The blanket bans on MSM blood donors are teetering on the line of homophobia

brainchild · Feb 11, 2019

To establish some context for those of you who aren't familiar with these specific blood donation regulations, here's an excerpt from Wikipedia:

The men who have sex with men blood donor controversy is the dispute over prohibitions on donations of blood or tissue for organ transplants from men who have sex with men(MSM), a classification of men who engage (or have engaged in the past) in sex with other men, regardless of whether they identify themselves as bisexual, gay, or otherwise. Restrictions on donors are sometimes called "deferrals", since blood donors who are found ineligible may be found eligible at a later date. However, many deferrals are indefinite meaning that donation may not be accepted at any point in the future, thus constituting a de facto ban. Restrictions vary from country to country and in some countries practice of protected sex or periods of abstinence are not considered. The restrictions affect these men and, in some cases, any female sex partners. They do not otherwise affect other women, including women who have sex with women. The United States Food & Drug Administration(FDA) asserts that the one year deferral window is "supported by the best available scientific evidence".[1]

https://en.m.wikipedia.org/wiki/Men_who_have_sex_with_men_blood_donor_controversy

In other words, regardless of the actual risks involved, all men who have sex with other men are institutionally descriminated against all over the world, with varying degrees of strictness, depending on the country. Here's some visual data to get some perspective:

Even in the case of 'only' temporary deferrals, they are typically deferred for at least one year.

Now let's get one thing straight. I don't have a problem with the science that says MSM partners have a higher chance contracting HIV and/or other viruses than other groups of people. I don't contest the veracity of the scientific data at all. The problem lies in the generalized prohibition or deferral of MSM donors without any distinction concerning their actual risk factors, which constitutes unjustified descrimination, and comes pretty close to espousing homophobic beliefs, due to stereotypes about gay men being inherently more promiscuous.

Take this excerpt from a meta-analysis regarding the FDA's stance on this issue for example:

The guidance document notes that the male donors who report that they are MSM have a lower prevalence of HIV infection than the general MSM population (.25% as opposed to 11-12%); the FDA concedes this suggests "considerable" self-selection by MSM individuals who choose to donate.23 Despite this evidence that the high rate of HIV among the general MSM population does not necessarily translate to a high rate of HIV among MSM donors, the FDA's twelve-month deferral does not allow for such self-selection, instead continuing the categorical association between gay sex and risky sex.

https://medicalreview.columbia.edu/article/ban-the-ban/

I mean, how can that even be justified?

The reality is that there are gay/bisexual/pansexual men who are monogamous/have protected sex/aren't promiscuous, and do not have HIV/contaminated blood, and these people should be allowed to donate, ESPECIALLY seeing as blood donations are pretty much always in short supply. More importantly, there is no scientific basis by which any health organization or blood bank could determine that a gay, monogamous HIV negative donor is at higher risk of having contaminated blood than a promiscuous heterosexual donor, and yet these blanket regulations would have you to believe that there was.

My suggestion to resolve this issue is simple (though I acknowledge that the logistics are pretty complex): qualification or disqualification should primarily be based on a combination of risk factors per each donor's individual medical history, personal experiences, and rigorous testing models that can help screen donors and samples before determining that a donation or transplant is medically viable. This approach will work fairly universally and those who are actually at high risk of having contaminated blood will be screened out an overwhelming majority of the time. There simply is no reason to turn away a healthy, low-risk blood donor because of their sexual orientation and to do so despite all evidence or ethical considerations telling you not to is no different than straight up homophobic policies, in effect.

I'd love to hear what you all have to say on the matter.

gozu · Feb 11, 2019

"there is no scientific basis by which any health organization or blood bank could determine that a gay, monogamous HIV negative donor is at higher risk of having contaminated blood than a promiscuous heterosexual donor, and yet these blanket regulations would have you to believe that there was. "

I tend to agree with you. I thought this was based on statistics and probabilities. If that's not the case, then WTF?

