Shulbank-Smith 1 Sarah Shulbank-Smith Persuasive Policy Paper Ben Henderson 9 April 2013 Ban on MSM Blood Donations is Antiquated

Any man who has had sex with another man since 1977 is banned from donating blood by a 1983 FDA (Federal Drug Administration) ruling. This was a cautionary step taken to protect against the spread of the HIV/AIDS virus through blood transfusion. While this was a potentially beneficial safeguard thirty years ago, the increased medical knowledge and development of accurate tests to identify HIV in blood donations has rendered the ban outdated. The FDA should lift the ban on blood donations from men who have had sex with men (often referred to as MSM), adding a one-year deferral for anyone who participates in unsafe sexual behavior, which will be defined by a more specific pre-donation survey. The ban perpetuates discrimination by holding heterosexual donors and homosexual donors to different standards of deferral, and robs hospitals of much-needed blood donations. The risk of HIV in blood going undetected is miniscule, and lifting the ban would encourage civic responsibility across the board, as well as adding to the pool of blood that can be used to help those in need. To fully understand the origin of the ban, one must be aware of what HIV is and how it is spread. HIV is a virus that gradually destroys the immune system. It can be spread through anal, oral, or vaginal sexual contact, from mother to child, and through infected blood (HIV Infection). HIV was first discovered in the United States at the beginning of the 1980s. In New York and California, men were being diagnosed with Kaposis Sarcoma, a rare cancer that had typically found in elderly men from specific heritages. Starting in 1980s, the men being

Shulbank-Smith 2 diagnosed were young and seemingly healthy, and did not fit the usual description of those with the disease. Men were also being diagnosed with Pneumocystis Pneumonia Carinii, a pneumonia that occurs in those with immune system deficiencies. The thread linking the various men infected with the cancer and the pneumonia was their homosexuality. Between 1980 and 1982, more and more cases were reported. The cases were starting to affect not only gay men, but a few heterosexual men and women, over half of whom used IV drugs (History of HIV/AIDS in America). What was occurring to all of these men and women? Why was this virus spreading so quickly? The answers to both of these questions were as yet unknown. The blossoming of gay pride in the 1970s and 1980s led to a subculture of widespread promiscuity and easily accessible anonymous sex. The Gay Rights Movement is widely recognized as having begun with the 1969 Stonewall Riots, which occurred at the Stonewall Inn, a popular Greenwich Village gay bar. New York police regularly raided bars, clubs and other locations that catered to gay people. On June 27, 1969, the police raid of the Stonewall Inn was met with opposition; riots broke out, with thousands of people gathered on the streets, chanting gay power! (The Stonewall Riots). The riots continued over the next week. This was one of the first examples of gay pride, and it was the start of a movement towards openness and acceptance. As gay pride increased, more and more people came out of the closet, experimenting and experiencing their sexuality. In 2005, Joseph Levitts released his documentary, Gay Sex in the 70s. The film features men recounting stories of anonymous sex on the pier, in bathhouses, outside bars, etc. The explosion of free sex and the lack of knowledge about HIV/AIDS is what led to the meteoric spread of the disease. One man in Gay Sex in the 70s recounts his experience attending a birthday party for a friend, and quickly realizing it was a gay orgy. Luckily for him, his lover demanded that they leave. You flash forward just a few

Shulbank-Smith 3 years, maybe five years, six years. Um, I think every man at that party except for us was dead I think every one (Gay Sex in the 70s). Due to the lack of information about HIV and the frenzied and sometimes secret sexual contact, the virus was spreading like wildfire. And doctors had no idea how to treat it. The general unfamiliarity towards the virus, as well as the associated stigma and discrimination were huge contributors to the spread of HIV in the 1980s, and led to the ban on gay blood donations. According to Alvin Friedman-Klein, a dermatologist and virologist in New York City, the disease attracted little attention from the government until it started affecting hemophiliacs, because gays and IV drug users, underdogsdidnt deserve any special attention (Landau, Elizabeth. HIV in the 80s: People didnt want to kiss you on the cheek). Hemophiliacs require frequent blood transfusions because their blood does not clot properly. The blood that hemophiliacs received was often pooled from many donors, making it an easy vehicle for HIV in the earlier generations when so little was known about the virus or the spread of it. According to the National Hemophilia Foundation, from the late 1970s to the mid-1980s, about half of those with hemophilia became infected with HIV ("HIV/AIDS, National Hemophilia Foundation). These shocking statistics, as well as the large number of affected gay men led to the MSM blood ban. At the time it was put in place, the ban was a cautionary step stemming from fear of the unknown. The life of gay men in 2013 is drastically different from the life of those in the 1970s and 1980s. As the LGBTQ community has been more and more assimilated into mainstream culture, there is less need or desire for screaming pride and frequent free sex. The gay culture has changed, but the ban has not. While not directly stated, the ban on blood donations from men who have sex with men discriminates against the gay population. On the American Association

