Blood donor eligibility

Discussion in 'Politics, Religion, Social Issues' started by Doctor Q, Apr 30, 2013.

  1. Doctor Q, Apr 30, 2013
    Last edited: May 1, 2013

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    Doctor Q

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    #1
    I've followed the news about blood donor eligibility requirements for years, and it's about time for a separate thread on the subject. The subject has been discussed in the long-standing Give Blood! thread, it comes up each year in conjunction with the annual MacRumors Blood Drive, and it deserves to be recognized again as this year's MacRumors Blood Drive gets underway. By policy, MacRumors doesn't take positions on political and social issues, but encourages users to share their opinions.

    There are dozens of reasons that a person may be ruled ineligible to donate blood (see bloodbook.com or the rules posted at almost any collection center's website). Almost all of these restrictions are science- and statistics-based and noncontroversial.

    The controversy revolves around the question of deferrals or prohibitions on blood donations by men who have had sex with men (MSM). It's a topic of debate in many countries although a major focus has been on the U.S., where the FDA has jurisdiction over the rules that the American Red Cross, America's Blood Centers, the American Association of Blood Banks, and other donor centers must follow. Under the current FDA policy, the screening process involves a questionnaire that asks about sexual practices, not sexual orientation, but still seems to focus on certain risks (MSM) while ignoring others factors such as promiscuity/monogamy.

    The U.K. change in 2011 from a lifetime ban on MSM blood donors to a 1 year deferral, based on medical research, has reportedly produced no statistical increase in HIV-positive blood donations. That's evidence that the same would be true in the U.S. and Canada, but there is still resistance to change.

    A proposal in Canada to reduce the current lifetime ban on MSM donors to a 5-year deferral is being considered by Health Canada for possible implementation by summer 2013. Australia and other countries have also adopted 1 year deferral periods, with a mixture of rules among E.U. countries (see chart).

    It should be made clear that hospitals and other blood collection centers don't establish their own eligibility rules. They are subject to the FDA's rules. The 2006 joint statement by the American Red Cross, America's Blood Centers, and the American Association of Blood Banks still stands:
    It does not appear rational to broadly differentiate sexual transmission via male-to-male sexual activity from that via heterosexual activity on scientific grounds. Neither does it seem reasonable to extend this reasoning to other infectious agents. To many, this differentiation is unfair and discriminatory, resulting in negative attitudes to blood donor eligibility criteria, blood collection facilities and, in some cases, to cancellation of blood drives. We think FDA should consider that the continued requirement for a deferral standard seen as scientifically marginal and unfair or discriminatory by individuals with the identified characteristic may motivate them to actively ignore the prohibition and provide blood collection facilities with less accurate information.

    Source: aabb.org
    Despite frequent condemnation that the current policy is discriminatory and not based on science or statistics, the FDA's Advisory Committee on Blood Safety and Availability has not changed its stance (see their June 2010 report), merely admitting that the policy is "suboptimal". Their next meeting is June 5-6, 2013 in Rockville Maryland.

    Protests against the policy have continued, including petitions and controversial efforts on some college campuses to prohibit blood drives until the FDA policy is changed. Advocacy sites such as Saving Lives With Helpful Guys have continued to make their case for blood donor eligibility reform that they say would increase the blood supply and reduce stigmatization without endangering the blood supply.

    Notable U.S. petitions:
    Change.org petition to the FDA: U.S. Food and Drug Administration: Allow gay/bisexual men to donate blood. (9700+ signatures in 1 year)

    Change.org petition to the United States President: REPEAL THE FDA MSM BLOOD BAN (6300+ signatures in 2 years)

    "We the People" (whitehouse.gov) petition started just 2 weeks ago: Re-Examine and Update the FDA's Blood Donation Guidelines

    Representative college protests:
    Blood drive ban at San Jose State University

    Blood drive ban at the University of Wyoming

    Blood drive ban at Carleton University (Ottawa, Canada)
     
  2. macrumors 68000

    VulchR

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    #2
    Interesting. Insurance companies cannot ask if you are HIV positive, but they can ask if you have ever been denied when trying to give blood.
     
  3. macrumors 6502

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    #3
    Just me....but 9700 and 6300 signatures in 2 different petitions from change.org? And I noticed that you didn't post that the We The People petition only had about 1000 signatures on it.