Personally, I find donating blood unpleasant. It can be a bit painful to get that needle in and it can make you feel a bit weak afterwards. So if I were MSM, i would probably be grateful for having an excuse not to so I don't feel guilty, but that's just me.

brainchild · Feb 11, 2019

gozu said:
"there is no scientific basis by which any health organization or blood bank could determine that a gay, monogamous HIV negative donor is at higher risk of having contaminated blood than a promiscuous heterosexual donor, and yet these blanket regulations would have you to believe that there was. "

I tend to agree with you. I thought this was based on statistics and probabilities. If that's not the case, then WTF?

Personally, I find donating blood unpleasant. It can be a bit painful to get that needle in and it can make you feel a bit weak afterwards. So if I were MSM, i would probably be grateful for having an excuse not to so I don't feel guilty, but that's just me.

Thanks to self-selection (which is statistically relevant, in this case) 99% of MSM donors don't have HIV or other infectious diseases. The fact that these people are turned away when donations are in such short supply is simply unconscionable.

Deleted member 11943 · Feb 11, 2019

Cant wait to see this change so they can not donate blood like the rest of us.

brainchild · Feb 11, 2019

Shinjuku 4x4 said:
Cant wait to see this change so they can not donate blood like the rest of us.

Some countries have already made the change (Italy, Spain, Russia) but they're in the minority. And as much as I would love to see the US turn around on this issue, I'm not too optimistic about it happening any time soon, unfortunately.

Richiek · Feb 11, 2019

Surprised Russia allows men to donate blood with no restrictions, considering how homophobic they are.

brainchild · Feb 11, 2019

Richiek said:
Surprised Russia allows men to donate blood with no restrictions, considering how homophobic they are.

That surprised me too!

Deleted member 25712 · Feb 11, 2019

I think it's just a holdover from the days where HIV wasn't as well understood and one of those "well, better be safe than sorry!" sort of things. But yeah...it's hard to see it as anything but homophobic now

Shiloh · Feb 11, 2019

Always fun to have work blood drives and get hassled because I don't have a sticker on because I can't give blood.

That convo is always fun and worth sharing 30 times

Figgles · Feb 11, 2019

Richiek said:
Surprised Russia allows men to donate blood with no restrictions, considering how homophobic they are.

Poland and Ukraine too... Eastern Europe is very progressive...

Grug · Feb 11, 2019

I'm colourblind, which category is Australia in?

brainchild · Feb 11, 2019

Thaedolus said:
I think it's just a holdover from the days where HIV wasn't as well understood and one of those "well, better be safe than sorry!" sort of things. But yeah...it's hard to see it as anything but homophobic now

I agree. I can see why it happened 30 years ago, but new evidence should should impact policy, and clearly that is not happening in many countries, which is a shame.

Shiloh said:
Always fun to have work blood drives and get hassled because I don't have a sticker on because I can't give blood.

That convo is always fun and worth sharing 30 times

It's fucked up on so many levels. And I can't believe that some people don't see the problem with a 1 year deferral. Like, do they actually expect gay men to abstain from sex for a year in order to donate blood? Really?

Grug said:
I'm colourblind, which category is Australia in?

Same as US; 1 year deferral.

AlexMeloche · Feb 11, 2019

Each time they call me to tell me there's a bloos drive coming I always jave to roll my tongue to avoid saying « Sorry I can't, I suck dick. ¯\_(ツ)_/¯ ».

Deleted member 2809 · Feb 11, 2019

Figgles said:
Eastern Europe is very progressive..

Ha.

jjreamPop · Feb 11, 2019

gozu said:
Personally, I find donating blood unpleasant. It can be a bit painful to get that needle in and it can make you feel a bit weak afterwards. So if I were MSM, i would probably be grateful for having an excuse not to so I don't feel guilty, but that's just me.

What an awful thing to say. Being discriminated against isn't some blessing in disguise to be grateful for. And it definitely isn't for the men who want to give blood and can't.

