Experts call for US to scrap ‘outdated’ gay blood donor rules

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Over 500 health professionals have signed an open letter calling on the US Food and Drug Administration to remove a “scientifically outdated ban” on blood donations from gay and bisexual men.

Two weeks ago, the FDA revised its blood donation rules to reduce the required sexual abstinence period for men who have sex with men from 12 months to three months.

But the letter states, “While the FDA’s recent decision to shorten the prohibition window to 3 months is a step in the right direction, it does not go far enough in reversing the unscientific ban.”

The infectious disease and HIV specialists want a “more scientifically rigorous” approach to screening blood donors that better reflects modern HIV testing technology.

In their letter, they argue that a “critical nationwide shortage of blood products” due to COVID-19 is the reason the FDA should further reduce the wait period for gay and bisexual men.

The letter adds that lifting the “ban would increase the number of convalescent plasma donors, a promising treatment for COVID-19.”

Modern HIV testing detects antigens days after infection

The letter, published by LGBTIQ group GLAAD, states new blood testing technologies can reliably detect HIV about a week after infection.

Requiring gay men to abstain from sex for three months prior to donating blood is based on “unscientific and based on outdated antibody-based HIV testing algorithms”, the letter argues.

In the 1980s, the FDA initially banned gay and bisexual men from giving blood altogether. In 2015, the lifetime ban was revised to a 12 months deferral period.

However, the experts argue modern HIV testing looks for antigens, which appear in the blood days after infection. Older tests looked for antibodies, which only appeared much later after infection.

“We can reliably test for HIV using antigen-based assays and maintain the safety of the US blood supply,” the experts state.

“Policies and protocols which focus on targeted screening for specific high-risk behaviours, regardless of sexual orientation, are a much more scientifically rigorous and non-discriminatory approach to maintaining a safe blood supply.

“We are not advocating for relaxing standards that would compromise the safety of our blood supply.

“Instead, we advocate for scientifically-driven standards that uphold the utmost safety of the blood supply and simultaneously promote equity and reverse historical discrimination in blood donation.”

FDA working on study into individual risk assessment

The FDA told NBC News it “remains committed to gathering the scientific data that support donor deferral policies that are non-exclusive while helping to ensure a high level of blood safety.”

“To investigate the scientific validity of such an approach, the FDA is working to commence a pilot study that will enroll about 2000 men who have sex with men and who would be willing to donate blood,” it said.

“This study… could generate data that will help the FDA determine if a donor questionnaire based on individual risk assessment would be as effective as time-based deferrals in reducing the risk of HIV.”

Australia also reducing gay blood donor deferral period

Australia is also in the process of easing similar rules for gay blood donors.

Currently, the Australian Red Cross Lifeblood donation service refuses gay male donors who have had sex with men in the past 12 months.

However last week the Therapeutic Goods Administration (TGA) agreed to reduce that period to three months after an expert review.

The service said, “Deferral policies are regularly reviewed and are underpinned by the most up-to-date clinical and scientific evidence, so that Australia maintains one of the safest blood supplies in the world.

“Lifeblood would like to make it easier for all Australians to give blood, while ensuring Australia’s blood and blood products are as safe as possible for recipients.”

However LGBTIQ group just.equal says the new three-month abstinence rule would still leave most gay men unable to donate.

“We urge the TGA and the Red Cross Lifeblood service to adopt a new policy of screening all donors for the safety of their sexual activity rather than the gender of their sexual partner,” the group said.

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