24 Dec 2014

FDA lifts ban on blood donation from homosexuals

The Food and Drug Administration announced Tuesday that it would scrap a decades-old lifetime prohibition on blood donation by gay and bisexual men, a major stride toward ending what many had seen as a national policy of discrimination.

However, the agency will continue to ban men who have had sex with a man in the last year, saying the barrier is necessary to keep the blood supply safe, a move that frustrated rights groups that were pushing for the ban to be removed entirely.

The F.D.A. enacted the ban in 1983, early in the AIDS epidemic. At the time, little was known about the human immunodeficiency virus, which causes the disease, and there was no quick test to determine whether somebody had it. But science — and the understanding of H.I.V. in particular — has advanced in the intervening decades. On Tuesday the F.D.A. acknowledged as much, lifting the lifetime ban but keeping in place a block on donations by men who have had sex with other men in the last 12 months.

The F.D.A. rules on blood donation generally include very wide margins of error. For example, it bars anyone who has traveled in areas where malariais common from giving blood for a year, even though malaria symptoms are almost unmistakable — chills and fever — and virtually always appear within 40 days. The agency also has a 12-month waiting period for heterosexuals who, among other activities, have sex with prostitutes or with people who inject drugs.
Restrictions on donors were written when H.I.V. testing was slower and less refined. Today, some tests can detect the virus in blood as little as nine days after infection.

In written remarks, the agency said it was keeping the 12-month ban because “compelling scientific evidence is not available at this time to support a change to a deferral period less than one year while still ensuring the safety of the blood supply.”

The shift puts the United States on par with many European countries, including Britain, which adjusted its lifetime ban in favor of a 12-month restriction in 2011.
Most men’s health advocates called the move long overdue, and said that the overall ban was not based on the latest science and that it perpetuated a stigma about gay men as a risk to the health of the nation. Legal experts said the change brought an important national health policy in line with other legal and political rights for gay Americans, like permitting gay people to marry and to serve openly in the military.

“This is a major victory for gay civil rights,” said I. Glenn Cohen, a law professor at Harvard who specializes in bioethics and health. “We’re leaving behind the old view that every gay man is a potential infection source.” He said, however, that the policy was “still not rational enough.”
Indeed, some advocacy groups attacked the change as too incremental. Leaving in place a 12-month ban essentially blocks any gay or bisexual man who is sexually active from donating, erasing about half the population of potential donors and perpetuating what rights groups say is tougher treatment for gay and bisexual men.

G MHC, the advocacy group formerly known as Gay Men’s Health Crisis, called the new policy “offensive and harmful.” AIDS United, a Washington-based lobbying group, said that it was a “step forward,” but that it “continues to perpetuate discrimination against gay and bisexual men.”
Today doctors have nucleic acid tests that can diagnose an H.I.V. infection within nine to 11 days of exposure, and all blood donations have to be tested before being shipped for transfusion.
“Many other Western countries had changed their policies, and I think the F.D.A. has come to accept the science supporting a change to their policy also,” said Debra Kessler, director of special donor services at the New York Blood Center. She said blood centers across the country “have been talking to the F.D.A. for years to encourage them to move forward.”

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