Airegin · Feb 11, 2019

Belgium, the second country to allow same sex marriage is red on the map. It's shameful.

Gakidou · Feb 11, 2019

Good OP, I am basically the same as where you are at. The reality of blood donation is complicated, its already expensive (youll be out over £200 for every pint of blood that gets tested and turns out to be unusable, last i heard) and they'd rather take broad strokes to minimise risks, but I still think the way they handle the HIV risk among male donors is needlessly discriminatory and they should adjust their approach to a set of qualifiers that fundamentally doesn't typify people by their sexuality when you could just have more relevant questions about sexual habits.
I'm willing to bet they wouldn't consider banning *all men* from donating blood when that could turn out to save money?

gozu said:
Personally, I find donating blood unpleasant. It can be a bit painful to get that needle in and it can make you feel a bit weak afterwards. So if I were MSM, i would probably be grateful for having an excuse not to so I don't feel guilty, but that's just me.

Kind of a gross way to look at it though. Yes I would secretly enjoy everyone of my people not having equal rights because I'm a prisoner of my own guilty conscience and therefore would like to join you under the wheel of the bus! If you're a baby about needles just own up to it instead of considering dragging others down with you.

Richiek said:
Surprised Russia allows men to donate blood with no restrictions, considering how homophobic they are.

*roll safe meme* dont need to ban gay blood donors if you ban all gays

Izzard · Feb 11, 2019

It's just something else on the list of stuff I haven't been able to do in my life due to who I'm attracted to.

Progress since when I was young has been slow, but we're heading in the right direction for the most part. One day this kind of thing will be a distant memory, but sadly I think not in my lifetime.

I used to like giving blood, and when I realised I couldn't it felt horrible as I liked doing it, and felt like I was helping someone somewhere.

brainchild · Feb 11, 2019

Airegin said:
Belgium, the second country to allow same sex marriage is red on the map. It's shameful.

Temporary deferrals are already bad enough but permanent bans are just purposefully cruel.

Gakidou said:
*roll safe meme* dont need to ban gay blood donors if you ban all gays

I didn't think about that, smh

The Emperor · Feb 11, 2019

So UK only recently reversed this

brainchild · Feb 11, 2019

Izzard said:
It's just something else on the list of stuff I haven't been able to do in my life due to who I'm attracted to.

Progress since when I was young has been slow, but we're heading in the right direction for the most part. One day this kind of thing will be a distant memory, but sadly I think not in my lifetime.

I used to like giving blood, and when I realised I couldn't it felt horrible as I liked doing it, and felt like I was helping someone somewhere.

Yeah, people need to realize that institutionalized homophobia is real and not all of the problems we members of the LGBTQ community face are resolved with the legalization of same sex marriage.

The Emperor said:
So UK only recently reversed this

It has been changed to a 3 month deferral (in 2017), which is better than before but still unnecessary for low-risk donors.

Deleted member 14459 · Feb 11, 2019

Are people against a 3 months deferral? I was under the impression there is quite sound scientific / statistical reasoning for that particular time window - ie statistically higher infection within MSM population (different statistics in different regions, the case tested in EU courts was France) and the test technology still used in many countries is such that non-detection is a risk below 3 months of infection. I think sound policy would be 3 months for MSM and any other group - sex workers and intravenal drug users would most likely need to be discriminated to ensure that protecting blood recepients takes precedence...

edit: an additional problem is that donator health questionnaies tend to have relatively high rates of non‐compliance, which means that blood tests and reliability of those are even more central, which would speak for 3 months deferral.

edit: here is an open access article that lays out some reasoning for a precautionary deferreal window of 3 months: https://www.researchgate.net/profil...OR-DEFERRAL-FOR-MSM?origin=publication_detail

Deleted member 18514 · Feb 11, 2019

Izzard said:
Progress since when I was young has been slow, but we're heading in the right direction for the most part. One day this kind of thing will be a distant memory, but sadly I think not in my lifetime.