Shulbank-Smith 4 of Blood Banks questionnaire that potential donors must answer, the question regarding this subject is from 1977 to the present, have you had sexual contact with another male, even once? By checking yes to this nonspecific question, you are deferred indefinitely from donating. A large number of men who have engaged in MSM sex are gay or bisexual. Due to the generality of the question, one might assume that all homosexual males are high-risk donors. The question does not specify sexual practices, nor does it further delve into the use of condoms, which can greatly lessen the risk of contracting HIV (HIV/AIDS, New York State Department of Health). As Joel Ginsberg, head of the Gay and Lesbian Medical Association explains, there's absolutely no risk for a gay man who is HIV-negative and only have [sic] safe sex with other people who are HIV-negative or who has any kind of sex with men who are HIV negative - it's scientifically impossible for that person to contract HIV or to spread it ("American Red Cross Fights Ban On Gays' Blood). Based on facts like Ginsbergs, it is clear that the survey suspends donations unnecessarily. While the questionnaire leads to a blanket exclusion of any male who has had sex with a male even once during the past 30 years, high-risk behavior by heterosexuals results in only a one-year suspension. This is illogical, as more people contract Hepatitis B and C (diseases transmitted through sex or blood) from blood transfusions than contract HIV (Staff, Mayo Clinic). The questionnaire disqualifies almost the entire gay population with one question,

while leaving a lot of room for any heterosexual donors who engage in high-risk behavior to donate. Instead, the survey should add questions similar to those that necessitate a one-year deferral for other potential donors. The questionnaire already poses questions about having sex with anyone who is HIV/AIDS positive, with a prostitute, with an IV drug user, with a hemophiliac, with those infected with STDs that are transmitted through blood, etc. With the

Shulbank-Smith 5 knowledge and testing that are now available to counter HIV spread through blood transfusion, these queries that target heterosexual donors should also suffice for homosexual donors. The FDAs ban has been gaining attention, and this has led to boycotts and cancelled blood drives, as well as widespread displeasure in the LGBTQ community. In 2008, President Don Kassing of the San Jose State University, made a decision to suspend all blood drives on campus. In the email Kassing distributed, he said I recognize the importance of giving blood and we know that universities are significant sources of blood . . . however lacking further action by the FDA, we are guided by the clear mandates of our non-discrimination policy (School ends blood drives in protest of anti-gay rules). Similar trends can be seen at a number of other universities and colleges. At Bowdoin, the organizers of a 2012 blood drive worked in tandem with the schools Queer Straight Alliance to take two steps towards raising awareness and countering the ban. They drafted a petition intended for the FDA, expressing their dissatisfaction with the ban. Also, the Bowdoin organizers devised a plan in which a student could donate in honor of a friend who was barred from donating (Students fight FDA stipulation with petition, sponsor blood drive). While the first sponsor drive did not have huge success, the organizers expected the plan would only grow in popularity. While Bowdoins reaction to the ban was constructive, the discontent, lowered spirit of civic duty and cancellation of blood drives are just a few of the negative social effects of the FDAs ban on MSM blood. An NPR article relays reports from the American Association of Blood Banks and the Red Cross saying the ban is medically and scientifically unwarranted (American Red Cross fights ban on gays blood). The ban has served to prolong discrimination, and has caused blood drives to be cancelled or boycotted. Overall, the FDA is negatively affecting both the social climate of the United States and the fulfillment of the need for blood donations.

Shulbank-Smith 6 The ban on MSM blood donations was instituted in 1983 in the thick of the HIV/AIDS scare, for reasons that no longer apply with the recent medical advances.. The policy applies to any man who has had sex with a man even once since 1977, regardless of sexuality, specifics of sexual contact, or usage of contraceptives. It was implemented as a fear-based reaction to the large number of people with hemophilia who contracted HIV from tainted blood over thirty years ago. With the strides made in blood testing, the risk of HIV transmission through blood transfusion has lessened significantly, now occurring in 1 of every 2.3 million donations (Blood Transfusion). In a Washington Post article, Richard Benjamin, the chief medical officer of the American Red Cross, explains the safety procedures taken to detect HIV in blood donations. The use of a highly sensitive nucleic test first implemented in 1999 has a high success rate, and can detect someone infected within 12 days of taking the test. Dr. Benjamin reports that on average people test positive within 9 to 11 days after exposure. The article additionally reports that an extra safety measure dictates that five tubes of blood are collected from a given donor. When tested for a variety of viruses, if an initial test comes up as positive, all blood from that donor is discarded even if a second test confirms the bloods safety (Ungar, Laura). This helps to eliminate errors or risks in case a donor lies or has incorrect information about his or her past. Furthermore, it has been repeated many times over that the United States is always in need of blood donations. According to the Red Cross, someone needs blood in the US every 2 seconds. The MSM population could help provide the blood for these donations. While HIV is still prevalent in the gay community, the Center for Disease Control reports that 19% of MSM are infected with HIV (Slick, Matt). This means the other 81% could be eligible to donate. However, in 2012 the Federal Advisory Committee that guides the FDA voted 9 to 6 to uphold the ban. They did, however, recommend basing the deferral on individual behavior instead of

