March 17, 2006

Red Cross now seeks to
allow gay blood donation

by Eric Resnick

Washington, D.C.--The American Red Cross has changed its mind on the safety of blood donated by gay and transgender people, and has asked the Food and Drug Administration to change its policies.

During the FDA?s Blood Products Advisory Committee meeting March 9 and 10, the American Red Cross said it believes ?the current lifetime deferral for men who have sex with men is no longer medically and scientifically warranted,? and recommended that it be modified.

The Red Cross joined its counterparts in recommending that ?rational, scientifically based? deferrals be used.

?It does not appear rational to broadly differentiate sexual transmission via male-to-male sexual activity from that via heterosexual activity on scientific grounds,? said Steven Kleinman, M.D., presenting a joint statement on behalf of the Red Cross, the American Association of Blood Banks and America?s Blood Centers.

Kleinman further recommended that the FDA should lift the ban on the donation of human cells and tissues by MSMs for the same reasons.

Currently, any man who has had had sex with another man, even once, since 1977 is permanently prohibited from donating blood. The ban was put into place in 1983, at the beginning of the AIDS epidemic.

The rule originates in the federal Food and Drug Administration policies for blood collection, and had been kept there at the insistence of the Red Cross, which collects about half of the blood used in the United States.

In September 2000, the Red Cross opposed efforts by the American Association of Blood Banks and America?s Blood Centers to change the guidance to allow donor eligibility for gay men with one year since their last sexual contact.

The other collectors and the scientific community argued that the permanent deferral was irrational, scientifically unnecessary, and discriminatory.

While barring gay men, even those in long-term monogamous relationships, the policy allows blood donation by heterosexual men and women who have unprotected oral, anal and vaginal sex and multiple sex partners, and who have unknown HIV status.

Donated blood is always tested for HIV and other pathogens. The first HIV blood test, used in 1985, tested for antibodies to the virus. The current version, called the nucleic acid test, reveals the virus itself, and is considered extremely reliable.

As recently as last fall, the Red Cross relied on an opinion titled ?Blood Supply Safety: a discussion of the policy that maintains indefinite ineligibility for blood donations from men who have had sex with men since 1977? published by the Southern California Red Cross as the basis for promoting the deferral.

That article says men who have sex with men have ?unique social relations, behavior patterns and experiences which relate to disease processes that could affect the blood supply.?

The article also says gay men aren?t interested in monogamy, and have more than 100 partners in a lifetime and ?fidelity within MSM relationships is not defined in terms of sexual behavior but rather by emotional commitment.?

But such positions have gotten the Red Cross compared to overtly anti-gay organizations like the Boy Scouts and the Salvation Army. College groups have boycotted blood collection efforts on campuses, and gay-affirming websites directed hurricane relief funds away from the Red Cross in favor of other charities.

Red Cross spokesperson Ryland Dodge says the new position is all about blood safety and has nothing to do with outside pressure and bad press.

The reasons given for the change are that more is known about HIV than when the FDA first issued its guidance, better donor histories are used at collection sites, and that nucleic acid testing has allowed for earlier detection of HIV in donated blood.

The new test was approved in February, 2002.

?We have more data now,? said Dodge in of the more effective test.

?As recently as last fall, we came to the conclusion that the MSM deferral was not necessary,? Dodge said.

Asked why it took the Red Cross so long to come to the conclusion it did, Dodge said, ?It takes a while to collect data.?

Dodge said no studies have been done to project how much more blood will be available when gay and transgender men resume donating.

It is not yet apparent what course the FDA will take or how long it will take them to decide.

In 2002, the vote to continue the ban was 8 to 7.

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