I used to like giving blood, and when I realised I couldn't it felt horrible as I liked doing it, and felt like I was helping someone somewhere.

There are a couple of new technologies that could pave the way for eliminating almost all "behavioral" limitations to donation. Pathogen reduction could clean virtually any virus (at least HIV and the ones associated with behaviors that also transmit HIV) and finally close the 7-10 day HIV window (the period between contracting HIV and it being detectable with our current tests). Better testing will also reduce the window period. Of course stem cell derived or artificial blood substitutes may render the donation process moot.

But the folks making these decisions very much remember the incredibly high HIV transmission rate in the early 80's (up to 1% in the San Francisco area!) and blood bankers are extremely conservative. Only a small percentage of eligible donors actually donate so quite frankly, the blood donation system doesn't really need MSM donors with the increased risk (however slight) they bring as opposed to marketing to the much larger non-MSM population in general.

As these older administrators retire and younger blood bankers take over, I'd expect more relaxation of the MSM deferral but it would be hard to imagine it completely going away until there are years of data to support the success of pathogen reduction. We probably should be deferring anyone with a new sexual partner within the past week or so, but that would be extremely difficult to enforce, so instead the deferral questionnaire focuses on the groups with the highest risk for diseases that absolutely have a known transmission risk, as MSM overwhelmingly account for new cases of HIV. Heck, we still defer folks who happened to live in the EU in the 80's and 90's during mad cow and there are almost no confirmed cases of transfusion transmitted prion diseases.

brainchild · Feb 11, 2019

Rupetta said:
Are people against a 3 months deferral? I was under the impression there is quite sound scientific / statistical reasoning for that particular time window - ie statistically higher infection within MSM population (different statistics in different regions, the case tested in EU courts was France) and the test technology still used in many countries is such that non-detection is a risk below 3 months of infection. I think sound policy would be 3 months for MSM and any other group - sex workers and intravenal drug users would most likely need to be discriminated to ensure that protecting blood recepients takes precedence...

Deferrals for high-risk people of any group is a reasonable policy. Deferral of low-risk people SOLELY based on their sexual orientation is not. When you ignore the actual data points for risk among potential donors, then the science/evidence isn't really what's governing the policy.

brainchild · Feb 11, 2019

jason10mm said:
the blood donation system doesn't really need MSM donors with the increased risk (however slight) they bring as opposed to marketing to the much larger non-MSM population in general.

The problem is that every gay blood donor is considered an increased risk, which isn't true, and the science never said it was true. If a gay male blood donor has a viable sample, WE NEED IT. The amount of contaminated samples that sneak past the screening is something like 1 in 3,000,000, and the evidence so far suggests that allowing MSM donors to enter the pool wouldn't significantly change that statistic.

SteveWinwood · Feb 11, 2019

im a straight man who's banned for 16 lifetimes last time i did the math on it

there are a lot of draconian rules still in place that people haven't bothered to update

Poltergust · Feb 11, 2019

"Teetering"? It is homophobic, full-stop.

When the Pulse shooting (one of the worst mass shootings in US history, and it specifically targeted gay people) happened, I tried to donate blood to the victims in one of the blood drives set up around Orlando, thinking that at least they'd make an exception for gay people this time around. But nope! Still barred from giving blood away. I was absolutely furious.

That "temporary deferral" might as well be permanent. It is completely unreasonable to expect gay men to go without sex for an entire year.

I just hate everything about this. I want to help so badly but it's illegal for me to do so.

PoppaBK · Feb 11, 2019

brainchild said:
Deferrals for high-risk people of any group is a reasonable policy. Deferral of low-risk people SOLELY based on their sexual orientation is not. When you ignore the actual data points for risk among potential donors, then the science/evidence isn't really what's governing the policy.

