The gay rights community is wrong about blood donations (again)

[Mercy Not Sacrifice]

Commoner, I'm waiting on an answer to my request for a reliable source.

 

[Mr Spinkles]

mball, talking to himself. Peculiar.

The problem I have with the numbers is that they tell the story you want them to tell. How many homosexual men who don't receive anally have HIV?

Good question. Look it up. Get back to us when you have evidence.

I'm pretty sure I could give a questionnaire that would have the desired results. It really shouldn't be that hard.

Put up or shut up. Then again, you don't believe we should screen high-risk groups with questions in the first place, right? So this issue of asking the "right" questions is moot.

 

[Mr Spinkles]

Commoner, I'm waiting on an answer to my request for a reliable source.

The blood tests on donated blood are extremely reliable for any individual donation (source: FDA, see OP for link). However, when there are 20 million blood transfusions a year, "extremely reliable" still means someone will get HIV or Hep or some other disease from a blood transfusion on very rare occasions. The biggest risk is actually not the test failing but a "quarantine release error" (QRE) where the test finds HIV-positive blood which is accidentally given to someone anyway. Ideally we want zero people to get HIV from blood transfusions. That's why people are pre-screened based on risk-behaviors before they even take the blood test. By pre-screening high risk groups you greatly reduce the prevalence of blood-borne disease in the donor pool. That in turn reduces the rate of test-errors or QRE's. This was shown to be the case in the study I cited with a data set of 1 million blood donors.

 

[Mr Spinkles]

I'm, sorry, but that's the entire premise of this thread. Exclusing high risk people.

But we would not be excluding high risk people by excluding black people. I explained this in post #188.

Now please answer my simple yes-or-no questions in post # 191.

Also, is not all blood tested now? Would it be such a horrible burden on the Red Cross to create a database of people who cannot donate? Last time I donated I was asked for my ID. Maybe it's different elsewhere, don't know. Don't care really.

Yes all blood is tested. I would be surprised if they didn't have a database. However, a database by itself is not good enough because tens of thousands of Americans are newly diagnosed with AIDS each year. I think the biggest risk is not HIV+ people who knowingly donate infected blood, but people who have diseases but don't know they have them.

 

[Commoner]

Commoner, I'm waiting on an answer to my request for a reliable source.

Sorry, didn't even see your post.

The way you'd usually test for hepatitis or HIV is basically looking for antibodies in the blood. So - you're not actually testing for hepatitis/HIV, but for your immune system's reaction to its presence - which, even if the test is 100% reliable, still does not exclude them (not to mention other, practical ways of messing things up).

" The World Health Organization estimated that, as of 2000, inadequate blood screening had resulted in 1 million new HIV infections worldwide." (link)

"Antibody tests may give false negative (no antibodies were detected despite HIV being present) results during the window period, an interval of three weeks to six months between the time of HIV infection and the production of measurable antibodies to HIV seroconversion. Most people develop detectable antibodies approximately 30 days after infection, although some seroconvert later. The vast majority of people (99%) have detectable antibodies by three months after HIV infection; a six-month window is extremely rare with modern antibody testing.[9] During the window period, an infected person can transmit HIV to others although their HIV infection may not be detectable with an antibody test." (link)

Don't get me wrong, the probability of a bad blood transfusion is very low, and the testing procedures are getting better and better, but it's certainly not clear that other screening methods do not contribute to lowering this risk significantly. Anyway, it's not a point I wanted to get very involved in as I think it's pretty irrelevant how effective blood test are in absolute terms, the only thing I think matters is how much of a difference (relatively) other methods of screening - such as excluding high risk groups - contribute to lowering the risk of a bad blood transfusion.

 

[9-10ths_Penguin]

The blood tests on donated blood are extremely reliable for any individual donation (source: FDA, see OP for link). However, when there are 20 million blood transfusions a year, "extremely reliable" still means someone will get HIV or Hep or some other disease from a blood transfusion on very rare occasions. The biggest risk is actually not the test failing but a "quarantine release error" (QRE) where the test finds HIV-positive blood which is accidentally given to someone anyway. Ideally we want zero people to get HIV from blood transfusions. That's why people are pre-screened based on risk-behaviors before they even take the blood test. By pre-screening high risk groups you greatly reduce the prevalence of blood-borne disease in the donor pool. That in turn reduces the rate of test-errors or QRE's. This was shown to be the case in the study I cited with a data set of 1 million blood donors.

There's a saying that makes the rounds in highway safety a fair bit: "the only perfectly safe road is one with no cars on it."

Same goes for the blood supply: the only way to eliminate all possibility of infection is to screen out all donors. Obviously, this goes completely against the point of having a blood supply in the first place. So, the question then becomes one of risk: how much is "too much"?

