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

[McBell]

First, a nurse goes through a page-long checklist of questions, any one of which could exclude you from giving blood... everything from whether you've used illegal intravenous drugs to whether you've visited certain countries in the past __ years.

Here is the step that the Red Cross banned me from giving blood.
I lived in Germany (Hanau) for four years from mid 1984 to 1989.
Thus they tell me they fear for mad cow disease.


MOOOOOO!

 

[9-10ths_Penguin]

Apropos to the topic of this thread, an article just came out today regarding gay men and blood donation:

Lift blood donation ban for some gay men, journal says

Monogamous gay men in long-term relationships should be allowed to donate blood in Canada, two of the country’s top AIDS doctors say.

A 27-year-old ban on all “men who have sex with men” is hypocritical and is largely being sustained by the families of people who were infected by the blood supply in the early 1980s, according to a report in the Canadian Medical Association Journal.

While saying that gay men who have multiple sex partners should still be denied the right to donate, those in long-term monogamous relationships pose few dangers, Drs. Mark Wainberg and Norbert Gilmore write in Tuesday’s journal.

“We clearly have a situation in which there are chronic blood shortages and we also have a situation in which gay men are totally discriminated against,” says Wainberg, head of the HIV program at Montreal’s Jewish General Hospital.

Wainberg says more sensitive blood tests preformed on every unit collected by the Canadian Blood Services have virtually eliminated the risk of false negative results for HIV.

Full article: Lift blood donation ban for some gay men, journal says - Healthzone.ca

 

[Kathryn]

Here is the step that the Red Cross banned me from giving blood.
I lived in Germany (Hanau) for four years from mid 1984 to 1989.
Thus they tell me they fear for mad cow disease.


MOOOOOO!

Hey, same here - I lived right down the road from you in Aschaffenburg! And I can't give blood either - for life.

Boy am I ******!

 

[McBell]

Hey, same here - I lived right down the road from you in Aschaffenburg! And I can't give blood either - for life.

Boy am I ******!

Hey!
It's their loss.

 

[Kathryn]

Damn straight - I've got great blood - disease free!

 

[McBell]

Damn straight - I've got great blood - disease free!

Mine is also disease free.
Though it might have a little more glucose than most other peoples...

 

[darkendless]

I got hepatitis when i was a baby because of bad blood.

Then again, that blood, although it made me sick, kept me alive.

Do you guys have the same problems sourcing blood as we do here?

 

[9-10ths_Penguin]

I got hepatitis when i was a baby because of bad blood.

Then again, that blood, although it made me sick, kept me alive.

Do you guys have the same problems sourcing blood as we do here?

In Canada, we had a tainted blood scandal that emerged in the late 80s and early 90s. A large number of people were infected with hepatitis.

A government inquiry was launched, and the result was a number of doctors and administrators being charged criminally, and responsibility for donated blood was taken from the Red Cross and given to the newly-created Canadian Blood Services. Testing of blood also received a major overhaul.

 

[Mr Spinkles]

Here's the problem. Do they ban heterosexuals who have had a lot of sex over the past 2 months from donating? Do they ban black women from donating?

No. That is most likely because black women have a far lower risk of blood-borne disease and form a larger group of potential blood donors than MSM (men who have had sex with other men since 1977), and asking the question "have you had a lot of sex over the past 2 months" has not been shown to isolate a group of high-risk people comparable to MSM, in this country. Maybe that's because people don't answer questions honestly, I don't know, at the end of the day the only thing that matters is the result.

I understand the point that you want the blood you give people to be as safe as possible, but blood is never going to be 100% safe, unless we get rid of deadly STDs. The problem is in the inconsistency. As a straight, white male I could go give blood even after having unprotected sex with 16 different women in the last 2 weeks, and they're OK with that. But if I've had sex with another man even once 25 years ago, and I've been tested 10 different times since then, twice since the last time I had any sex at all, that's no good. That's the big problem with it. Instead of saying "If you're a gay man, we and you need to be extra careful considering your high risk of infection", they just say "If you're a gay man, we don't want you". And that's despite the fact that they're not the only high-risk group out there.

I think the link I provided answers these arguments.

 

[Mr Spinkles]

Apropos to the topic of this thread, an article just came out today regarding gay men and blood donation:



Full article: Lift blood donation ban for some gay men, journal says - Healthzone.ca

It's worth noting, from the article:

But Canadian Blood Services spokesperson Ron Vezina says that the journal piece adds no new scientific evidence to the issue, which remains a question of hot medical debate among AIDS researchers. And because no evidence on safety has yet been compiled from countries where the ban was lifted, it should remain in place here until a more definitive answer emerges.