I think it is okay to be conservative (small c) on this issue. Identifying high risk and low risk people with any granularity is going to be both difficult and intrusive for donors, and may well drive away more people than it brings in. The self selection of donors for example may be, in part, due to the year ban being in place.
I say this as someone who is still banned from giving blood in the US because I ate beef in the UK, even though it has been 25 years since the BSE outbreak, and there have only been 200 odd cases of vCJD ever reported worldwide.

Deleted member 14459 · Feb 11, 2019

brainchild said:
Deferrals for high-risk people of any group is a reasonable policy. Deferral of low-risk people SOLELY based on their sexual orientation is not. When you ignore the actual data points for risk among potential donors, then the science/evidence isn't really what's governing the policy.

Sure but as laid out in the article I linked there is some scientific reasoning behind a 3 months deferral for MSM with current technologies if we accept that precautionary principle of protecting recepients takes predecence over rights of donors. As the article notes, if screening would contain interviews as standard it would mitigate some risks with the DHQ of determing high risk groups, but in most places that is not feasible as standard.

brainchild · Feb 11, 2019

Poltergust said:
"Teetering"? It is homophobic, full-stop.

When the Pulse shooting (one of the worst mass shootings in US history, and it specifically targeted gay people) happened, I tried to donate blood to the victims in one of the blood drives set up around Orlando, thinking that at least they'd make an exception for gay people this time around. But nope! Still barred from giving blood away. I was absolutely furious.

That "temporary deferral" might as well be permanent. It is completely unreasonable to expect gay men to go without sex for an entire year.

I just hate everything about this. I want to help so badly but it's illegal for me to do so.

I agree with you whole-heartedly. I just said that so the thread wouldn't be derailed over semantics.

PoppaBK said:
I think it is okay to be conservative (small c) on this issue. Identifying high risk and low risk people with any granularity is going to be both difficult and intrusive for donors, and may well drive away more people than it brings in. The self selection of donors for example may be, in part, due to the year ban being in place.
I say this as someone who is still banned from giving blood in the US because I ate beef in the UK, even though it has been 25 years since the BSE outbreak, and there have only been 200 odd cases of vCJD ever reported worldwide.

Advocates for lifting these bans are simply asking for MSM donors to be evaluated on the distinction of risk within their own group, just like everybody else in their respective groups. There is already an assessment of risk for heterosexual donors, but that assessment is deemed irrelevant for MSM donors because they're all assumed to be high risk, which is wrong and unscientific.

Deleted member 18514 · Feb 11, 2019

brainchild said:
The problem is that every gay blood donor is considered an increased risk, which isn't true, and the science never said it was true. If a gay male blood donor has a viable sample, WE NEED IT. The amount of contaminated samples that sneak past the screening is something like 1 in 3,000,000, and the evidence so far suggests that allowing MSM donors to enter the pool wouldn't significantly change that statistic.

Could be, but barring a donor with an extremely rare phenotype there is almost no "WE NEED IT" blood out there worth the risk of allowing disease transmission from a high risk group. Even "low risk" MSM donors would be higher risk than the general donor population because A. how can you really sort out those 2 groups based on a questionnaire and B. and recent sexual contact with MSM poses a much higher HIV transmission risk than non-MSM sexual contact.

We've gotten the HIV transmission risk down to 1:2 MILLION, so theoretically out of the 12 million red cell transfusions a year there would be just a handful of HIV exposures. Of course correlating HIV transmission from a blood transfusion is difficult if the recipitent doesn't get tested positive until years later but it is still considered an extremely low risk, both due to appropriate (if conservative and broad reaching) donor screening and enhanced testing.

It won't always be that way, but just talk to a blood banker around in the 80's and you will see the lasting effect of that era on them. The testing isn't perfect so the donor screening is still a useful adjunct measure, even if it defers folks who are willing and able to donate.

Deleted member 18514 · Feb 11, 2019

Poltergust said:
That "temporary deferral" might as well be permanent. It is completely unreasonable to expect gay men to go without sex for an entire year.

