Minnesota seeks to end blood donation discrimination
Christopher Johns got into the habit of donating blood when he was in high school.
But after graduating and coming out as gay, he was surprised to learn that blood banks would refuse donations from him and other sexually active gay people.
“I was very taken aback,” he said. ” I didn’t understand. This led to more questions than answers.
Now a fourth-year medical student at the University of Minnesota, Johns has devoted part of his studies to understanding the ban and how lifting the ban could affect blood donations from other men who have sex partners. masculine.
Along with a few colleagues, he interviewed nearly 600 men and found that most would donate blood if the ban was lifted. Currently, homosexuals must abstain from sex for 90 days before they can make vital donations.
Johns’ research indicates there is an untapped pool of donors at a time when blood banks have in recent weeks said blood supplies are still critically low – continuing a crisis that began at the start of the pandemic of COVID-19.
Blood donations plummeted as workplaces and schools closed and with them the blood drives they organized. Blood banks were still accepting donations at their facilities, but many potential donors were reluctant to turn up for fear of being exposed to COVID-19, especially before vaccines were widely available.
In January, the American Red Cross said the blood shortage was the worst in a decade, calling it a “national blood crisis”.
Medical organizations, advocacy groups, politicians and state governments are increasingly calling on the US Food and Drug Administration, which sets blood donation policies, to end its exclusion of gay men. sexually active and to implement better risk-based screening, regardless of sexual orientation.
In a rare public criticism of the federal policy, the Minnesota Department of Health said federal regulations regarding gay people and blood donation are discriminatory and unsupported by scientific evidence.
“This is truly an outdated policy that needs to be revisited, which is why we decided it was important for Minnesota to sign on to this ‘nascent movement to end exclusion,’ the MDH spokesperson said, Doug Schultz.
Apparently FDA policy is aimed at protecting the nation’s blood supply from the HIV virus, but critics say donor eligibility guidelines have not kept pace with advances in HIV testing , HIV treatment and a better epidemiological understanding of AIDS transmission.
“It’s based on outdated belief systems,” said Alex Sheldon, executive director of the Gay and Lesbian Medical Association. “Any policy governing blood donation should be developed without group membership and should instead focus on individual potential risk.”
According to research published in Transfusion Medicine Opinion.
Despite being screened, around 8% of those surveyed managed to donate blood despite not abstaining from sex in the previous three months – a finding that has been replicated in other studies. This raises questions about the effectiveness of screening. But 11% were turned away during the selection process – an experience some have described as humiliating, demoralizing or embarrassing.
The blood banking industry has also wants changes to be made to the ban, because its supply comes solely from volunteers. Donations keep blood on hand for emergency and elective surgeries, as well as for transfusions for people with anemia, blood disorders, cancer treatments and other needs.
While a recent drop in donations has put pressure on the country’s blood supply, there have been more asks the FDA to change its blood donation policyincluding from Senator Tammy Baldwin, D-Wisconsin, joined by Minnesota DFL Senators Amy Klobuchar and Tina Smith.
In North Carolina, the head of the state Department of Health and Human Services was asked in January if he would donate blood as part of an effort to get political leaders to lead by example.
“I had to explain the long-standing exclusion of gay and bisexual men who participated in sex acts so as not to donate blood,” said Secretary Kody Kinsley, who is gay. “It wasn’t the first time I had this conversation at work.”
He decided to turn a “very disappointing experience” into action, which ultimately led to an appeal — signed by health officials from the District of Columbia and nine states, including Minnesota — to FDA Commissioner Robert Caliph.
Kinsley noted that it’s been 40 years since the FDA first restricted gay and bisexual blood donations. Although there have been some changes, overall it has remained a ‘cudgel’, despite advances in HIV testing and understanding of transmission and prevention.
“It continues to reinforce this stigma that by virtue of being gay you have this equal risk,” Kinsley said.
However, the FDA has tightened its restrictions on gay and bisexual men in recent years. In 2015, it dropped a lifetime ban for men who had previously had sexual contact with another man and replaced it with a one-year look-back period. In April 2020, this was replaced with a 90 day window.
Several other countries – including Spain, Italy, England, Israel and France – have already backed away from banning homosexuals from donating blood. The United States continues to deny some gay and bisexual men who want to donate, including those in monogamous relationships and men who practice safer sex, prompting growing calls for change.
The FDA is funding a study, known as the ADVANCE, which will test different donor screening policies to see how effective they are in protecting the blood supply. Enrollment in the study, which is conducted by three of the nation’s largest blood banks, was recently closed.
But it’s unclear when it will release the results and whether the FDA will drop its blanket ban and move to a risk-based system.
Regulators should consider whether a new risk-based system might still turn away other potential donors.
The standard screening routine already asks dozens of questions, some of which relate to sexual partners, including whether they have tested positive for HIV, have used intravenous drugs or are sex workers.
Studies by the Canadian health agency found that a more risk-based approach requiring a few more intrusive questions — about multiple partners and anal sex, for example — would result in some donors being lost.
Yet Canada recently changed its guidelines because it anticipates a net gain.
“Being more inclusive will get you more donors…that would make up for those losses,” said Dr. Jed Gorlin, medical director of St. Paul-based Memorial Blood Centers.
“I see us getting there,” Gorlin said. “I think it’s a matter of time and a matter of validating the most useful questions.”
Johns hopes gay people will be able to donate blood without restriction when he leaves medical school.
“I have a significant other and we are in a monogamous relationship and I really hope that by the time I graduate, in eight to nine more months, there will be something in the works,” he said. -he declares. “I think it’s important to give back to the community…and now more than ever given such a shortage of blood.”