Is the FDA Ban on MSM Blood Donations Discriminatory?

With fanfare, the Food and Drug Administration announced a new policy on blood donations from men who have sex with men.  Much to the disappointment of activists seeking to terminate the ban entirely, the new policy replaced a lifetime ban with a limitation on donations from MSM for one year following the last time the male potential donor had sex with a man.

The FDA website includes the following:  Men who have had sex with other men represent approximately 2% of the US population, yet are the population most severely affected by HIV. In 2010, MSM accounted for at least 61% of all new HIV infections in the U.S. and an estimated 77% of diagnosed HIV infections among males were attributed to male-to-male sexual contact. Between 2008 and 2010, the estimated overall incidence of HIV was stable in the U.S. However the incidence in MSM increased 12%, while it decreased in other populations. The largest increase was a 22% increase in MSM aged 13 to 24 years. Since younger individuals are more likely to donate blood, the implications of this increase in incidence need to be further evaluated.

Yet those who oppose the ban point out that the ban assumes that MSM do not take precautions to avoid transmission and wonder if the FDA  isn’t promoting the myth that MSM are never in monogomous relations.  Both conditions dramatically reduce the risk of infection according to the FDA.   Testing donated blood for HIV, while not 100% accurate, has an extremely low failure rate in detecting infected blood.  The FDA counters that the ban is not discriminatory because other groups, such as IV drug users and women who have sex with bi-sexual men, are also banned from donation because of their increased risk of HIV infection. 

Ryan James Yezak, a Los Angeles-based filmmaker and activist, has organized events to protest the policy. “There are a lot of people who still equate being gay with contracting HIV, and look at it as a disease. And if you look at our government and the policies and laws in place, the only one that supports that notion is this FDA policy,” he said. While protests tend to focus on the American Red Cross, that organization is on record as opposing the ban.  Susan Stramer, the executive scientific officer with the Red Cross, stated “The question is about what’s equitable.”

Dr. Louis Katz is chief medical officer for America’s Blood Centers, a nonprofit that provides half of the nation’s blood supply. His group, along with the Red Cross, has called on the FDA to change its policy on gay and bisexual men. “A (then) lifetime deferral is not justified by the science,” he said.

“Testing of donated blood has become so accurate that the chance of infected blood being given to a patient is almost nonexistent,” Katz said. “Since 1999, when blood centers started using nucleic acid testing to detect HIV, fewer than 10 people have gotten HIV from a blood transfusion.  And we transfuse over 20 million components a year, so do the math. The rates are microscopic.”