December 23, 2014
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Scott Schoettes

The U.S. Food and Drug Administration (FDA) today announced it plans to move ahead with a recommendation to reduce the deferral period for blood donations from gay and bisexual men from the current lifetime ban to one year. This recommendation follows increasing calls from LGBT advocates and the medical establishment, including the American Red Cross, the American Association of Blood Banks, America’s Blood Centers, and, most recently, the American Medical Association, to end the lifetime ban.

This is a step in the right direction, but blood donation policy should be based on current scientific knowledge and experience, not unfounded fear, generalizations and stereotypes. Merely changing the parameters of this outdated policy does not alter its underlying discriminatory nature, eliminate its negative and stigmatizing effects, nor transform it into a policy based on current scientific and medical knowledge.

Within 45 days of exposure, currently required blood donation testing detects all known serious blood-borne pathogens, including HIV.  Therefore, a deferral of more than two months—for anyone—is not necessary and does not noticeably enhance the safety of the blood supply. Furthermore, donor deferrals should be based entirely on the conduct of the potential donor and not on sexual orientation, gender identity or the perceived health status or risk factors of the donor's sexual partners. The reason is straight-forward, and is a foundational principle of our prevention efforts: an adult person becomes HIV-positive—or acquires another blood-borne pathogen—only after engaging in activities that present a risk of transmission. To base deferrals primarily on prevalence within certain communities rather than behavior could serve to disqualify other segments of the population based on race, sex and where they reside—a very slippery slope toward more easily recognizable forms of illegal discrimination. If we are serious about a policy that is truly most protective of the blood supply, it will treat all potential donors the same and base any deferrals on the conduct of those potential donors within a scientifically justified ‘window period’ prior to donation.

Lambda Legal also supports a fully-funded, more robust and comprehensive system for monitoring blood donations—particularly those donations that test positive for a blood-borne pathogen, like HIV or hepatitis C.  Such a system—known as a ‘hemovigilance’ system—is the international standard and could inform further development of the donor questionnaire used to assess an individual’s conduct-based risk, as well as to track any new, emerging infections before they have the chance to infiltrate the blood supply. But let’s not pretend that further research is needed or that more information about the make-up of the current donor pool must be gathered before moving to an individualized risk-based assessment and much shorter deferral period.  We already know the routes and relative risks of transmission for the blood-borne pathogens that recipients are legitimately concerned about, and we should move as swiftly as possible to a system that defers only individual donors who recently have engaged in activities placing them at risk—not to a system that still prevents groups of people from donating based simply on who they are.

Read the press release.