Shulbank-Smith 7 maintaining the broad lifetime deferral (Landau, Elizabeth. Ban on gay men donating blood upheld). This supports the above-mentioned proposal to lift the ban and simply allow MSM to undergo the same questioning as other high-risk groups. Additionally, the article cites a University of California Los Angeles study reporting 219,000 more pints of blood that could be available if the ban were lifted. This statistic powerfully illustrates the positive effect lifting the ban could have for the medical world. The FDAs ban on MSM blood donations has become antiquated over the past 30 years. While the widespread promiscuity and the rampant spread of HIV in the 70s and 80s explain why the ban may have made sense then, the lifestyle changes and medical advances that have been made since then render the ban obsolete. The ban maintains discriminatory assumptions about the sexual practices of gay men. It also discourages blood donations. With the extremely sound HIV testing that blood donations undergo, the life-long ban is no longer necessary. Men who have had sex with men should be held to the same standards as sexually active heterosexual males and females. The lifetime deferral of any man who has had sex with a man since 1977 is unreasonable, and these men should instead receive one-year deferrals for the same criteria as all other donors. Lifting the ban is the best way to advance both the acceptance of the country, as well as the quantity of blood transfusions available to help those in need.

Shulbank-Smith 8 Works Cited "American Red Cross Fights Ban On Gays' Blood : NPR." NPR : National Public Radio : News & Analysis, World, US, Music & Arts : NPR. N.p., 30 May 2007. Web. 9 Apr. 2013. <http://www.npr.org/templates/story/story.php?storyId=10540971>. Gay Sex in the 70's. Dir. Joseph F. Lovett. Perf. n/a. Wolfe Video, 2006. DVD. "History of HIV & AIDS in the United States of America." HIV & AIDS Information from AVERT.org. N.p., n.d. Web. 5 Apr. 2013. <http://www.avert.org/aids-historyamerica.htm#contentTable0>. "HIV/AIDS." New York State Department of Health. N.p., n.d. Web. 05 Apr. 2013. < http://www.health.ny.gov/diseases/aids/ >. "HIV/AIDS ." National Hemophilia Foundation . N.p., n.d. Web. 7 Apr. 2013. <http://www.hemophilia.org/NHFWeb/MainPgs/MainNHF.aspx?menuid=43&contentid= 39>. "HIV Infection: MedlinePlus Medical Encyclopedia." U.S National Library of Medicine. U.S. National Library of Medicine, n.d. Web. 05 Apr. 2013. <http://www.nlm.nih.gov/medlineplus/ency/article/000602.htm>. Landau, Elizabeth. "Ban on gay men donating blood upheld." CNN Health. N.p., 14 June 2010. Web. 8 Apr. 2013. <thechart.blogs.cnn.com/2010/06/14/ban-on-gay-men-donatingblood-upheld/>. Landau, Elizabeth. "HIV in the '80s: 'People Didn't Want to Kiss You on the Cheek'" CNN. Cable News Network, 25 May 2011. Web. 06 Apr. 2013. <http://www.cnn.com/2011/HEALTH/05/25/edmund.white.hiv.aids/index.html>.

Shulbank-Smith 9 "School ends blood drives in protest of anti-gay rules" The Daily Free Press | The Independent Student Newspaper at Boston University . N.p., 7 Feb. 2008. Web. 8 Apr. 2013. <http://dailyfreepress.com/2008/02/07/school-ends-blood-drives-in-protest-of-anti-gayrules/>. Slick, Matt. "Statistics on HIV/AIDS and percentage of population infected | What are the percentages of people infected with HIV? | Christian Apologetics and Research Ministry." CARM - Christian Apologetics and Research Ministry. N.p., n.d. Web. 9 Apr. 2013. <http://carm.org/statistics-percentage-population-hiv-infected>. Staff, Mayo Clinic. "Blood Transfusion." Mayo Clinic. Mayo Foundation for Medical Education and Research, 26 Apr. 2012. Web. 05 Apr. 2013. <http://www.mayoclinic.com/health/blood-transfusion/MY01054/DSECTION=risks>. "Students fight FDA stipulation with petition, sponsor blood drive The Bowdoin Orient." The Bowdoin Orient. N.p., 21 Sept. 2012. Web. 9 Apr. 2013. <http://bowdoinorient.com/article/7425>. "The Stonewall Riots." About.com Manhattan, NY. N.p., n.d. Web. 05 Apr. 2013. <http://manhattan.about.com/od/glbtscene/a/stonewallriots.htm>. Ungar, Laura. "With better HIV tests, should FDA end its ban on gay men donating blood? Washington Post." Featured Articles From The Washington Post. N.p., 16 Apr. 2012. Web. 9 Apr. 2013. <http://articles.washingtonpost.com/2012-0416/national/35453125_1_blood-safety-and-availability-blood-banks-human-servicesadvisory-committee>.