Is there some absolute value? If so, what is it? How many infections per year are "acceptable" (remembering that the response "zero" implies that there will be no blood supply at all)?

Is it a matter of allowing a level of risk high enough for the supply of blood to meet the demand? If so, then I'd say that in many places, this isn't being met - the demand is outstripping the supply. Should the risk be increased to add more supply?

I'm not sure what the answers to any of these questions should be, but I realize that a refusal to accept any risk of infection at all is impractical.

I think the biggest risk is not HIV+ people who knowingly donate infected blood, but people who have diseases but don't know they have them.

I agree... and I think this points to a potential problem with the studies you cited: AFAICT, they all assumed that the donor pool for a particular group would have the same infection rate as the group as a whole.

However, I don't think this assumption is valid. For it to be correct, it would mean that HIV-positive status wouldn't have any effect on a person's decision to donate blood. IOW, there isn't anybody who knows that they're HIV-positive and whose HIV infection status plays a role in their decision to donate blood or not.

This would mean that almost all HIV-positive people would wantonly and knowingly donate blood despite their disease (which you seem to agree is unlikely), or almost all HIV-positive people don't know that they're HIV-positive... or some combination of the two.

 

[Magic Man]

mball, talking to himself. Peculiar.

Good question. Look it up. Get back to us when you have evidence.

Put up or shut up. Then again, you don't believe we should screen high-risk groups with questions in the first place, right? So this issue of asking the "right" questions is moot.

 

[Gunfingers]

mball, talking to himself. Peculiar.

This is why i've got him on ignore. It makes this thread a lot less juvenile.

 

[Mr Spinkles]

There's a saying that makes the rounds in highway safety a fair bit: "the only perfectly safe road is one with no cars on it."

Same goes for the blood supply: the only way to eliminate all possibility of infection is to screen out all donors. Obviously, this goes completely against the point of having a blood supply in the first place. So, the question then becomes one of risk: how much is "too much"?

Absolutely. The problem is that it seems any way you slice it, MSM have higher risk than other groups. So, wherever we draw the line, MSM are going to be high risk, or else no one can be considered high risk.

Is there some absolute value? If so, what is it? How many infections per year are "acceptable" (remembering that the response "zero" implies that there will be no blood supply at all)?

Again, I totally agree. Remember, the study from the UK blood services I cited determined that accepting MSM would increase the HIV risk in that country by 500% and increase the blood supply by 2%, IIRC. Is that worth it? I don't know the answer. But there's a legitimate debate to be had here. The debate is not just about people discriminating against gays vs. people who support gay rights. But many gay rights websites, and people on this thread, are (mis)characterizing the issue that way.

See what I'm saying? Is that fair?

I'm not sure what the answers to any of these questions should be, but I realize that a refusal to accept any risk of infection at all is impractical.

Agreed, so maybe instead of deferring everyone from donating blood we should try to defer the smallest number of people who contribute the highest risk. For example, in post #188 I think I showed why the cost/benefit ratio is much better for deferring MSM donors than for deferring black donors.

I agree... and I think this points to a potential problem with the studies you cited: AFAICT, they all assumed that the donor pool for a particular group would have the same infection rate as the group as a whole.

However, I don't think this assumption is valid. For it to be correct, it would mean that HIV-positive status wouldn't have any effect on a person's decision to donate blood. IOW, there isn't anybody who knows that they're HIV-positive and whose HIV infection status plays a role in their decision to donate blood or not.

In fact, I do believe some of the studies examined the issue of self-deferral. Furthermore, this is irrelevant when we consider *new diagnoses*. Ostensibly no one knows they have a disease before they are diagnosed. As recently as 2007 MSM had the highest rate of new diagnoses and therefore, the highest rate of people who have HIV but don't know it yet.

 

[AxisMundi]

Sure, but you're misinterpreting what a high risk group is. It's not "there are a lot of such-and-such people that have HIV, therefore all such-and-such people are high risk". The fact that, for example - black people are more likely to have HIV (I have no idea if that true or not), does not make a black individual part of a high risk group. There is nothing that "black" contributes to getting HIV. A white person in the same situation, doing the same things is just as likely to get infected as a black person. However, certain activities do significantly increase an individual's risk of getting infected. Therefore, all those individuals do belong to a high-risk group.

So - is there a good reason not to exclude high risk groups, which ever those are?

To answer your question - even if all blood does get tested (and I'm pretty sure it does), all tests produce a certain percentage of false results (both negative nad positive) - that's the whole point of excluding some groups. If excluding high-risk groups lowers this risk by a statistically significant amount, and the effect of losing a certain volume of blood donations does not outway that immediate positive result, why not do it?

