Max Pemberton on rejected blood donors
While the others get up, John remains seated. "I can't go," he says, shaking his head. In the hospital grounds sits a mobile blood donation unit, and doctors and nurses are going to donate blood.
"Why not?" I ask.
"I'm gay," he shrugs.
The National Blood Service's (NBS) policy, as stated on its website, is never to accept blood from men who have had sex with a man. It doesn't matter if you've used condoms or been monogamous: you're banned for life. This is despite the NBS being short of blood products, and the fact that there's no such policy on organ donation.
The policy dates back to the dark days of HIV, when moral panic was high and knowledge about transmission low. All blood is screened, but the potential for a brief window when testing cannot detect infection remains.
But it represents a tiny risk. Indeed, since 1985 only three infections have been blamed on the "window period", but still, even one more infection should be avoided at all costs.
John, a nurse, has been with his partner for 20 years. Their most high-risk activity is going to Ikea at weekends. The ironic thing is, while John stays put, Will, a straight doctor whose sexual adventures make Casanova look chaste, bounces up and soon a pint of his blood is being greeted by the blood service with smiles and offers of sweet tea and biscuits.
The rules appear to be based on a warped morality whereby the sexual practices of straight men, no matter how heinous, are ignored, while gay men - and women - are vilified.
A man can have whatever type of sex he desires with a woman, protected or not, and with as many women as he wants, and the blood service won't mind. He can have unprotected sex with a prostitute and a year later donate blood. A woman who's been paid for sex, though, is banned for life.
Last week a campaign backed by Amnesty's Lesbian, Gay, Bisexual and Transgender Network to change the rules, and a petition, BloodBan, were put to the Scottish Parliament.
The rationale for upholding the existing policy rests largely on statistical modelling, which raises concerns that lifting the ban could result in an increased risk of HIV contamination of the blood supply. However, the theoretical concerns don't seem to correspond to reality.
France, Italy, Spain, South Africa, Sweden, Russia and Australia have lifted their bans, and none has seen a rise in contaminated blood. Indeed clinical evidence suggests lifting the ban has cut contamination.
Italy screens donors on the basis of risk, rather than sexuality, and since introducing this policy in 2001 the number of HIV infections via blood transfusion has fallen by two thirds. Spain also screens according to risk. Its health ministry says HIV contaminations have plummeted 80 per cent.
It seems the NBS is irresponsible in not screening donors' sexual history. It focuses on gay men when it should assess all sexual practices. Its policy is based on generalisations that all gay men pose the same risk, ignoring the fact that their lifestyles are as myriad as any heterosexual. Back in the office, Will recounts his latest sexual conquest, while John looks on. I know whose blood I'd prefer.
'Trust Me, I'm a Junior Doctor' by Max Pemberton is published by Hodder. To order a copy for £11.99 + £1.25 p&p, call Telegraph Books on 0870 428 4112.
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Blood Supply in Crisis: Behind the Gay-Donor Ban Protests
by Steve Weinstein / New York Editor-In-Chief / Thursday Apr 24, 2008
On April 23, Sean Martin, a student at Bowling Green State University, wrote an opinion piece in the Ohio public college's newspaper, in which he defended the ban on men who have sex with men giving blood. What was unusual about the piece was that it appeared at all.
The vast majority of colleges that have weighed in on this issue around the country, and increasingly, the world, are coming down heavily on the side of the ban being lifted. And notably, the vast majority of comments appended to Martin's article expressed a different opinion.
The issue of gay men donating blood has been a contentious one for the Red Cross, which generally oversees the blood supply in this country, and other such groups. In the early 1980s, the formative years of the AIDS epidemic, AIDS was initially thought of as a disease only among gay men. When Haitians and IV drug users started getting sick, researchers suspected a blood- as well as semen-born virus.
Then, one by one, people who had had blood transfusions in large urban centers came down with AIDS. Hemophiliacs were especially susceptible, since they depended on blood transfusions. The case of the three brothers in Florida who were forced out of their home by hostile neighbors became a cause celebre. But it was a young Midwesterner, Ryan White, who transfixed the nation and became a symbol of the "innocent victim" of the crisis.
The Red Cross and others responded by banning anyone who had male-on-male sex since 1977. The ban has remained in effect from 1983 through today.
