Outdated Donation Rules Exacerbate Blood Shortage

The COVID-19 pandemic put a strain on the country’s blood supply, leaving some communities in dire situations. Last February, a helicopter had to deliver platelets from north Louisiana to Baton Rouge General amid a crisis blood shortage. Pandemic shortages like this brought a renewed push to lift donor restrictions for gay and bisexual men, with some reports estimating an impact of an additional 345,400 to 615,300 pints of blood annually.

Why is there a restriction?

Right now in the U.S., men who have sex with men have to abstain from same-sex sexual activity for 90 days to be eligible to donate blood. The policy is set by the U.S. Food and Drug Administration with input from the Blood Products Advisory Council.

It’s true that every unit of donated blooded is tested extensively for possible blood-borne diseases, but the testing is not 100-percent accurate especially at detecting a very early infection. So even with the current restrictions and testing of approximately 12 million units donated each year, it’s not foolproof. To ensure the safety of blood and other tissues for donation, the FDA uses scientific data to automatically defer certain populations. And because gay and bisexual men have higher incidence of disease, they are eliminated from the donor pool immediately.

Restrictions on gay and bisexual men donating blood stem from the AIDS crisis in the 1980s, starting with the enactment of a lifetime ban from donating blood in 1983. Major change to the federal policy didn’t happen until more than 30 years later, in 2015, when the outright ban was replaced with the one-year abstinence requirement. Then in April 2020, the FDA decreased the donation deferral period from 12 months to three months.

The limitations on gay and bisexual men have long been criticized as discriminatory and seen by many in the medical community as an unnecessary obstacle to securing the nation’s blood supply. The Red Cross has previously urged the FDA to lift the ban on donations, as have leading U.S. medical organizations, including the American Medical Association.

What are the proposed changes?

When you arrive to give blood, you’ll first take a pre-screening questionnaire to determine risk factors that could indicate possible infection with a transmissible disease, such as HIV or hepatitis. According to the FDA, this pre-screening eliminates up to 90 percent of donors who may be carrying a blood-borne disease.

But, this process is based strictly on a person’s membership in a “group” and doesn’t look at risk equally person-to-person. For example, a man who has had protected oral sex with another man once within three months would not be able to donate blood, but a woman who has had unprotected sex with multiple partners over the same period with no knowledge of their personal histories would still be eligible.

Groups like the Human Rights Campaign advocate revising the current donor questionnaire to be based on an individual risk assessment of sexual behaviors, regardless of a person’s sexual orientation or gender identity.

In December 2020, the FDA announced a joint study with three major blood donor organizations -- American Red Cross, Vitalant and OneBlood -- to provide data to determine if eligibility based on an individual’s risk could replace the time-based deferral system while maintaining the safety of the blood supply. Called “ADVANCE” (Assessing Donor Variability And New Concepts in Eligibility), the study is still ongoing.

What can you do?

If you’re eligible, participate in the ADVANCE study. The study includes gay and bisexual men who are interested in donating blood, and who have had sex with at least one other man in the three months before joining in the study. Eligible participants need to be 18-39 years old and live in one of the eight communities where the study is being done (Baton Rouge/New Orleans is one of the locations!)

For those who aren’t eligible for the study, do your part by telling the FDA that you support ending these restrictions on blood donation.