    The LGBT community got over 150,000 signatures to get Apple to remove an app. They got 3,267 signature to make the Gay Oreo a real Oreo. :confused: No Idea what a gay oreo is.

    Seems even the LGBT community doesn't care. So do we really need a thread about it?
     
  4. thread starter Administrator

    Doctor Q

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    #4
    The "We the People" petition was created only 2 weeks ago so the vote count doesn't tell us much, except that it certainly won't reach the threshold required for a government response. There are a number of similar change.org petitions with vote counts even smaller than the examples I linked to, but this is the only "We the People" petition I've run across about blood donation.
     
  5. macrumors 6502a

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    #5
    can u donate if u have an STD
     
  6. thread starter Administrator

    Doctor Q

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    #6
    Some STDs don't affect blood so you can still donate if you feel healthy.

    Some STDs affect blood so you are deferred from donating for 12 months since your STD treatment is complete.

    You can find details (for the U.S.) here.
     
  7. macrumors demi-god

    ChristianJapan

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    #7
    I have some difficulties to donate in Japan as foreigner who lived in EU for most part of my life. The Japanese are very concerned about BSE etc. So I guess I might be eligible in 10 years ... :eek:

    So I can only support by "spreading" ...:mad:
     
  8. macrumors 65816

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    #8
    It's possible that the LGBT community doesn't know. Or maybe members of that community are reluctant to sign a petition, for all kinds of reasons. Or maybe those other petitions got attention precisely because people disseminated information about it. It's also possible that people outside of that community care. So yes, we really do need a thread about it. Cheers!
     
  9. macrumors 6502

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    #9
    Why do they ask those questions? Don't they test all the blood anyway?
     
  10. macrumors 6502

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    #10
    Non-LGBT people don't care much for it either (almost none of my [straight] family and friends donate, a couple, but that's it), so it's no surprise LGBT-people don't, especially when hitting a wall year after year. At some point, you just give up and stop caring.

    A couple of years ago, there was a big story about dwindling blood reserves in my country and I was shocked nobody ran out to give blood ASAP - even our Red Cross didn't bother to update its policies, limiting the scarce supply even more.

    Either people don't care for other people or are just not well-informed about the benefits of donating blood.
     
  11. thread starter Administrator

    Doctor Q

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    #11
    The interview isn't foolproof (people can lie or forget details) and the testing isn't foolproof either. For HIV there is a "window period" after infection and before there are detectable antibodies, during which blood tests won't detect the infection. The average window period is 25 days, but it varies from 2 to 8 weeks, sometimes even longer. Source: CDC.

    The idea behind the interview is to avoid taking blood from those at highest risk of being in the window period. That's the justification behind temporary deferrals for people in high-risk groups. The challenges are in the ways they identify who is in a high-risk group.
     
  12. thread starter Administrator

    Doctor Q

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    #12
    FDA Update

    The Health and Human Services Advisory Committee of Blood and Tissue Safety and Availability had their most recent meeting in December 2013 and announced that they had drawn the same conclusion as last time: that further research is required before changing the MSM eligibility rules.

    Those with plenty of spare time can watch the 8-hour committee meeting video. It takes only 3 minutes to watch the testimony of a representative of Banned4Life.

    Banned4Life has been organizing its own blood drives, including one in San Francisco in February 2014 and in Amherst, MA in conjunction with the University of Massachusetts Red Cross Club earlier this month (March 2014).

    For an interesting look at statistics, see the section named Projected outcomes of ban change in this Washington Times article. The numbers can be used both to support and to resist changes in the FDA policy.


    Petition Update

    FDA: Stop discriminating against me and other gay men who want to donate blood: over 50,000 signatures

    Remove the FDA policy that bans gay men from donating blood: over 10,000 signatures

    U.S. Food and Drug Administration: Allow gay/bisexual men to donate blood: over 10,000 signatures

    REPEAL THE FDA MSM BLOOD BAN: over 7,000 signatures
     
  13. macrumors 68040

    takao

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    #13
    side note from austria:
    the MSM - HIV issue aside the austria red cross also stumbled into a open discussion a few months ago because it denied "culture associtions" groups of in austria with members being immigrants/decendants from either tukey, the balkan or middle east to collectivly donate without pre-testing

    reason:
    in the age groups 40-50+ the prevalence of hepatitis variants was increased nearly 10 times because because of growing up in the balkan/anatolia.
    the red cross eve nstated that in some instances they had to trow away 60% of all blood donated opposed to the usual average 5%
     
  14. macrumors G4

    Eraserhead

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    #14
    That doesn't mean that bisexual men who are currently exclusively having sex with a woman and who have taken an HIV test since they had sex with a man shouldn't be able to donate.
     
