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Cathy Burri records Ohio University senior Holly Craddock's information as Craddock donates blood during a Red Cross blood drive outside the Living Learning Center in Athens, on Oct. 2. 

Prior sexual experiences could defer one from donating blood, FDA in process of changing policy

Those attending Red Cross blood drives in Athens may be surprised to find out that they may be ineligible to donate blood based on their sexual history.

When Jacob Adams went to donate blood in the fall of his senior year of high school, he wore a “first-timer” sticker and excitedly proceeded to the donation station. He said he filled out a questionnaire and answered each question honestly, including a question about if he’d ever had sexual relations with a man.

He checked “yes.” He said he had recently had sex for the first time with his boyfriend, and they were both virgins beforehand — but when his answer was reviewed, he was deferred. Taken aback, Adams confided in a teacher whom he trusted, who then spoke to those in charge of the drive. Adams said he was told he had a lifetime ban on giving blood because he was gay.

Adams stepped into the area where many people recover after donating blood and cried.

“I was like, ‘What does this have to do with anything? I don’t have a disease. It’s just me, that’s who I am,’ ” Adams, now a freshman studying psychology, said. “I wanted to help people. That’s a really simple way to help. And I can’t — even though I’m perfectly fine.”

Under the Food and Drug Administration’s guidelines, if a man has engaged in sexual relations with another man — even once — since 1977, the beginning of the AIDS epidemic in the United States, he is ineligible to donate blood for life. In May, the FDA proposed an amendment to the ban, recommending that gay men could donate so long as it had been 12 months since they had oral or anal sex with a man, with or without a condom. The process to change the lifetime ban to a 12-month ban is still underway, Rodney Wilson, external communications manager of the American Red Cross in the Central Ohio Blood Services Region, said.

“All blood donation policies are set by the FDA, not by the Red Cross,” Wilson said in an email. “It is the position of the Red Cross and other blood banks that the current FDA lifetime deferral from giving blood for the MSM, which stands for men who have sex with men, population is not scientifically or medically warranted.”

More than 14,000 people were infected with HIV through blood transfusions before 1985, according to the Center for Disease Control and Prevention. Today, all blood is screened before it is donated, and the CDC stated that based on 2007-08 data, the risk of contracting HIV through a blood transfusion is one in 1.5 million.

While delfin bautista, director of the Ohio University LGBT Center, does not support the ban, bautista said they know people who have become infected with HIV via blood transfusion. 

“For a time, the blood donations weren’t being screened; now they are,” bautista, who uses they/them pronouns and the lowercase spelling of their name, said. “So when this policy was initially created, it made sense. We didn’t know how AIDS was transmitted and the assumption was it was a gay male disease. (Now) there really isn’t a justifiable reason to enforce the law because it specifically targets men who have sex with men.”

In addition to gay men, women who have had sex with a gay man are also deferred from donating blood, and anyone who has had sex with a commercial sex worker or an injection-drug user are also deferred from donating. People can also be deferred for reasons such as traveling abroad or for weighing less than 110 pounds.

Sarah Jenkins, program coordinator for the OU Women’s Center, said she feels these policies are different than the MSM policy, which she believes is discriminatory.

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“I see those as very different because they’re not related to your identity as a human being,” Jenkins said. “I don’t see (the 12-month ban) as really taking care of the problem, which is that you’re discriminating against an entire class of people for something that makes no sense.”

The switch from a lifetime ban to a 12-month one is, according to the FDA, necessary because of a “window period,” which exists very early after infection. In this period, a person could test negative when they are actually infectious.

According to its website, “The American Red Cross performs laboratory tests for multiple infectious disease markers on every unit of donated blood.” HIV-1 and HIV-2 are included in these screenings. This window period can be as short as nine days, but the average is three months said Tania Basta, associate professor of social and public health at OU.

“I think the (lifetime ban) policy has become outdated,” Basta, whose area of expertise is HIV/AIDs, said. “I don’t know why the policy is still in effect given that there’s so many people who get HIV via other ways than just MSM.”

Having previously worked with HIV patients in clinics in Atlanta, Georgia, Basta said asking about behaviors as opposed to sexuality — through the term MSM as opposed to identifying as “gay,” for example — is helpful. Though she believes the lifetime ban is outdated, she said a 12-month ban on men who have recently had unprotected sex with other men may be helpful for extreme precaution. As far as changing the wording of questions, Basta said it’s all about trusting that people are honest and the problem comes with the fact that they require self-reporting.

“Anybody could say they’re in a committed relationship, but who knows what’s going on outside that close relationship?” Basta said. “Are there perfect questions? No. We have to trust that people are being truthful in their responses.”

According to the Red Cross, every two seconds, someone in the U.S. needs blood — that’s more than 41,000 blood donations needed every day. The website states that one donation can help save up to three people's lives.

study from the Williams Institute at the UCLA School of Law projected that if gay and bisexual men were able to donate blood, men could provide 615,300 pints of blood a year.

The study states that increase would save up to more than a million lives.

Women who have had sexual conduct with women are not included in the MSM policy and therefore are eligible to donate, according to a statement from the Red Cross in 2015. Gay men, transgender individuals and bisexual individuals may be eligible to donate if the MSM policy does not apply, the Red Cross also stated.

On the other hand, black heterosexual women were at the highest risk of HIV infection at 5,300 in the U.S. in 2010, just behind MSM, according to AIDS.gov.

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Including if the sexual acts were consensual or if protection was used is something bautista said they would suggest to include in future questionnaires. bautista said with the new recommendation, HIV-negative, married men who have sex with only each other are still denied from giving blood.

About five million people receive blood transfusions each year in the U.S., whether that be for injury, surgery, cancer treatments or treatment for diseases that affect the blood, such as sickle cell anemia.

Years ago, bautista received a call that their O-negative blood was needed for a 4-year-old with cancer.

O-negative blood is always in great demand and often in short supply because it can be transfused to all patients, according to the Red Cross.

Despite knowing they were not allowed to donate even though they were HIV-negative, bautista said they chose to lie about their sexual history in order to help the child.

“From then on, any time I received a call for a blood donation, I would donate,” bautista said. “All of the times, it was for children. These kids need it, and for me, that outweighs the discriminatory practice.”

bautista added that their partner, who they have been monogamous with for 13 years, is also HIV-negative but chooses not to donate blood out of protest.

Adams also said he doesn’t feel comfortable lying about his sexual practices and instead said he wishes for a systematic change to the policy.

“Cutting me off before they know (the HIV status) is such a waste,” Adams said. “There’s probably (people) who cleared their preliminary steps and (after being tested,) it’s dirty and thrown away. If they would have given me a chance, it would have been fine. I just want to help.”

@rachel_hartwick

rh375113@ohio.edu

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