As I noted early, the high incidence of HIV/AIDs in the black commnity is due to the high incarceration rate.

Therefore, by the "logic" of this thread, they are indeed a "high risk group".

 

[Commoner]

As I noted early, the high incidence of HIV/AIDs in the black commnity is due to the high incarceration rate.

Therefore, by the "logic" of this thread, they are indeed a "high risk group".

No...you have completely disregarded everything I've said - at best, that would make people who have been incarcerated a high risk group - which they might very well be. I find it hard to believe you don't understand the distinction.

Are you just busting my balls?

 

[AxisMundi]

No...you have completely disregard everything I've said - at best, that would make people who have been incarcerated a high risk group - which they might very well be. I find it hard to believe you don't understand the distinction.

Are you just busting my balls?

Not busting anything, and I am completely and utterly aware to.

I am merely pointing out the simple dishonesty required to relegate the entire GLBT community to "high risk".

Not all minorities go to jail, not all gays have aids.

 

[Commoner]

Not all minorities go to jail, not all gays have aids.

See, you're missing it again. It is not belonging to a minority that makes an individual part of a high-risk group. Now, are you seriously saying that that's what you just understood from my post?

And who the hell is relegating the entire GLBT community to anything? The only people who are considered high-risk are men who have sex with other men. They are not a minority, they are not a race, they are not people from California. They are individuals who engage in a very specific activity and it is that activity that carries with it the high risk of infection.

Now, will you please stop misrepresenting my position?

 

[AxisMundi]

See, you're missing it again. It is not belonging to a minority that makes an individual part of a high-risk group. Now, are you seriously saying that that's what you just understood from my post?

And who the hell is relegating the entire GLBT community to anything? The only people who are considered high-risk are men who have sex with other men. They are not a minority, they are not a race, they are not people from California. They are individuals who engage in a very specific activity and it is that activity that carries with it the high risk of infection.

Now, will you please stop misrepresenting my position?

Just love watching people twist simply statements about to justify their opinions.

Pretty simple, neighbor.

The entire gay community is banned from donating blood because some have AIDs.

And I'm sorry to intrude onto your little world, but gays ARE a minority. Their homosexuality is as natural and unchangable as any person's race.

 

[SoyLeche]

The entire gay male community is banned from donating blood because they participate in activities that put them at high risk with people who are also at high risk AIDs.

That's more like it.

 

[SoyLeche]

I agree... and I think this points to a potential problem with the studies you cited: AFAICT, they all assumed that the donor pool for a particular group would have the same infection rate as the group as a whole.

However, I don't think this assumption is valid. For it to be correct, it would mean that HIV-positive status wouldn't have any effect on a person's decision to donate blood. IOW, there isn't anybody who knows that they're HIV-positive and whose HIV infection status plays a role in their decision to donate blood or not.

This would mean that almost all HIV-positive people would wantonly and knowingly donate blood despite their disease (which you seem to agree is unlikely), or almost all HIV-positive people don't know that they're HIV-positive... or some combination of the two.

I'll go ahead and post this again:

Even taking into account that 75% of HIV infected men who have sex with men already know they are HIV positive and would be unlikely to donate blood, the HIV prevalence in potential donors with history of male sex with males is 200 times higher than first time blood donors and 2000 times higher than repeat blood donors.

 

[SoyLeche]

As I noted early, the high incidence of HIV/AIDs in the black commnity is due to the high incarceration rate.

And they are high risk because while incarcerated they had sexual relations with another man or used needles. The risky part of the black community is already excluded.

 

[Commoner]

Just love watching people twist simply statements about to justify their opinions.

Pretty simple, neighbor.

The entire gay community is banned from donating blood because some have AIDs.

And I'm sorry to intrude onto your little world, but gays ARE a minority. Their homosexuality is as natural and unchangable as any person's race.

No, the entire gay community is not banned from donating blood because some are HIV positive. This is outright false - it's not true that the entire GLBT community is "banned" from donating and it's not true that the reason is that "some have AIDS".

It's mind-boggling to me that this is even an issue let alone a gay rights issue.

EDIT: and accusing me of "twisting statements" to justify my opinions...can you point out a single inconsistency in my posts? How hypocritical of you to say that, when you have been continually and blatantly misrepresenting my position on this issue.

 

[Magic Man]

This is why i've got him on ignore. It makes this thread a lot less juvenile.

Yeah, that's a good way to deal with people who don't put up with your BS when you don't like to be called out on it.

 

[AxisMundi]

That's more like it.

Merely makes my point, yet again.

Black men make up the primary demographic of new AIDs cases, but a significant amount.

So, byt he "logic" used on this thread, ALL black men should be banned from donating blood.