  15. thread starter Administrator

    Doctor Q

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    #15
    Policy change in Canada, not in the U.S.

    Since last year's MacRumors Blood Drive, there have been more calls for the FDA to change its policy for American blood donors. Among the new actions were a statement from the American Medical Association and a resolution passed by the Washington DC City Council (download).

    They join the American Red Cross, the American Association of Blood Banks, America's Blood Centers, and other mainstream groups that have called for an end to the lifetime ban and a reliance on scientific evidence to ensure blood safety, rather than bans based only on sexual orientation.

    Policies in other countries continue to evolve. It's been almost 3 years since the health ministers in England, Scotland, and Wales changed to temporary deferrals (see September 2011 press release). Last year they were joined by Canada, when Canadian Blood Services changed its MSM policy from a lifetime ban to a deferral period.
     
  16. macrumors 68000

    VulchR

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    #16
    I cannot donate blood because I am on anticoagulants. I used to regularly and I miss being able to help people that way. It must be infuriating to be excluded through prejudice. If there are no demonstrable increase in medical risks, why exclude any class of people unnecessarily?
     
  17. macrumors 65816

    Southern Dad

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    #17
    The truth is that if there is no greater risk from the blood of this category and there is a shortage of blood, they shouldn't be barred from giving. If there is an abundance of blood, then they can afford to be picky but I'm always hearing about shortages.

    I donated blood while in Iraq several times but when I returned to the USA, they deferred me for a year because I had been in Iraq. Doesn't quite make sense.
     
  18. macrumors G4

    Eraserhead

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    #18
    There is higher risk. That's why actively gay men are barred - http://www.fda.gov/biologicsbloodvaccines/bloodbloodproducts/questionsaboutblood/ucm108186.htm.
     
  19. macrumors 65816

    Southern Dad

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    #19
    This topic is speaking about whether this should be a lifetime ban on donation of blood is appropriate. Going to Iraq or Haiti only results in a one year ban. HIV should show up during blood testing after that long of a period. I can't see how a lifetime ban serves any real purpose other than keeping some willing donors out of the pool.
     
  20. macrumors G4

    Eraserhead

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    #20
    Ok, I agree with that. That's our position.
     
  21. macrumors 65816

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    #21
    Thinking it through, it may. If there is increased biological risk to body or blood in Iraq and the blood you gave while there was only given to those who were already there (similarly exposed) and everyone there was screened and deferred for a year upon return to contain (and reveal) a biological agent before full reintegration. Yes.

    But that is a lot of ANDs.
     
  22. macrumors 65816

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    #22
    I'd love to, but I'm gay, so my blood is apparently unclean and therefore not wanted. Funny though, because I have a large number of straight mates who have regular, promiscuious, unprotected sex and their blood is readily accepted.

    Oh well.
     
  23. macrumors member

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    Aug 27, 2014
    #23
    you don't want my blood
     
  24. macrumors 6502

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    #24
    In the UK you cant give blood up to a year after you have gay sex. This is complete unfair as they test the blood before using it. Its steriotyping. Also where Because I'm from Wales, next year, unless you opt out of it, you are automaticly premumed that you want your organs presumed, so hopefully this will help with an organ shortage!
    http://www.bbc.co.uk/news/uk-wales-24032031
     
  25. Anonymous Freak, Sep 3, 2014
    Last edited: May 20, 2015

    macrumors 601

    Anonymous Freak

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    #25
    In the US, the Red Cross bars you from donating if you "are a male who has had sexual contact with another male, even once, since 1977".

    The father of a friend of mine and his partner have been a monogomous, committed couple since 1980. They are each other's first and only same-sex partner. Ever. They are *FAR* safer than many people who engage in opposite-sex sexual contact. (They don't engage in any other risky behaviors, either.) Thus they have *ZERO* risk of HIV/AIDS. (Well, as much risk as any married couple that were virgins before they got married; since my friend's father's only other relationship was to my friend's mother, a marriage that lasted 2 years before he realized he was gay. They're still friends, too.)
     

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