“There’s no data or no evidence to substantiate that a change is warranted in this case,” Vezina says.


“And we’re looking forward to when that data comes because we don’t think Canadians want to be guinea pigs, we think they want us to make changes that are based on empirical evidence and science.”

Again, IMO the way people are framing this issue is wrong. It's not about anyone's right to donate blood, because such a right doesn't exist.

Any statistical test you come up with is going to bar many people who have perfectly good blood from donating. That is going to be part of any screening process based on a questionnaire. A "fair" way to do it would be to ask each person's detailed sexual/medical history, and have this history reviewed on a case-by-case basis for every one of the millions of transfusions that occur per year in the U.S. The way it is done now is to ask only a few key questions which have been shown to be most effective in mitigating the risk without too much loss to the donor pool.

Maybe it's time to change the policy to a one-year or five-year deferral instead of a ban. But it should be changed based on actual evidence and data, not based on a completely flawed and mistaken civil rights crusade for blood donors, who simply have no rights.

 

[Kathryn]

Amen, Mr Spinkles.

Sheeze, I can't even believe this is an issue.

Was I bummed when I went in to give blood, like I had done every few weeks for years, and they suddenly told me that I couldn't give blood anymore? Yes. Did I consider it a violation of my civil rights? Hell, no.

Frankly, I think it's a ridiculous position to take. Though I guess if I was supplementing my income from it, I would have thought to myself, "Damn, do I have any other body parts I can sell to make $40 every 6-8 weeks? This is really putting a hit on my budget!"

Surely there are other ways to make money.

 

[tarasan]

the problem is that Homosexuals think that if they arnt allowed to do anything they are being discriminated agianst, its silly they need to wake up to the facts and accept that there certian consequences we all face with our sexual orientation, this just happens to be theirs.

 

[Kathryn]

Yep, and I chose to live in Europe for several years and now I can't give blood.

So be it.

 

[Magic Man]

No. That is most likely because black women have a far lower risk of blood-borne disease and form a larger group of potential blood donors than MSM (men who have had sex with other men since 1977), and asking the question "have you had a lot of sex over the past 2 months" has not been shown to isolate a group of high-risk people comparable to MSM, in this country. Maybe that's because people don't answer questions honestly, I don't know, at the end of the day the only thing that matters is the result.

And? If it's a high-risk group, I want them not to be able to give blood, and I'm guessing black women isn't exactly a huge group of donors (because they aren't a big portion of the population). You're right that the only thing that matters is the result. In that case, we should test everyone before they give blood. I mean, why trust something like this to the honesty of the people?

I think the link I provided answers these arguments.

I'm sure you do. I don't think it does.

 

[Magic Man]

Maybe it's time to change the policy to a one-year or five-year deferral instead of a ban. But it should be changed based on actual evidence and data, not based on a completely flawed and mistaken civil rights crusade for blood donors, who simply have no rights.

You're missing the point. This isn't about gay rights or anything like that. It's about a system that is outdated.

 

[9-10ths_Penguin]

Maybe it's time to change the policy to a one-year or five-year deferral instead of a ban. But it should be changed based on actual evidence and data, not based on a completely flawed and mistaken civil rights crusade for blood donors, who simply have no rights.

I think it's quite likely that the lifetime ban on donating for men who have had sex with men is a product of an era before effective (or maybe cost-effective) tests for HIV in donated blood, and when the disease could go decades without being detected.

And I agree with you that there's no such thing as the "right to donate blood", but there is such a thing as a right to equality. If a group of people are going to be banned from donating blood, then there should be a legitimate, scientific justification the ban.

This is also a matter of pragmatism for the blood service: it does them no good to tell a healthy donor that they don't want his (or her) blood.

the problem is that Homosexuals think that if they arnt allowed to do anything they are being discriminated agianst, its silly they need to wake up to the facts and accept that there certian consequences we all face with our sexual orientation, this just happens to be theirs.

Wait one minute. I think that if the ban is based on a real increase in risk associated with certain sexual contact (just as there's a real increase in risk associated with having lived in certain parts of the world), then fine... though at the same time, it's completely valid to ask whether this risk can be adequately addressed by other means besides an across-the-board lifetime ban.

However, if the ban is based on outdated assumptions, or on some general idea that gay men are "unclean", then I think it's right to challenge it.

I'm not entirely sure which is the case here.

 

[9-10ths_Penguin]

Frankly, I think it's a ridiculous position to take. Though I guess if I was supplementing my income from it, I would have thought to myself, "Damn, do I have any other body parts I can sell to make $40 every 6-8 weeks? This is really putting a hit on my budget!"

