© Illustration by INJECTION
Has the time come to lift the lifelong general ban on blood donations by gay and bisexual men?
The Coronavirus pandemic led to a global shortage in blood supply and a chain reaction in western countries to amend their blood donation restrictions so that they are more inclusive for men who have sex with men. Prohibitive restrictions arose following the HIV/AIDS epidemic which hit the LGBTQ+ community in the 1980s and 1990s, placing a lifetime blanket ban on blood donations from gay and bisexual men. The preventative ban was introduced to limit the spread of HIV and Hepatitis B through blood donations since effective screening to test for these diseases was not available. Despite the scientific developments which allowed for effective screening, banning blood donations from men who have sex with men has only recently been overturned although not all countries have adhered to this.
The HIV and AIDS epidemic
The first noted case of HIV occurred in the US during 1981. The Centre for Disease Control (CDC) published an article describing a rare lung infection in 5 young (previously healthy) gay men, 2 of which had died at the time of publication and the other 3 consequently dying soon after. As with any outbreak of disease, the cases snowballed and led to the deaths of millions of gay men as well as opportunistic homophobia and the hindering of equal rights to the LGBTQ+ community. The AIDS epidemic objectively saw systematic failures towards gay men. The media in the United States branded it ‘The Gay Plague’ and gay men who contracted the virus were often met with shame and were isolated out of fear of contamination. The emergency pill, post-exposure prophylaxis (PrEP) medication was approved for the treatment of AIDS in 1987 and acts as a preventative pill following exposure to HIV. Antiretroviral medicines are used in the treatment of AIDS in the form of a combined pill which works by stopping the virus from replicating in the body thus preventing further damage. Scientific developments mean that HIV is now treatable and in the present day around 37 million individuals worldwide live with HIV, of whom 22 million are on treatment.
Restricting Blood Donations
Over 112 million blood donations are collected around the world annually but there will never be enough blood. Policies regarding blood donations from men who have sex with men stemmed during the 1980’s AIDS epidemic where facilities to check blood for viruses were not available. In the US, contaminated blood supplies caused over 20,000 HIV infections, therefore gay men were deemed ‘high risk’ thus prohibited from donating blood. Notably monogamous men, as well as men who didn’t engage in sexual relations, were also banned and what commenced as a precautionary measure became the norm for the subsequent 30 years. Studies by the ACSB (Advisory Committee on the Safety of Blood) have shown that men who have sex with men have a higher risk of acquiring blood-borne infections. In the UK, 2011 saw the ban lifted and replaced by a twelve-month deferral period in which gay and bisexual men had to abstain from sexual activity to donate blood. The rules were then further updated in 2017 to a 3-month deferral period. Challenges to blood supply levels as well as campaigning from LGBTQ+ members led to the lifting of restrictions for blood donations for men who have sex with men. Limiting a whole community on their ability to donate blood based on HIV (which can now be screened effectively) lacked medical rationality and was seen as discriminatory. On the 14th June 2021 (World Blood Donor Day), the UK lifted the prohibitive restrictions and no longer discriminated against blood donations based on sexual orientation. The US still operates under a 3-month deferral period for men who have sex with men yet there are still pressures from LGBTQ+ groups to ease these measures.
Are prohibitive restrictions still necessary?
There is a global shortage of blood, yet most countries still impose restrictions and deferral periods upon men who have sex with men. Scientific evidence no longer supports the requirement of men who have sex with men to have to abstain and such restrictions are often viewed as discriminatory and an emergency measure that is outdated in the present day. Screening for HIV is faster and more effective now and it is also notable that HIV isn’t exclusive to gay men and can be transmittable regardless of sexual orientation, sex, or gender.