End ‘discriminatory’ blood donation policy for gay men, new NC DHHS leader urges FDA
North Carolina’s top health official, joined by public health leaders from eight other states and the District of Columbia, is asking the Food and Drug Administration to lift a three-month waiting period for gay men who are sexually active to donate blood.
On Thursday, Department of Health and Human Services Secretary Kody Kinsley sent a letter to FDA Commissioner Robert Califf asking the agency to remove a blood donor deferral policy that prevents men who have had sex with another man in the last 90 days from donating blood. In addition to Kinsley and N.C. Health Director Dr. Elizabeth Tilson, the letter was signed by health officials from California, Connecticut, Kentucky, Massachusetts, Minnesota, Nevada, New York, Oregon and Washington, D.C.
Up until a few years ago, gay and bisexual men were subject to a lifetime ban on blood donation that was put in place in 1983, at the beginning of the HIV/AIDS epidemic. In December 2015, the FDA lifted the ban, replacing it with a policy allowing gay and bisexual men to donate blood, but only if they hadn’t been sexually active for 12 months. The deferral period was shortened to 90 days in April 2020, soon after the start of the coronavirus pandemic, when there was a substantial drop in the nationwide blood supply.
In the nearly 40 years since the ban was originally put in place, “there have been incredible advancements in both the development of highly sensitive HIV diagnostic platforms and our scientific understanding of HIV transmission,” Kinsley wrote in the letter.
Now, all blood donations are required to be screened for HIV through nucleic acid testing, which can detect the virus within two weeks of infection, Kinsley wrote. That means that the risk of HIV-infected blood entering the blood supply “is negligible.”
A policy that discriminates and furthers stigma
Kinsley, who is the first gay person to serve as a cabinet secretary in North Carolina’s history, said the FDA’s policy was personal for him.
“Personally, it has been incredibly disappointing to be unable to join my colleagues and loved ones in donating blood, seeing how significantly the COVID-19 pandemic impacted the national blood shortage, risking patient care & safety,” Kinsley wrote in a post on Twitter.
Kinsey said there is no credible evidence showing that the 90-day deferral period is effective in protecting the blood supply, which means there is “no clinical reason” for the FDA to keep the “discriminatory” policy in place.
“The continuation of this policy serves only to further stigmatize an already marginalized demographic group and unnecessarily restricts the eligible donor population during a time of extraordinary need in the US,” Kinsley wrote.
Equality NC, the largest LGBTQ advocacy group in North Carolina, celebrated Kinsley’s call for an end to the policy, which the organization called “outdated and scientifically unnecessary.”
In an email, Kendra Johnson, the organization’s executive director, said she was thrilled to see state health officials taking a stand against the FDA’s policy, adding that people “who hold positions of power within systems are critical in advancing change.”
“Prohibiting gay and bisexual men from donating stigmatizes an entire class of people by connecting them to HIV, a disease that potentially impacts everyone,” Johnson said.
Of the several years it’s taken for the FDA to first lift its ban on gay and bisexual men donating blood and then shorten the deferral period, Johnson said: “Unfortunately, bigotry and misinformation can take decades to overcome.”
Nationwide blood shortage exacerbated by COVID-19
Kinsley’s request to the FDA chief comes amid a nationwide shortage of blood.
In January, the American Red Cross declared its first-ever blood crisis. Blood donations had declined by 10% since the beginning of the pandemic, the organization said, leading the Red Cross to limit how much blood it was distributing to hospitals. Some hospitals, on certain days, were lacking up to 25% of the blood products they were asking for.
At the time, the Red Cross said the drop in donations was being exacerbated by fears about the highly transmissible omicron variant. Low turnout among blood donors had already begun in light of the spread of the delta variant in August.
The FDA’s restrictions on when gay and bisexual men can donate blood are only amplifying the ongoing blood shortage, Kinsley and other health officials wrote.
The Red Cross says blood donation eligibility shouldn’t be determined by sexual orientation, and acknowledges “the hurt this policy has caused to many in the LGBTQ+ community.” Doing away with the deferral policy also has the support of the American Medical Association.
The Red Cross says it’s helping evaluate other criteria that could be used to identify eligible donors, but in the meantime, it can’t as a regulated organization “unilaterally enact changes concerning” the deferral policy for gay and bisexual men.
Instead of blocking all sexually active gay and bisexual men from donating blood, the FDA should compliment nucleic acid testing “with an individual risk-based assessment based on our robust knowledge of how HIV is transmitted,” Kinsley wrote.
Assessing individual behavior means screening for “engagement in risky behavior, such as unprotected sex,” according to the Human Rights Campaign.
The FDA is currently working on a study to determine if individual risk assessment could replace a time-based deferral policy as an effective way to protect the blood supply. In February, the agency told WCNC it doesn’t have a specific timeline for the study’s completion.
Organizers of the study have said they expect to enroll 2,000 gay and bisexual men from across the country who are interested in donating blood and have had sex with another man in the last three months.
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This story was originally published March 12, 2022 at 1:38 PM.
