More gay and bisexual men may soon be allowed to donate blood in the U.S., as the Food and Drug Administration is considering regulatory changes that could go into effect as soon as the end of this year.
Donation restrictions against men who have sex with men have been in place since 1985, due to fears about transmitting HIV. Until 2015, the agency banned such potential donors for life. The rules were most recently revamped in 2020: Currently a man cannot donate blood if he’s had sexual contact with another man in the past three months.
The University of Pittsburgh’s Dr. Ken Ho is one of many infectious disease experts who say this policy doesn’t make sense. For one thing, monogamous gay couples are at less risk of getting HIV than heterosexual people with multiple partners.
“It shouldn't really matter that they’re gay or straight. It’s really, how at risk is the sexual network?” said Ho.
Instead of focusing on a potential donor’s sexuality or gender, the FDA’s draft proposal assesses the odds they unknowingly have HIV.
- First a person is asked if they’ve had sex with a new partner, or have been with multiple partners in the past three months.
- If they answer “yes” to either question, the donor is asked if they’ve had anal sex within the past three months.
- If the answer is also “yes,” the individual can’t donate blood for three months.
HIV is more easily transmitted during anal sex, prompting these proposed rules.
The potential change is welcome news to people currently barred from donating blood, said Sean DeYoung, CEO of Allies for Health + Wellbeing. The Pittsburgh-based organization specializes in sexual health and HIV prevention. He says many members of the community he serves have wanted to give blood during health crises or after mass shootings, but have been unable to serve as donors.
“There’s been a lot of frustration, so I’m really excited about the FDA putting out new guidance,” he said. “There’s a lot of helpers out there.”
A spokeswoman for the Vitalant blood bank, which serves the Pittsburgh area, said via email that the organization supports the proposed regulatory changes: “We believe that donor eligibility criteria should be based on the latest available scientific data, not sexual orientation.”
Vitalant, along with OneBlood and the American Red Cross, worked on an FDA-funded pilot study to assess the risk posed by blood donated by men who have sex with men; results have yet to be published.
Ho says the proposed draft is an imperfect way to screen people, but it is an improvement. Ideally, people would be asked more in-depth questions, though that would take longer and possibly deter some donors. Additionally, Ho wants to make donation requirements even less restrictive. He thinks that could be done if tests were more sensitive and therefore better able to detect the very small number of HIV-positive blood donations that potentially exist in the nation’s blood supply.
According to Tufts Medical Center, the odds of someone getting HIV after a blood transfusion is less than one in nearly 2 million: “However, if a blood donor was infected with HIV within 2 weeks before giving blood, tests may not find the virus in the blood.”
People taking oral pre-exposure prophylaxis for HIV are not permitted to donate for three months; it’s possible the medication could cause false-negative results when their blood is tested for HIV. Likewise, HIV patients who have undetectable viral loads due to antiviral treatment are also not eligible.