During the HIV epidemic of the 1980s, in an effort to protect the blood supply, the FDA permanently deferred blood donations from what they referred to as “men who have sex with men,” or MSM, a group that generally included cisgender men and transgender women.
That ban stayed in effect for decades, preventing a portion of the population from donating blood.
Making inclusive changes
Now, with fewer donors and a decreasing blood supply over the last few years, the FDA has been slowly adjusting donor policies like this one to encourage more donors, basing the deferment on how recently MSM have had sex rather than a wide, permanent ban based on sexuality.
“And now, as of May 11, they completely removed that question altogether, and they've replaced it with three more inclusive questions,” said Waseem Anani, medical director of ARUP Blood Services.
Those questions are:
- Have you had a new partner in the last three months?
- Have you had multiple partners in the last three months?
If you answer yes to either of those, you'll be asked another question:
- Have you had anal sex in the last three months with any of those partners?
If yes, you’re deferred for three months.
“The nice thing about this is it does not target any one particular person, gender or sexual orientation,” Anani said.
Anani said that while this doesn’t bring ARUP fully to where they want to be, it’s still a big milestone. According to an advanced trial conducted out of San Francisco, it will make 30-35% of gay men eligible instead of virtually zero.
Who's still ineligible
Notably, those who are on PrEP, a medication to protect against HIV, are also currently deferred. Anani said this is because current tests can’t tell if PrEP is currently clearing HIV out of your system, which means there could be a small amount of the virus in the blood they take.
“One of the things to remember is that the FDA takes a stance of zero tolerance for risk, zero at all, because they don't want a single person who receives blood to have harm,” Anani said.
Though that makes a number of single queer men ineligible, Anani says that doesn’t mean you should pick blood donation over being on PrEP.
“The FDA very clearly states that you should not go on the go off the medication just to donate,” Anani said. “As much as I love blood donation and I think everyone should be a blood donor, PrEP is far more important from the safety perspective of a person who is sexually active.”
Implementing the changes
These recommendations came out in May, but it takes time for blood centers to implement them. On top of IT system changes, Anani says there’s a large amount of education involved.
“If you think about it, we've never seen really gay donors to a large extent,” Anani said. “So I'm having our staff understand how to approach someone who may feel like they were traumatized in the past by not being able to donate or feel like they were under attack. So part of it is rebuilding bridges with the community.”
Most centers won’t be done with implementation until at least August or September. ARUP went live on July 18 with the theme "Donate with Pride."
“I'm proud to say that ARUP Blood Services will be the first in Utah to collect and very likely one of the first, if not the first, in the U.S. to collect,” Anani said.
ARUP’s website also has frequently asked questions for queer people wondering about eligibility and how to answer certain questions such as “male/female.”
Anani says he’s excited for these changes to roll out, as well as future ones that could allow even more people to be eligible.
“There are all sorts of people who get injured—gay, straight, bi, nonbinary, doesn't matter. So a lot of people in the queer community have received blood, but they've never been able to give back to their own community,” Anani said. “And this is now a great way for them, from my perspective, to give back to the people that have helped them as well and also save lives.”
