a spread of red blood cells
Human blood is a cocktail of proteins, salt, platelets, and red and white blood cells perfectly engineered to deliver oxygen and nutrients throughout the body with precision and efficiency. Annie Cavanagh, Wellcome Images
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The U.S. Food and Drug Administration plans to lift its long-held ban on men who have had sex with men from donating blood, the agency announced today. However, the FDA still wants men to pledge they haven’t had sex with another man for a year before donating blood. Nevertheless, the proposed policy is a big change from the lifetime ban that the U.S. has had in place since 1983.

The change has been brewing for a while. In the fall, for the first time, a U.S. Health and Human Services Department panel recommended lifting the ban. But an FDA panel had seemed reluctant to do so just a few weeks ago, as the Hill reports. Many countries don’t have bans or have recently reduced their “time-since-last-sex” waiting periods, including Australia, Canada, Japan, Italy, the U.K., and South Africa. For years now, a number of non-government medical groups, including the American Medical Association and the American Red Cross, have recommended a lift on the lifetime ban. Because the current U.S. policy reinforces negative stereotypes about gay men, LGBT advocates have also lobbied for a lift on the ban as a matter of civil rights, which is important. But we’ll focus on a little of the science.

An FDA website says the agency has maintained a ban because men who have had sex with men are at an increased risk for HIV, hepatitis B, and other illnesses that are transmitted through shared blood. Opponents argue the ban is discriminatory because other people whose behaviors put them at risk for blood-borne diseases are still allowed to donate after waiting periods. For example, men who had sex with a sex worker and men who have had sex with an HIV-positive woman are allowed to donate 12 months after their “risky” encounters. (People who have had sex for money are also entirely banned from donating blood.) Nevertheless, the U.S. blood supply is very low-risk. A study of the American Red Cross’ supply estimated the chances of getting HIV from a donation are one in 2 million.

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Donating

U.S. embassy officers donate blood, 2009

The U.S. established its ban during a time when researchers knew very little about HIV and how the virus passed from person to person. With newer science, blood banks should be able to keep the U.S. blood supply safe without resorting to discriminatory bans, experts argued in an opinion piece published in the Journal of the American Medical Association this summer. The piece argues that questionnaires asking people about their behaviors, such as whether they use condoms, work to screen out higher-risk donors.

The FDA website contends questionnaires don’t work for separating out lower- and higher-risk gay male donors. But perhaps the agency has new data about questionnaires or has otherwise changed its mind. In its announcement about its plans to change its policy, the agency said it “carefully examined and considered the available scientific evidence . . . including the results of several recently completed scientific studies.”

Of course, we’re now able to test people for HIV, too, unlike in 1983. There is a window of time when blood from a person who just contracted HIV or another illness won’t show up positive in a blood bank’s test — but it is still infectious. There is about a two-week window in which blood bank tests can’t detect HIV, Vox reports. For blood-bank tests of hepatitis B, the window is about two months. That’s the window agencies like the FDA is trying to avoid with waiting periods.

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