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Opinion The FDA must move to end its ban on blood donations from gay and bisexual men

A volunteer donates blood in Chicago.
A volunteer donates blood in Chicago. (Scott Olson/Getty Images)
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THIS WEEK, the Trump administration caused alarm by touting convalescent plasma from the blood of recovered covid-19 patients as an effective therapeutic before studies robustly supported that claim. But even if convalescent plasma turns out to be an effective therapy, under current guidelines one group of recovered covid-19 patients will be effectively banned from donating: gay and bisexual men.

Food and Drug Administration policies regulating blood donations from “men who have sex with men” (MSM) originated during the AIDS epidemic. In the early 1980s, as HIV/AIDS ravaged the gay community, doctors could neither reliably detect nor treat the disease, and they feared that donations from HIV-positive donors could threaten the blood supply. The agency enacted a “lifetime deferral” (or lifelong ban) for MSM who sought to donate.

Much has changed since those fearful early days. Almost 40 years later, the disease is not the death sentence it once was, and tools exist to screen blood donations for HIV (though there remains a nine-day window after infection in which the virus might not be detected). Despite these advances, and pressure from advocates who argued that the blanket ban on MSM perpetuated harmful, homophobic stigma, the lifetime ban stayed in place until 2015.

In 2015, the FDA moved to a one-year deferral, meaning MSM donors could now donate if they had been abstinent for 12 months. While an improvement, this was still an effective ban for many MSM, even those in long-term, monogamous relationships. This was especially painful after a gunman attacked a gay nightclub in Orlando in 2016. Some gay men wanted to donate blood to the survivors but couldn’t because of the FDA’s policies.

When the pandemic hit, thousands of blood drives were canceled under social distancing orders, and the nation began to run out of donated blood. In April, the FDA lowered the deferral period for MSM from 12 months to three months. Some in the gay community felt frustration that a national blood shortage helped precipitate this change rather than decades of committed advocacy for a less discriminatory policy.

The frustration is warranted: The FDA has shown that it can move swiftly when it wants to. If finding alternatives to a process based on sexual orientation were a priority, would the current system still be in place? A better approach would be individual risk assessment, which Italy found to be just as effective at keeping HIV from the blood supply as blanket deferral. Encouragingly, the FDA is studying the risk assessment approach. Change would have to be implemented carefully; getting people to honestly answer sensitive behavioral questions can be tricky. But many countries manage to screen individual donors based on risk assessments. It’s past time for the United States to join them.

Read more:

Read a letter in response to this editorial: Blood banks and burning crosses

Mark McClellan, Margaret Hamburg, Robert Califf and Scott Gottlieb: 4 former FDA commissioners: Blood plasma might be the covid-19 treatment we need

Paul Waldman: Supreme Court bends to reality on LGBTQ rights

Sasha Issenberg: Joe Biden and Kamala Harris both worked for gay marriage — in opposite ways

J.R. McNeill: Covid-19 will provoke a societal immunity that can protect us from the next pandemic

The Post’s View: 50,000 more people are dead, and there’s no end in sight. It didn’t have to be this way.

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