Efforts to overturn a ban on gay male blood donors suffered a setback Thursday, but the government is still considering lightening the rule, implemented 15 years ago out of fear of AIDS.
A panel of scientists voted 7-6 on Thursday to recommend the Federal Drug Administration keep the ban in place, citing concern that there wasn’t enough evidence about how the move might affect the AIDS risk to the nation’s blood supply.
The FDA is not bound by its scientific advisers’ decisions but typically follows them.
The 1985 ban declares that any man who has had sex with another man even once since 1977 cannot give blood. Many blood bank officials want to change the rule; the American Red Cross wants to keep it. The FDA’s Blood Products Advisory Committee will meet again today to discuss the issue.
Panelists complained that the FDA’s projections of the effect of lifting the ban were based on mathematical models — nobody knows exactly how many homosexual men want to donate or how many of that subset have HIV.
“I encourage the FDA to continue to look at possible options for how this can be changed in a safe fashion,” said Dr. Jeanne Linden of the New York State Department of Health.
FDA officials say they have reviewed the policy every few years and that their priority was the safety of the blood supply. A change, if any, would be implemented months from now.
Science or Discrimination?
Under the current rule, a heterosexual woman who has had sex with numerous AIDS-infected partners can give blood after waiting a year, but a gay man who’s been celibate since 1978 is banned. Gay activists say that’s discrimination.
“The existing policy is archaic and discriminatory because it falsely assumes that all gay men are HIV-positive regardless of their sexual behavior. At the same time, it allows heterosexuals to donate blood even if they have participated in risky sexual or drug-use behavior,” says Martin Algaze, spokesman for Gay Men’s Health Crisis.
Safety of the blood supply is the first priority, agrees Doni Gewirtzman of the Lambda Legal Defense Fund, a legal-aid organization for gay people and people with AIDS. He suggests the current restrictions may be too tight on gays and too loose on promiscuous heterosexuals.
“Everyone is equally at risk for HIV infection. It’s about specific sexual behavior, not about sexual orientation,” says Tom Duane, a Democratic New York state senator who is both openly gay and HIV-positive.
Red Cross Wants Ban
Blood bank officials say AIDS-detection technology has vastly improved since the 1980s. Back then, tests only checked for antibodies to the virus. Now they check for parts of the virus itself.
But that doesn’t reassure Mary Romo, a blood donor in San Francisco. She doesn’t want the ban on donations from gay men lifted.
“I’m not favorable toward it at all. I don’t think many people would want to receive from the blood banks. They would want private donations instead,” she says.
The Red Cross argued that changing the policy would increase the amount of HIV-infected blood that would have to be caught by tests.
“We cannot change our procedures in a way that would result in increased numbers of infectious donation in our blood supply,” said Dr. Rebecca Haley, the Red Cross’s chief medical officer.
Old Worries, New Fears
Blood bank officials said new tests were good enough to stop infectious blood — and that the nation can’t afford to turn away thousands of healthy donors.
When the ban was enacted, “there was a great deal of anxiety and there was a lot of public concern, and we didn’t know very much [about AIDS] at the time,” says Herbert Perkins, who ran the Blood Centers of the Pacific in San Francisco back then.
Now, experts say, political problems, not scientific ones, are the major barrier.
“It’s mostly one of perception, not science,” said Debra Kessler, director of regional services at the New York Blood Center, the nation’s largest blood bank. “It’s not just gay men, but it’s also people who have used IV drugs, and prostitutes” who are under lifelong bans.
The blood banks say they need the extra blood. A shortage in the New York area has reached “crisis proportions” and the bank has cut back on shipments, according to New York Blood Center President Robert Jones.
“Unless there is an immediate and dramatic donation increase, these reduced shipments will continue or grow worse,” he said in a statement.
If the FDA changes the policy, they’re most likely to shift to a policy under which a gay man must have abstained from homosexual sex for five years before donating blood, Kessler says.
The agency is being conservative because it’s worried about blood banking errors — units of infected blood that slip through the cracks because of human error at blood banks. Banking errors were considered the “most significant risk” of changing the policy in 1997, Dr. Andrew Dayton says in a presentation prepared for the FDA meeting.
Dayton says changing to a five-year celibacy policy will result in more than 62,000 new men donating blood. Less than one unit of HIV-positive blood per year would escape into the blood supply.
A one-year celibacy policy would generate 112,000 new donors and up to three units of HIV-infected blood, Dayton says.
“Most gay men want to do their duty and be able to give blood,” says Duane.
Last year, the Blood Centers of the Pacific in San Francisco collected 100,000 units of blood. Three tested positive for AIDS.
ABC affiliate KGO in San Francisco, ABCNEWS.com’s Sascha Segan and the Associated Press contributed to this story.