It's not unreasonable at all. Plenty of heterosexual people can be celibate for over a year (widowed, divorced, lack of options, lack of desire). So the deferral is trying to defer the high risk BEHAVIOR, not the sexual orientation. So a 50 year old gay man not in a sexual relationship would be free to donate, while a 25 year old gay man with recent MSM sexual partners would be deferred. Like it or not, the data shows this is effective and safe when paired with HIV testing of the donated unit.

Deleted member 8561 · Feb 11, 2019

brainchild said:
The problem is that every gay blood donor is considered an increased risk, which isn't true, and the science never said it was true. If a gay male blood donor has a viable sample, WE NEED IT. The amount of contaminated samples that sneak past the screening is something like 1 in 3,000,000, and the evidence so far suggests that allowing MSM donors to enter the pool wouldn't significantly change that statistic.

The guidance document notes that the male donors who report that they are MSM have a lower prevalence of HIV infection than the general MSM population (.25% as opposed to 11-12%); the FDA concedes this suggests "considerable" self-selection by MSM individuals who choose to donate

The study you linked even noted that the MSM population who was looking to donate blood had a strikingly lower HIV infection percentage than the general gay/bi population. I'm going to assume this isn't just statistical noise and has some very specific reasons. Making an assumption that you're going to stick with that lower risk MSM population is an unreasonable assumption, at least in my view.

As it stands less than 40% of the US can donate blood based on current guidelines. It's extremely strict, but when it comes to keeping something like the blood supply clean (which was how HIV spread like wild-fire due to everyone thinking it was 'the gay virus') being overly cautious is well within reason when it comes to populations that are higher-risk for having bloodborne diseases.

Deferment is a reasonable policy considering the high-risk HIV population in the gay/bi community and detection rates after a specific amount of time. Removing higher-risk populations is not discriminatory

brainchild said:
Advocates for lifting these bans are simply asking for MSM donors to be evaluated on the distinction of risk within their own group, just like everybody else in their respective groups. There is already an assessment of risk for heterosexual donors, but that assessment is deemed irrelevant for MSM donors because they're all assumed to be high risk, which is wrong and unscientific.

MSM are assumed to be high risk because the HIV transmission rate for any type of anal sex ranges from .1% all the way to 1.43%. Lifetime bans are dumb, deferrals are more than reasonable given the at risk population you're dealing with and the likely transmission vectors.

Deleted member 14459 · Feb 11, 2019

Regarding the map in OP - some precaution in terms if celebrating the progressive nature of these countries is also in order, for instance the DHQs in some of those countries (catholic 'state' church) do not recognize condoms as risk mitigating factor, &!the reason for not using MSM as identified risk group is religious...

brainchild · Feb 11, 2019

Rupetta said:
Sure but as laid out in the article I linked there is some scientific reasoning behind a 3 months deferral for MSM with current technologies if we accept that precautionary principle of protecting recepients takes predecence over rights of donors. As the article notes, if screening would contain interviews as standard it would mitigate some risks with the DHQ of determing high risk groups, but in most places that is not feasible as standard.

The difference is that that protocol wouldn't apply to just MSM donors.

jason10mm said:
Could be, but barring a donor with an extremely rare phenotype there is almost no "WE NEED IT" blood out there worth the risk of allowing disease transmission from a high risk group

I'm not even advocating for this.

jason10mm said:
Even "low risk" MSM donors would be higher risk than the general donor population because A. how can you really sort out those 2 groups based on a questionnaire and B. and recent sexual contact with MSM poses a much higher HIV transmission risk than non-MSM sexual contact.

The reliability problem with the questionnaire applies to any group of donors. And by your logic, African American donors pose a much higher HIV transmission risk than donors of other races. Should they not be allowed to donate blood?

Deleted member 8561 · Feb 11, 2019

brainchild said:
The reliability problem with the questionnaire applies to any group of donors. And by your logic, African American donors pose a much higher HIV transmission risk than donors of other races. Should they not be allowed to donate blood?

That's a silly statement because you know that there are pretty clear reasons why minority populations have a higher risk of HIV vs. white populations, and infection rates are primarily within the gay/bi community for people of color.