Surely there are other ways to make money.

Personally, I find it bizarre that blood donors in the US get paid in the first place.

 

[Mr Spinkles]

And? If it's a high-risk group, I want them not to be able to give blood, and I'm guessing black women isn't exactly a huge group of donors (because they aren't a big portion of the population).

"High risk" is a subjective term. Let's be precise, let's talk about numbers. Here are the numbers for blood-borne diseaes prevalence in MSM, according to the FDA and Red Cross http://www.fda.gov/biologicsbloodvaccines/bloodbloodproducts/questionsaboutblood/ucm108186.htm

• Men who have had sex with men since 1977 have an HIV prevalence (the total number of cases of a disease that are present in a population at a specific point in time) 60 times higher than the general population, 800 times higher than first time blood donors and 8000 times higher than repeat blood donors (American Red Cross). 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.
• Men who have had sex with men account for the largest single group of blood donors who are found HIV positive by blood donor testing.
• ...
• Men who have sex with men also have an increased risk of having other infections that can be transmitted to others by blood transfusion. For example, infection with the Hepatitis B virus is about 5-6 times more common and Hepatitis C virus infections are about 2 times more common in men who have sex with other men than in the general population. Additionally, men who have sex with men have an increased incidence and prevalence of Human Herpes Virus-8 (HHV-8). HHV-8 causes a cancer called Kaposi's sarcoma in immunocompromised individuals.

Okay, now what are the numbers for black women?

You're right that the only thing that matters is the result. In that case, we should test everyone before they give blood. I mean, why trust something like this to the honesty of the people?

Everyone's blood is tested. Screening people with a questionnaire is just the first line of defense which further reduces the risk, since tests can fail. There have been 9 confirmed cases of people getting HIV from blood donations since 1991, the last occurred in 2002. This is despite the fact that there are screens and despite the fact that all blood is tested.

As the FDA explains:

• Blood donor testing using current advanced technologies has greatly reduced the risk of HIV transmission but cannot yet detect all infected donors or prevent all transmission by transfusions. While today's highly sensitive tests fail to detect less than one in a million HIV infected donors, it is important to remember that in the US there are over 20 million transfusions of blood, red cell concentrates, plasma or platelets every year. Therefore, even a failure rate of 1 in a million can be significant if there is an increased risk of undetected HIV in the blood donor population.
• Detection of HIV infection is particularly challenging when very low levels of virus are present in the blood for example during the so-called "window period". The "window period" is the time between being infected with HIV and the ability of an HIV test to detect HIV in an infected person.
• FDA's MSM policy reduces the likelihood that a person would unknowingly donate blood during the "window period" of infection. This is important because the rate of new infections in MSM is higher than in the general population and current blood donors.
• Collection of blood from persons with an increased risk of HIV infection also presents an added risk if blood were to be accidentally given to a patient in error either before testing is completed or following a positive test. Such medical errors occur very rarely, but given that there are over 20 million transfusions every year, in the USA, they can occur. That is one more reason why FDA and other regulatory authorities work to assure that there are multiple safeguards, not just testing.
• Several scientific models show there would be a small but definite increased risk to people who receive blood transfusions if FDA's MSM policy were changed and that preventable transfusion transmission of HIV could occur as a result.
• No alternate set of donor eligibility criteria (even including practice of safe sex or a low number of lifetime partners) has yet been found to reliably identify MSM who are not at increased risk for HIV or certain other transfusion transmissible infections.

I'm sure you do. I don't think it does.

Please explain why the above doesn't address your concerns. You say the test should ask about safe sex or a low number of partners, but that has not been demonstrated to work.

 

[9-10ths_Penguin]

• Detection of HIV infection is particularly challenging when very low levels of virus are present in the blood for example during the so-called "window period". The "window period" is the time between being infected with HIV and the ability of an HIV test to detect HIV in an infected person.
• FDA's MSM policy reduces the likelihood that a person would unknowingly donate blood during the "window period" of infection. This is important because the rate of new infections in MSM is higher than in the general population and current blood donors.

I think that some of the other points are valid, but I don't think that either of these are... not for justifing a lifetime ban, anyhow. The "window period" for HIV testing is 3 months.

 

[Mr Spinkles]

You're missing the point. This isn't about gay rights or anything like that. It's about a system that is outdated.

I wish that were true, but I am afraid you are wrong. The way many people are framing the issue, it IS about gay rights "or anything like that". Read what gay rights websites are saying. Read what you and Enchanted_One are saying. I agree with you that it *ought* to be a purely medical issue.