Seth Thomas looks at one of the many stories behind why the MSM blood policy needs to change…and one man fighting for that change.
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Enacted in 1983 at the start of America’s AIDS crisis, the blanket ban remained unaltered for three decades. Its first critical evaluation came in 2010 when an advisory committee from the U.S. Dept. of Health & Human Services declared it suboptimal, kicking off a wave of research and data crunching. This November, the committee voted 16-2 to recommend that the FDA switch to a one-year deferral policy, keeping pace with other countries like Brazil, Japan and parts of the United Kingdom. On Dec. 23, the FDA announced it would be replacing the blanket ban in favor of a one-year deferral model, which requires donors to remain abstinent for 12 months before becoming eligible.
This sudden announcement before Christmas came after years of debate. By the time the ban was lifted, there had been a groundswell of opposition over the old model. The Red Cross, AABB and America’s Blood centers had previously supported a one-year deferral policy. In 2013, the American Medical Association voted to end the ban, writing in a statement that the current policy is “not based on sound science.” Sen. Elizabeth Warren weighed in with a letter signed by her and 85 lawmakers expressing concern over the speed at which the ACBTSA’s research had been rolling out. This past summer on July 10, U.S. Rep. Mike Quigley addressed Congress in support of National Gay Blood Drive, saying that “being gay does not implicitly make someone an unsafe blood donor.” The organization that the congressmen referenced represents perhaps the loudest voice against the former blanket ban: grassroots activists.
It was at the steps of the Supreme Court during United States v. Windsor, the 2012 case that effectively made same-sex unions legal throughout the states, where Franzone met Ryan James Yezak, founder of National Gay Blood Drive. Yezak had just formed the organization after his own run-in with the policy.
“We got a work email that went to everybody about natural disasters that had hit our CMT office in Tennessee,” says Yezak, who worked at MTV at the time. A group of coworkers had decided to donate together when he had a stray thought: The last time he donated was in high school, and he could vaguely recall some question about sexual orientation. At the time, he had ignored it because he was unsure how to answer.
But this time was different. After a quick Google search, he had to inform his colleagues that he wouldn’t be joining them. His coworkers were shocked. Yezak was disappointed. “I felt, for the first time, that I wasn’t able to do something that everybody else could do solely because of my sexual orientation.”
Feeling compelled to action, Yezak decided to raise awareness of the issue. In its first year, National Gay Blood Drive gathered HIV-negative results and deferral letters of 500 would-be donors and mailed them to the FDA.
“In 2013, we had a lot of allies who wanted to get involved,” says Franzone, who went on to help organize the group on a national level. In its second year, gay and bisexual candidates would bring an eligible ally to donate in their place. After donating, the two would have their photograph taken together, and their paperwork would be packaged and mailed to the FDA. This past summer, across 61 locations in America, allies donated 1,500 pints of blood.
“While it’s a complicated issue to explain, I find that most people get it when I talk to them,” says Yezak. “Most of their reactions are: ‘Don’t they test all the blood anyway?’”
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The FDA has spent years resisting changes to the blanket ban for reasons “not based on any judgment concerning the donor’s sexual orientation.” They argue that framing the issue as one of gay rights or the broader LGBTQ+ movement is missing the point. It’s an issue of patient safety. The CDC reports there are 50,000 new cases of HIV reported in America annually, with two-thirds being gay and bisexual men. Half of those infected between 18 and 24 aren’t aware they’re carrying the virus.
With current technology, the Red Cross notes that blood recipients have a one in two million chance of contracting HIV through a transfusion. The last reported case happened in 2008 and, before that, 2002. It turns out that the “one” in that one-in-two-million figure comes almost exclusively from those who donate blood during the window period of an HIV infection — when it’s hard to detect the presence of the virus.
In some countries, however, the blanket ban has been replaced with a deferral period, which requires MSM donors to remain abstinent for a year (or in the case of countries like Canada, five) before becoming eligible to donate. England and Wales, which adopted a one-year deferral in 2011, altered the policy after the Advisory Committee on the Safety of Blood, Tissues and Organs concluded that current testing methods — namely, the Nucleic Acid Test (NAT), which became a routine test for donated blood over a decade ago — shortens the window period to nine days.
The committee also based its decision on an Australian studythat looked at trends following the implementation of a one-year deferral policy in the country. During the study, some cases of HIV were detected in parts of Australia. However, it was concluded that this increase stemmed from donors dishonestly reporting their sexual behavior, not because of their orientation.
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Removing questions that focus on sexual orientation from the universal donor questionnaire, the aim of National Gay Blood Drive, is something they realize will be a lengthy process. “I think it’s more realistic that [the FDA] will take slow steps,” says Yezak. Though, change may roll out faster than in the past, where public perception and lack of scientific information set the agenda.
Daniel Renfrow, a sociology professor at Wells College in upstate New York, remembers growing up during the heart of the AIDS crisis. He was around the same age as Ryan White, a young hemophiliac diagnosed with HIV in 1984 following a blood transfusion. The fallout from White’s diagnosis – particularly, the ways in which his Indiana community responded – typified the public panic surrounding the new disease.
“It made me aware that our culture defines some people as normal and other people not,” says Renfrow. “And it’s really quite arbitrary how those decisions are made.”
White finished the eighth grade at Western Middle School, but not without insurmountable pressure from his community. The narrative was that he was either gay, being punished by God or going to infect everyone with HIV — or some combination of the three. After someone fired a shot into the family’s home, the Whites moved to another part of Indiana.
Given the climate of the early ‘80s, the absence of a proper HIV test and the amount of data the FDA and CDC had at their disposal, the blanket ban was largely a necessary action to address public panic and prevent more deaths — especially among hemophiliacs — even if it lacked precision.
“At the time, there were some members of the gay and lesbian movement willing to go along with this because they knew something had to be done,” says Renfrow. “But in more recent years, there’s been a lot more people seeing this as a lingering policy we no longer should accept.”
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Back in November, when it was still unclear if the FDA would move on this issue, members of National Gay Blood Drive were leaving the HHS committee meeting in Arlington, Virginia, already plotting the 2015 drive. Two days later, Franzone received phones calls in the grocery store from community organizers around the country. They were ready to discuss dates when they could start looking for donation centers to house their next drive. Regardless of the FDA’s decision, National Gay Blood Drive remains undeterred. “We want to make sure that we’re not stalled by this, or that people aren’t content with the one-year [deferral],” says Yezak.
Meanwhile, Franzone intends on celebrating by doing something he’s never done before: donating. “I’d personally consider being abstinent for a full year just to be able to give blood that one time. I think it’d be really special, and I could say, ‘Yes, I did that, but there’s still more work to be done.”
Photo: ☰☵ Michele M. F./Flickr
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