PoppaBK · Feb 11, 2019

brainchild said:
Advocates for lifting these bans are simply asking for MSM donors to be evaluated on the distinction of risk within their own group, just like everybody else in their respective groups. There is already an assessment of risk for heterosexual donors, but that assessment is deemed irrelevant for MSM donors because they're all assumed to be high risk, which is wrong and unscientific.

The assessment doesn't cover number of partners, anal sex, unprotected sex etc that would be required to assess risk in any granular way. There isn't really any assessment of risk for heterosexual donors - if you have been exposed to a risk factor (paid for sex etc) then you are not allowed to give blood.

brainchild · Feb 11, 2019

TheLostBigBoss said:
Deferment is a reasonable policy considering the high-risk HIV population in the gay/bi community and detection rates after a specific amount of time. Removing higher-risk populations is not discriminatory

No one is advocating anything to the contrary.

TheLostBigBoss said:
MSM are assumed to be high risk because the HIV transmission rate for any type of anal sex ranges from .1% all the way to 1.43%. Lifetime bans are dumb, deferrals are more than reasonable given the at risk population you're dealing with and the likely transmission vectors.

And it's a fallacious assumption because MSM donors have differing lifestyles and sexual behaviors. Some participate in anal sex, some don't. Some are monogamous and HIV negative, some aren't. Some have protected sex, some don't. In any case, these different subgroups don't possess the same risks and this needs to be acknowledged and considered when qualifying or disqualifying a donor.

GameAddict411 · Feb 11, 2019

Rupetta said:
Are people against a 3 months deferral? I was under the impression there is quite sound scientific / statistical reasoning for that particular time window - ie statistically higher infection within MSM population (different statistics in different regions, the case tested in EU courts was France) and the test technology still used in many countries is such that non-detection is a risk below 3 months of infection. I think sound policy would be 3 months for MSM and any other group - sex workers and intravenal drug users would most likely need to be discriminated to ensure that protecting blood recepients takes precedence...

edit: an additional problem is that donator health questionnaies tend to have relatively high rates of non‐compliance, which means that blood tests and reliability of those are even more central, which would speak for 3 months deferral.

edit: here is an open access article that lays out some reasoning for a precautionary deferreal window of 3 months: https://www.researchgate.net/profil...OR-DEFERRAL-FOR-MSM?origin=publication_detail

From my understanding, for blood donations at least, they use the RNA HIV test which is accurate to within a few days to a week. It's only the test for sti screening that needs the 3 month window since it relies on anti-bodies to be present to test positive. The former actually looks for the virus.

brainchild · Feb 11, 2019

TheLostBigBoss said:
That's a silly statement because you know that there are pretty clear reasons why minority populations have a higher risk of HIV vs. white populations, and infection rates are primarily within the gay/bi community for people of color.

I'm just pointing out the absurdity of your logic. Depending on how you frame the data, you could eliminate even larger groups. For instance, you could ban men from donating since they pose a higher risk of contamination than women. And if you want to narrow the scope, there's no reason to stop at MSM donors with varying risk factors.

PoppaBK said:
The assessment doesn't cover number of partners, anal sex, unprotected sex etc that would be required to assess risk in any granular way. There isn't really any assessment of risk for heterosexual donors

Well this is just patently untrue for many countries.

Deleted member 14459 · Feb 11, 2019

brainchild said:
The difference is that that protocol wouldn't apply to just MSM donors.

I'm not even advocating for this.

The reliability problem with the questionnaire applies to any group of donors. And by your logic, African American donors pose a much higher HIV transmission risk than donors of other races. Should they not be allowed to donate blood?

I don't fully get what you are advocating - that MSM should not be recognized as a group in DHQs or that you refute that MSM have significantly higher infection rates than heterosexuals or that this higher infection rate is not statistically significant for risk mitigation purposes?

