The Food and Drug Administration said Tuesday that it would discontinue a lifetime ban that prevents men who have sex with men from donating blood, shortening the donor deferral period to 12 months.
The existing ban was instated in 1983 when much less was known about the human immunodeficiency virus, or HIV. The FDA has previously said men who have sex with men are at an increased risk of transmitting HIV, in addition to hepatitis B. The policy has long been criticized by advocacy groups as outdated and lacking in scientific evidence.
An independent expert advisory panel and the HHS Advisory Committee on Blood and Tissue Safety and Availability recommended the change in policy. The agency came to the decision after it “carefully examined and considered the available scientific evidence,” a statement from FDA Commissioner Dr. Margaret Hamburg said.
The deferral period is similar to that for people who have had sex with other men and women who are at an increased risk for HIV infection, such as IV drug abusers or commercial sex workers.
In the past, the FDA has maintained that men who have sex with men, also known as MSM, are at an unusually high risk for HIV infection. The FDA notes on its website that from 2007 to 2010, the annual number of adult and adolescent males diagnosed with HIV due to MSM increased, while infections attributed to other causes decreased.
Advocacy groups stopped short of praising the FDA action. Most are advocating for a risk-based assessment.
The FDA is moving toward a more sound MSM policy, but they're not quite there yet, said William McColl, director of health policy at Washington, D.C.-based AIDS United, a group working to end the AIDS epidemic. While it could allow some MSM to donate, it still unfairly discriminates against homosexual and bisexual individuals, he said.
“In our opinion, it doesn't adequately sort out the actual risk of one person from another,” McColl said. “While we think this is an important step in the right direction toward making those kinds of changes, at the same time it still kind of fails to acknowledge the reality of the impact of this ban.”
An objective, more detailed screening process for all donors has been advocated by Gay Men's Health Crisis, an organization that provides HIV/AIDS care and advocates for awareness and prevention. In a 2010 report, the organization explained that objective screening could individually defer donors based on high-risk sexual practices, such as having unprotected sex or sex with multiple partners, rather than deferring a group.
The GMHC report notes that a yearlong deferral period, or even a six-month deferral period, are irrelevant, because post-donation tests could detect infections in donated blood that were transmitted in a much shorter time period. GMHC Tuesday called the policy change “offensive and harmful,” and asked the FDA and HHS Secretary Sylvia Mathews Burwell to implement a risk-based policy.
“This a lifetime ban dressed in new clothes. It still tells people that the risk of HIV is based on who you are and not what you do,” said Jason Cianciotto, GMHC's public policy director, in an interview.
Cianciotto, who participated in a conference call with the FDA and other gay rights advocates Tuesday, said FDA officials weren't able to adequately explain why the agency decided to shorten the MSM deferral period instead of doing away with it all together.
“What we need to do is stop hiding behind the notion that HIV is a gay disease and address what constitutes everyone's risk for HIV,” he said.
It's estimated that 53,269 additional men would be likely to donate 89,716 pints a year if the U.S. implements a 12-month deferral period, according to a 2010 report (PDF) by the Williams Institute at the University of California at Los Angeles School of Law.
Follow Adam Rubenfire on Twitter: @arubenfire
