Gay marriage laws and court rulings against sexual-orientation discrimination are all signs that it’s time for the federal government to change its blood-donor policy for gay and bisexual men, authors said in a commentary released Saturday.
The lifetime ban for blood donation by men who have sex with men (MSM) “may be perpetuating outdated homophobic perceptions,” wrote Dr. Eli Y. Adashi of Brown University and scholars I. Glenn Cohen and Jeremy Feigenbaum, both of Harvard Law School, in the July 23/30 issue of the Journal of the American Medical Association.
“Even though well intentioned and guided by a need to protect the integrity of the national blood supply, a policy that demands permanent deferrals for sexually active MSMs raises the specter of exclusion, stigmatization and marginalization,” they wrote.
The current blood-donor policy “may not survive legal challenges,” the authors added, citing the Windsor case, in which the Supreme Court said the federal government could not disregard the legal marriages of gay couples, and the SmithKline Beecham ruling by the 9th Circuit Court of Appeals, which found that a juror could not be dismissed solely based on his sexual orientation.
“The goal should be to reduce whatever discrimination remains to the lowest possible level, without doing harm to the public, or, in our case, the end-user and patient population,” Mark Skinner, former president of the World Federation of Hemophilia, said Friday.
“We want a science-based decision, not a politically based decision,” Mr. Skinner said, noting that the Department of Health and Human Services and Food and Drug Administration are already gathering data on how to change the donor questionnaire and related policies.
The National Hemophilia Foundation’s position “remains the same — we are certainly very open to anything that will increase the blood supply here in the U.S., as long as the decisions that are made are based on medical science,” said John Indence, the group’s vice president of marketing and communications.
“This community was devastated back in the early 1980s,” Mr. Indence said. More than 10,000 people with bleeding disorders received infected transfusions, “and most of them have passed away, from either HIV or Hepatitis C,” he said. “So our concern is always going to be on the safety of the blood.”
The new JAMA opinion piece noted that other countries have recently updated their blood-donor policies and defer MSM if they have had sex with a man in the last six months (South Africa), one year (United Kingdom) or five years (Canada).
Dr. Adashi and his colleagues suggested an alternative U.S. policy, known as “assess and test.”
It would defer a MSM for a brief period — such as four months — if he has engaged in certain risky behavior, such as having sex with someone of unknown HIV status or who is HIV-positive. Such a man could come back after the deferral period, be tested, and then potentially be re-instituted as a blood donor, they wrote.
Permanent deferrals could still be applied for other risky behaviors, such as exchanging sex for money, injecting drugs, or having repeated sex with one or more HIV-positive partners, they wrote.