Deleted member 8561 · Feb 11, 2019

brainchild said:
And it's a fallacious assumption because MSM donors have differing lifestyles and sexual behaviors. Some participate in anal sex, some don't. Some are monogamous and HIV negative, some aren't. Some have protected sex, some don't. In any case, these different subgroups don't possess the same risks and this needs to be acknowledged and considered when qualifying or disqualifying a donor.

I agree, I think there are reasonable ways to deduce lower risk MSM populations in the screening process. Should a single male who has had multiple male partners in the last year be differed from donating blood? Yea, I think that's well within reason.

Should a married male who's been monogamous for over a year with a male partner be differed? No, probably not.

However, the questioner I'm finding is pretty basic. For example, if you've had sex with someone in the last year who ever used needles (not prescribed by doctor) then you're instantly differed. I can ask why they don't ask me how long they've been clean for example, because that high-risk population in itself has other sub-populations that will be lower risk than the mean average of the population.

So when it comes down to it, from what I see the screening is just a basic wide swath that knocks out the highest risk populations in one swoop so that the overall risk of contaminated blood is far lower than trying to categorize sub-populations in a three page questionnaire. Is it extremely conservative, yes. Is it designed to be that way? I'm guessing yes.

Deleted member 8561 · Feb 11, 2019

brainchild said:
I'm just pointing out the absurdity of your logic. Depending on how you frame the data, you could eliminate even larger groups. For instance, you could ban men from donating since they pose a higher risk of contamination than women. And if you want to narrow the scope, there's no reason to stop at MSM donors with varying risk factors.

More at risk != high-risk

There is a very standard method in deducing high-risk populations, it's not "subjective"

brainchild · Feb 11, 2019

Rupetta said:
that you refute that MSM have significantly higher infection rates than heterosexuals

Some MSM donors are higher risk than others; this shouldn't be ignored in favor of a blanket ban.

Rupetta said:
that this higher infection rate is not significant for risk mitigation purposes?

Current evidence suggests that the increased risk factor from the MSM group isn't enough to significantly change the screening results.

Joni · Feb 11, 2019

Airegin said:
Belgium, the second country to allow same sex marriage is red on the map. It's shameful.

Belgium did vote to allow it back in 2017, and according to the red Cross it is a 12 month deferral now.

BernardoOne · Feb 11, 2019

Yep. My country found no significant impact on infections after allowing MSM. In fact it even went down.

Deleted member 14459 · Feb 11, 2019

brainchild said:
Some MSM donors are higher risk than others; this shouldn't be ignored in favor of a blanket ban.

Current evidence suggests that the increased risk factor from the MSM group isn't enough to significantly change the screening results.

I feel fairly confident in stating that from a purely statistical science-based approach that starts from protecting blood recepients, that a 3 months deferral for MSM and 3 months deferral for heterosexuals who have switched partners is a fair standard across the board with current screening and DHQ privacy invasion levels.

edit: This is the most comprehensive consolidating review of studies I could find: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4398316/

brainchild · Feb 11, 2019

TheLostBigBoss said:
More at risk != high-risk

There is a very standard method in deducing high-risk populations, it's not "subjective"

The data isn't subjective but the framing can be. The logic here would be that any man could be MSM and just isn't being honest about it. Banning all men would remove that potential high-risk completely. It doesn't make it a sound solution, however.

brainchild · Feb 11, 2019

Rupetta said:
I feel fairly confident in stating that from a purely statistical science-based approach that starts from protecting blood recepients, that a 3 months deferral for MSM and 3 months deferral for heterosexuals who have switched partners is a fair standard across the board with current screening and DHQ privacy invasion levels.

Equal screening procedures has always been the goal. If a 3 month deferral is necessary then so be it, but there needs to be more consideration than just "have you had sex with men?"

pirata · Feb 11, 2019

Yeah, it kind of makes my blood boil (pun not intended) that the government's official stance is still that my blood is too dirty for the straights.

The blanket bans on MSM blood donors are teetering on the line of homophobia

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