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Who can donate blood? – Los Angeles Times



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As a sophomore in school in 2011, I used to be deferred from donating blood for being a homosexual man. I used to be confronting the homophobia constructed into the FDA’s blood donation ban for males who’ve intercourse with males.

After imposing that rule in 1985 and making a number of minor revisions since, the FDA is in the end considering meaningful updates to think about donors primarily based on their sexual habits no matter their orientation. The brand new laws would permit homosexual and bisexual males to donate blood — if they’re monogamous. The proposal would additionally for the primary time defer anybody from donating if they’ve had new or a number of companions up to now three months and had anal intercourse throughout that point.

It’s progress that officers are revisiting insurance policies which have enshrined stigma and prejudice. The adjustments would open the door to many homosexual and bisexual males who have been beforehand — and wrongly — excluded, serving to shore up the U.S.’s lagging blood provide.

However we want additional adjustments. The brand new coverage’s slender give attention to anal intercourse and monogamy nonetheless fails to evaluate sexual threat for HIV precisely, and it continues to stigmatize folks primarily based on their sexual exercise.

First, because the FDA’s proposal highlights, not all kinds of intercourse are equal on the subject of HIV risk. The best such threat is from unprotected anal intercourse with an HIV-positive companion who has a detectable viral load. However threat differs considerably primarily based on place — whether or not somebody is the receptive or insertive companion. Unprotected receptive vaginal intercourse and unprotected insertive anal intercourse have a comparable threat of HIV transmission, which means a coverage focus solely on the latter displays some subjective judgment of sexual exercise dangers.

Monogamy can be not essentially a dependable technique of stopping sexually transmitted infections, given the truth of sexual exercise outdoors of presumed monogamous relationships. Analysis exhibits that people in consensual nonmonogamous (e.g. open) relationships are literally more likely to get HIV and STI testing and use condoms than those that report monogamy. They could due to this fact be extra more likely to precisely assess their very own HIV threat earlier than donating blood.

No matter the kind of intercourse individuals are having, or their variety of companions, HIV threat may be just about eradicated by means of prevention strategies corresponding to consistent and reliable condom usage and taking pre-exposure prophylaxis (PrEP) medicine.

But the FDA’s revised pointers don’t have in mind these different protecting behaviors. In truth, they’d proceed to require people to be off PrEP for 3 months earlier than donating due to issues that taking the medicine will increase your chance of getting a false destructive HIV check. However a donation coverage inclusive of people that frequently take PrEP might assist guarantee a safer blood provide. And to stop the principally hypothetical threat of a false destructive HIV check, blood from these potential donors might be individually screened using nucleic acid testing.

The newly proposed guidelines additionally proceed to particularly defer people who’ve had any kind of intercourse for cash and medicines from donating for 3 months. Although transactional sex is often higher risk for HIV on account of decreased condom utilization, blanket deferrals with out evaluation of precise behavioral threat appears primarily based extra on prejudice in opposition to intercourse work, substance use and poverty than on proof.

Generalizations about intercourse won’t really measure HIV threat — however it can perpetuate stigma. Quite than lean on assumptions, up to date FDA pointers ought to ask extra detailed behavior-based questions that mirror the science of HIV transmission.

Past bettering the blood donation course of, higher questionnaires may also help educate extra Individuals about HIV threat. Many colleges do not provide comprehensive sexual health education, and even fewer present info inclusive of LGBTQ well being. Donation screenings supply a strong instructional alternative and may be the primary time folks fastidiously assess their very own sexual behaviors. They need to get the details on the best way to precisely consider HIV threat and defend themselves, not oversimplifications which will result in misinformation.

The FDA is clearly making an attempt to create extra inclusive and evidence-backed insurance policies. The proposed adjustments will seemingly scale back stigma for some Individuals and probably scale back the variety of younger males who’re outed at work and faculty throughout blood donation drives.

But as a health care provider, I’m disenchanted by the dearth of nuance that also exists within the new donation guidelines — and I hope to see additional adjustments. As a homosexual man, I’m relieved to see the FDA work towards ending a ban primarily based on sexual orientation. I stay up for once I can donate blood and contribute to the provision my sufferers depend on.

Eric Kutscher is a main care and dependancy medication physician in New York Metropolis.