Human Exceptionalism

Men Who Have Sex With Men as Blood Donors?

AIDS has been too caught up with politics from the beginning, treated often as more a civil rights issue than one of public health.

Partially as a consequence, we still have a terrible rate of annual new HIV infections–to the point that there are now serious calls for all men who have sex with men to take anti-retroviral drugs as a prophylactic! In other words, the danger of becoming infected remains alarming.

This is why I find my jaw dropping at advocacy in the Journal of the American Medical Association to drop the lifetime ban on blood donation from men who have sex with men. From the article by law professor, I Glenn Cohen,

In 2013, the US Supreme Court took a historic step in United States v Windsor by striking down the Defense of Marriage Act on the grounds that it imposed a “disability on the class [of gay Americans] by refusing to acknowledge a status the State finds to be dignified and proper.”

This milestone in gay rights stands in stark contrast to the ongoing lifetime ban imposed in 1983 on blood donation by men who have ever had sex with men (MSMs)

even once.

This is mixing apples with oranges. The marriage issue isn’t a scientific question. In contrast, whether it is safe for MSMs to donate blood should solely be an issue of science. 

Cohen seems to believe that social policy is the primary concern:

Viewed in the aggregate, the current FDA policy may be perpetuating outdated homophobic perceptions. 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.

Given the discerning capability of contemporary behavioral assessments and the ever-improving sensitivity of modern diagnostic technology, the disproportionate share of HIV cases among sexually active MSMs can no longer support the current restrictive policy of the FDA.

Cohen even opposes a more moderate deferral from donating for 12 months from last MSM sexual contact:

Accordingly, policy makers should consider…an “assess and test” approach. Specifically, a thoughtfully reformulated risk level–focused assessment of donor eligibility should be coupled with rigorous testing (and retesting) of identifiably high risk groups who may present for donation. 

He also believes the current policy could be unconstitutional discrimination, as if there is a “right” to donate blood.

And he doesn’t mention the value of increasing the blood supply, so caught up is he in issues that should have no relevance to the question at hand.

But here is an issue that is relevant to the question of safety: The infection rate for MSMs is going up. From an AP story about the otherwise reducing infection rate for HIV in the USA:

The only group in which diagnoses increased was gay and bisexual men, the study found.

After 9/11, I tried to donate blood and was turned away because I had been to a rain forest within the previous twelve months. That was a wise policy to keep me from spreading a malady inadvertently.

So is this policy, barring absolute proof that the ban can be lifted safely. With the call going out for all men who have sex with men to take prophylactic anti-retrovirial drugs, I don’t see how that can be done. Keep social issues and politics out of the safety of our blood supply.

And really: How many people would really think worse of men because they can’t donate blood? And why should anyone care what those people think?

Wesley J. Smith — Wesley J. Smith is a senior fellow at the Discovery Institute’s Center on Human Exceptionalism.

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