Pressure Mounts to Lift Ban
But now, more and more groups are asking why the ban is needed. HIV testing for blood has been in place for decades. Nucleic Acid Testing can even find out if HIV is present in the blood before antibodies form.
To date, only a handful of people have developed AIDS from blood in developed nations with the notable exception of Japan and France, where two individual cases of corrupted blood resulted in lawsuits and prison sentences. Those two anomalies aside, however, supporters of the ban are hard-pressed to point to tainted blood.
Gay groups have long asked that the ban be lifted. They have been joined by the Red Cross itself. But the Food and Drug Administration, the federal agency responsible for protecting the nation's blood supply, has reaffirmed several times its lifetime ban on any man who has had gay sex, most recently a little over two years ago.
But the pressure is mounting, and it's coming from some unlikely sources.
Outside U.S., Protest-& Change
In the United Kingdom, a lifetime ban on gay men donating blood also exists. But it looks to be on the ropes, as government officials inch away from the policy. The Scottish Parliament, which has some self-governing authority away from Parliament in London, is expected to lift the ban soon.
If so, it joins France, Italy, Spain, South Africa, Sweden, Russia and Australia, which have lifted their bans. Most significantly, none of those countries has seen a rise in contamination in its blood supply. Clinical evidence suggests lifting the ban has actually cut contamination, according to several news reports.
Italy screens donors on the basis of risk, rather than sexual orientation. As the U.K. Telegraph reports, "Since introducing this policy in 2001, the number of HIV infections via blood transfusion has fallen by two thirds. Spain also screens according to risk. Its health ministry says HIV contaminations have plummeted 80 per cent."
What these countries have done is to change screening procedures to allow gay men who have been monogamous or safe in their sex lives--and instead screening for specific risk factors regardless of sexual orientation. This follows the theory that a heterosexual man, for example, who has been notably promiscuous is at least as likely if not more so than a relatively monogamous gay man who has practiced safe sex. Examples of heterosexual transmission are certainly not uncommon, from basketball player Magic Johnson to less notable figures.
In fact, the fastest-growing risk group for HIV infection is women of color. Women overall have far outpaced men in HIV infections for several years.
Compounding the issue is the fact that the nation's blood supply remains at critically low levels, which leads advocates to ask why a swath of the population is excluded because of what they see as an outmoded rule.
Significantly, the rules for tissue and organ donation--where the shortage is even more critical than the blood supply--have been relaxed for gay men. The FDA now mandates five years of no gay sex for such donations. And even that rule is stretched in critical situations.
It isn't just Western nations that have changed their policies. In mid-April, Thailand moved to allow gay blood donations. The Southeast Asian nation is especially notable because of its high rate of HIV infections: 28 percent of gay men in Bangkok in 2005.
Closer to home, Canada has just announced that it will re-examine its policy. "What we want to do is get a really firm handle on where we are now, what can be supported by science and move forward when and where we can," says Anne Trueman, a spokesperson for Canadian Blood Services.
Students Lead Protests Here
In the U.S., college students--often led by gay groups but supported by non-gay groups--are leading the fight to rescind the ban.
Middlebury College in Vermont recently held an open forum with the American Red Cross on the issue. An official with the Red Cross again blamed the FDA for the policy, but he also complained that campus protests across the country could threaten the nation's blood supply and may prove counter-productive.
"We've had meetings with other schools that just have not been productive in any way," said the Red Cross' David Carmichael. "The response we got from the community made us feel backed up."
The student government of the University of Pennsylvania recently discouraged students from participating in a blood drive. Activists maintained that the FDA is discriminating and hence violates the university's own policies--an argument similar to the battles against military recruiting roiling college campuses because of the "Don't Ask Don't Tell" rule banning openly gay Armed Forces personnel.
In Januray, San Jose State University in California banned outright blood drives in protest. The university's president took the unusual step after reviewing the school's anti-discriminatory policies. The ban attracted wide media attention, both positive and negative. But more importantly, it instigated a flood of editorials and discussions on other college campuses, including Dartmouth in New Hampshire, and the University of Buffalo and State University of New York/Binghamton, both in New York.
Meanwhile, the Red Cross is putting pressure on the FDA to change a policy that is increasingly dogging its efforts to replenish the nation's blood supply. "The Red Cross is working really hard to fight this restriction," said Amy Pudvar-Pecor, an account executive for the American Red Cross.
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