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Policies for Blood Donation Are Rooted in Fear and Stigma

By Dr. Cynthia Brinson and Christopher Hamilton
The following opinion piece originally ran in the Austin American Statesman on May 7, 2020.

While the Texas economy slowly begins to reopen, the need for blood donations, especially from those with COVID-19 antibodies, remains extremely high. Yet, even as we face critical shortages during this global pandemic, one group of people in our country continues to be discriminated against: men who have sex with men.


During the HIV/AIDS crisis, the U.S. Food and Drug Administration (FDA) implemented a lifetime ban on all blood donations from men who have sex with men. Since the blood donation ban went into effect in 1985, the medical community has revolutionized our ability to screen donated blood for various infections like HIV and Hepatitis C. Fast forward to 2020. The lifetime ban has been modified, but gay men are required to abstain from sex for at least three months before donating blood. This policy is rooted in stigma, not in science.


By discriminating against men who have sex with men, the FDA is also hurting people who need blood and blood products like plasma, especially black and brown communities who are facing much higher COVID-19 fatality rates. We need a policy that allows every viable donor the opportunity to donate, regardless of sexual orientation.


What’s worse, in many instances, those who take medication that is more than 99% effective at preventing the transmission of HIV (pre-exposure prophylaxis) are not allowed to donate at all. That’s right, many individuals who know their status and are taking pre-exposure prophylaxis (also known as PrEP) are not allowed to donate. Blood banks can determine additional restrictions like banning people on PrEP, punishing our community for good prevention behavior and undermining one of the best tools we have to stop new HIV infections. Each blood bank making its own additional restrictions allows for discrimination based on stigma and prejudice, not science.


Our community endured unspeakable trauma during the height of the HIV/AIDS epidemic. While so many leaders and communities went about their lives, LGBTQIA+ individuals and allies fought for life-saving medical treatments. We learned from this fight. We want to help those in need. Instead of policies rooted in decades of stigma, we need policies that are rooted in scientific evidence and enable collective, consistent action.


At Texas Health Action, we operate Kind Clinic, which provides sexual healthcare for all who need it, regardless of ability to pay. Many of our patients are on PrEP, which prevents them from being eligible to donate blood. Unfortunately, the FDA’s discriminatory policies and the inconsistent donation policies from one blood bank to another implicitly encourage potential donors to decide between donating blood or stopping their medication and abstaining from sex. We strongly discourage anyone from stopping an HIV prevention behavior like using PrEP. We need to address our state’s blood shortage head-on. If the FDA does not stop discriminating against gay men, its policy could inadvertently encourage HIV transmission and undermine our ability to fight COVID-19.


This is why we have co-signed an open letter to the FDA with medical professionals across the United States, asking the FDA to reverse its unscientific ban. We are asking all HIV specialists, public health professionals, clinicians, researchers and healthcare administrators to join us and sign the letter as well. As a public health community, we can do better. Texas can do better.


Brinson is the chief medical officer and Hamilton is the CEO of Texas Health Action. Kind Clinic is a program of Texas Health Action.


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