By MEGAN JAMES
MIDDLEBURY — Federal authorities charged with protecting the U.S. blood supply make a person who is ill or who has used illicit drugs wait a period of time before they are allowed to give blood. Only three behaviors, when disclosed, can result in a lifetime ban on blood donation: taking medication for HIV, taking money for sex and, if you are a man, having sex even once with another man.
When it comes to giving blood in the United States, gay and bisexual men, even those using condoms or in long-term monogamous relationships, need not apply.
Despite the fact that HIV testing has grown considerably more precise over the past 20 years, that the virus infects far more than just gay men, and that blood banks around the country have criticized the policy as outdated and discriminatory, the U.S. Food and Drug Administration (FDA) has been enforcing the ban since 1983.
At Middlebury College last week, in the days leading up to an American Red Cross blood drive, the college’s non-discrimination policy — which requires that organizations with discriminatory policies, other than the military, hold an open forum at which community members can hold them accountable for those policies — was tested.
In lieu of banning the organization from collecting blood on campus, like San Jose State University in California did last month, the Middlebury Open Queer Alliance (MOQA) invited Red Cross officials to discuss the policy at a community forum.
More than 70 people attended last Monday’s event, which was the first of its kind for the Red Cross, to confront four representatives from the Northern Vermont Chapter about the FDA policy and what they’re doing to change it.
The precise wording of the FDA policy is this: “Potential male donors who answer yes to the question, ‘Have you had sex with another man, even once, since 1977?’ are currently indefinitely deferred from donating blood in the United States.”
“Do we think this is fair? No,” said Red Cross spokesperson Carol Dembeck. “And yes, we have tried to change it.”
In the early ’80s, when HIV was just emerging, no tests were available to detect HIV, she explained. Blood banks could only use questioning, donor history forms and surrogate testing — tests that checked for HIV indicators other than antibodies — to gauge whether potential donors were infected.
Tests that could identify antibodies, which a body produces in response to the virus, didn’t arrive until 10 years later, and even then, months could pass between infection and detection.
In the late ’90s a test was developed that detected the virus itself, and by 2000 the FDA was considering changing its lifetime deferral policy for gay men. But studies released by the Centers for Disease Control (CDC) suggesting that gay men still posed a considerable risk kept the policy in place, Dembeck said.
While the American Blood Centers and the American Association of Blood Banking advocated changing it to a one-year deferral more in line with other “high-risk deferrals,” like using cocaine, getting a tattoo or having sex with a prostitute, the Red Cross held back. Officials there are waiting to see about a brand new HIV test: Nucleic Acid Testing (NAT), a procedure that detects the actual genetic material of the virus.
Shortening the time period between infection and detection even more, the accuracy of NAT convinced the Red Cross that the FDA should do away with its policy. The organization testified in 2006 in support of a one-year deferral for gay and bisexual men.
Still, the FDA held firm to its policy. To disregard it, Red Cross representative Marni Willms explained in Middlebury, her organization would risk fines, a removal of its blood license or jail time.
The Red Cross’ top priority is to collect the safest possible blood supply. Over the years, the questions donors are required to answer before giving blood have multiplied from fitting neatly on half a page to filling a double-sided, four-page “monumental questionnaire,” Dembeck said.
Currently demand for blood in the United States is much higher than the supply, explained Red Cross representative David Carmichael. There has been a decline in blood donors recently, he said, and while deferrals are necessary to lower the risk of infected blood, they also eliminate plenty of healthy donors.
One man in the Middlebury audience last week, who asked to remain anonymous, posed this scenario to the Red Cross officials: A gay man who has been out about his sexual orientation for more than 20 years, he engages in protected sex with other men and he is HIV negative, he said.
He donates blood every year.
“I lie every single time I give blood,” he said. “I will not respond to that particular question because I find it offensive and discriminatory. However, there must be some scientific way that you guys check my blood and find out it’s HIV negative and pass it through the blood system.”
Dembeck responded that while she can’t condone anyone lying, realistically, she knows this is not an uncommon scenario.
But another Red Cross representative, Willms, stressed that a blood bank can’t simply rely on the testing process after blood has been collected. Throughout a blood drive, many people handle the blood before it has been tested. Without asking questions up front, they run the risk of exposing someone to infected blood.
AT THE BLOOD DRIVE
At Middlebury’s blood drive the following day, MOQA led a “sponsor drive,” in which people could sign a statement saying they made their donation in the name of a gay or bisexual member of the community who is not allowed to give blood. The Red Cross representatives agreed to collect these statements and deliver them to the FDA.
Carmichael stressed that in his 20 years working for the Red Cross, he had never sat before a college community and discussed such an important topic. He commended the students, faculty and staff from their initiative.
But the audience urged him, and the rest of the Red Cross officials, to take on the fight to change the policy themselves.
“I’m hoping that you, as an entity — even if you feel that you are burdened by the FDA — have the social responsibility to speak your mind as well and say there is no reason why this (policy) should be in place, and fight just as hard as we are by being here,” said the college’s Assistant Director of Admissions Shawn Rae Passalacqua. “It is ridiculously wrong.”