AMA Opposes Lifetime Ban on Blood Donations from MSM

On June 18, 2013 at its annual meeting, the American Medical Association (AMA) voted to adopt a policy opposing the thirty year lifetime ban on blood donations from men who have sex with men (MSM). This recommendation was made to the Federal Drug Administration (FDA), the governing body that oversees issues the policy.

The ban was implemented thirty years ago before tests were available to screen for HIV or AIDS. The AMA holds the position now that the lifetime ban on blood donation from MSM is discriminatory since there are adequate methods to screen donated blood for HIV and AIDS. The American Medical Association (AMA) also noted its’ support for the “use of rational scientifically based deferral periods that are fairly and consistently apply to blood donors.”  One of example of such a guideline is the 12-month waiting period for individuals who have had sexual contact with someone who is HIV-positive.

In June 2010 the Department of Health and Human Services Secretary’s Advisory Committee on Blood Safety and Availability reconsidered the lifetime ban. While admitting that there were problems with the ban, they voted against lifting it. The Red Cross, the largest blood collection organization in the country, supported a lift on the ban in 2010 as well as presently.

If in the future the Federal Drug Administration decides to lift the ban they will follow a number of other countries who have done the same. In May of this year Canada lifted its lifetime ban on blood donations from MSM. However the new policy requires that MSM who wish to donate blood abstain from sexual contact with men for five years prior to the blood donation.

Other countries that have recently changed policies so that MSM may donate blood include the United Kingdom and Australia. Both of these countries require a 12 month period of abstinence. South Africa also recently lifted their ban on blood donation for MSM. However the period of abstinence is 6 months.

In recent years, several other countries have amended their blood donation policies to allow gay men to give blood, many of which use a smaller window of deferral for sexually active gay men than Canada has adopted. Both Australia and the U.K., for example, allow gay men who have abstained from sex with another man for one year to donate, while South Africa requires only a six-month period.

National HIV Testing Day Encourages Americans to Know Their Status

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Last week saw the observance of National HIV Testing Day on June 27, encouraging Americans to get tested and find out their status. A number of organizations nation-wide provided free tests. President Obama even released a public statement, saying that getting tested “opens the door to treatment, reduces the spread of the virus, and helps people lead longer, healthier lives.” Information about the disease constantly increases while test result waiting time decreases.

The Centers for Disease Control (CDC) report that one in five Americans are HIV-positive and don’t realize they have the virus. That number increases to half when looking at people under the age of 24. The CDC also state that the virus is still impacting populations very differently: black Americans are eight times more likely to have the disease, Americans living below the poverty line are six-times, and men who have sex with men (MSM) account for nearly two-thirds of all new cases.

These statistics at home are worrisome because of so many public awareness campaigns. The United Nations declared late last year that because of a global response and solidarity in combating the epidemic the end to the disease and its toll on human life was feasible, but the prevalence of new cases still remains high in the U.S. For a decade new cases of HIV have remained around 50,000, a great reduction from the 130,000 levels of the late-1980s, but as Dr. Kevin Fenton, the chief of AIDS prevention for the CDC, states it is still an “unacceptably high level,” where if not changed, “we’re likely to face an era of rising infection rates.”

This day is important not just for those don’t know their status, but also for those that do, and are still discriminated against.

A week before National HIV Testing Day, the American Medical Association (AMA) voted to oppose the Food and Drug Administration’s long-time ban of MSM from donating blood. The AMA vote was based on the fact that the policy is decades old and needs revision, is not based on sound science, and is discriminatory of an entire group rather than individual’s risk rates.

The AMA’s position reflects the growing trend of questioning the blood ban, though with statistics like those above, the FDA has plenty of excuses to delay lifting the ban, citing high population risks and not enough reliable technology.

Internationally, the current trend is to allow deferral periods for MSM before they can donate blood. Countries like Brazil, Sweden, the U.K., Australia, and Japan allow MSM to donate blood after not having sex with another man for at least one year. South Africa has the shortest time frame of six months, while Canada and New Zealand have a deferral period of five years. Chile, Italy, Mexico, Poland, Spain, and Uruguay, however, do not currently have bans on MSM blood donations and freely accept them.

The reason for these differences is because outside of the United States, HIV isn’t a gay men’s disease. The United Nations Programme on HIV/AIDS (UNAIDS) reports that in the main reason for risky sexual behavior is the lack of reliable education about HIV infection as well as access to condoms, and great social stigma. They also report that while new infection rates in Sub-Saharan Africa, the region with the largest amount of people with the disease, has stabilized, rates in South-East Asia continue to rise.

So even if you didn’t observe national testing day, you can—and should—get tested at a clinic. In fact, under The Health Care for America plan (ObamaCare) you should be able to get free HIV testing with your regular checkup. And if you did get tested recently, be sure it isn’t the only time you are tested, and always be sure of your status.

Shhh! Don’t mention IT – HIV

Then…and Now

In 1993, Philadelphia was one of the first mainstream Hollywood films to acknowledge HIV/AIDS, homosexuality and homophobia. In this movie, Andrew Beckett, played by Tom Hanks, was a lawyer who hides his AIDS-related lesions from his boss for fear of being fired.

Scene Not So Different Twenty Years Later

Flash to 2012 and those afflicted are still reticent. They are scared of losing their jobs, lovers or friends. According to a Harvard Law School’s Health Law and Policy Clinic study in 2009, more than one in five Massachusetts residents living with HIV reported that they “work hard” to keep their medical status private from everyone. Nearly half said they did not reveal their HIV status outside of their family.

Even Drs. Don’t Treat HIV Patients Well

Approximately 30% of a survey of 284 HIV positive people reported they had been treated badly by health care providers or felt stigmatized by not only support staff but the doctors themselves. One patient had her HIV status disclosed twice in South Shore Hospital: the retiree had two friends, visitors in her hospital room, when her doctor walked into the room and said,” I understand you have HIV.” Her so-called friends no longer speak to her as a result. (“Stigma of HIV keeps thousands silent” by Deborah Kotz, The Boston Globe, 8/13/12.) Another time, she didn’t tell anyone she was diagnosed with HIV in 1985. It went undisclosed until she was admitted to South Shore ten years later for seizures caused by the HIV infection. Without her approval, the doctor announced her HIV condition to her mother and brother in the waiting room.

Under federal law, providers can in some cases be fined for publicly disclosing health information without a patient’s consent. State law specifically prohibits health care providers from disclosing patients’ HIV status without their written consent.

New Law

As of last month, patients now have to give only verbal consent to their doctors. “We pushed for this law to normalize testing for HIV,” said Rebecca Haag, president of the AIDS Action Committee of Massachusetts. It should encourage more patients to get tested. It is estimated that 15 to 18 percent of Massachusetts’s 26 to 28,000 residents have HIV and don’t know they are carriers.

Old Myths Persist

Many people believe that the virus can be transmitted through toilet seats, food plates, drinking glasses, saliva, according to the federal Centers for Disease Control. They do not know that it can be spread only by blood or sexual intercourse.

Consequently, some say that they prefer to avoid people who are infected. HIVspecialists point to such attitudes as reasons for people at risk for HIV don’t get tested for the virus.