FDA eases blood donation restrictions against men who have sex with men

The FDA announced plans to ease a decades-old restriction preventing men who have sex with men from donating blood. A lifetime ban was put in place during the AIDS epidemic over fears of HIV transmission. The new guidelines would ask all potential donors about their recent sexual history. Cole Williams of Pride and Plasma joined Amna Nawaz to discuss the change.

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  • Amna Nawaz:

    The FDA today announced plans to ease a decades-old restriction preventing men who have sex with men from donating blood. A lifetime ban was put into place during the AIDS epidemic over fears of HIV transmission.

    The new guidelines would ask all potential donors about their recent sexual history, instead of singling out queer men. Any potential donors who had anal sex in the last three months with new or multiple partners would not be allowed to donate. Anyone taking medications to prevent HIV infections would also be deferred for a period of time.

    For more on this, I'm joined by Cole Williams. He founded the organization Pride and Plasma last spring to bring attention to this issue.

    Cole, welcome. And thanks for joining us.

    We have to point out that, for over a generation, gay and bisexual men have been shut out from donating blood as freely as anyone else and fighting for the right to do so.

    When you — when you think about this moment, how important is it right now?

    Cole Williams, Founder, Pride and Plasma: This is critical.

    This is the biggest reduction that we have seen since the policy was implemented in 1985. Every time that they cut it back, there was still a blanket deferment policy. This is the first time that we have really seen the FDA look at individual donors and see what their individual risk is.

  • Amna Nawaz:

    Cole, you came to this work from a very personal experience. During the pandemic, the nation was experiencing a blood supply shortage. Your whole family wanted to donate, as I understand.

    What happened?

  • Cole Williams:

    Yes, so there was commercials, you couldn't miss them, all the time on the TVs, and my family decided, as the four of us, that we wanted to go give blood.

    However, I knew that, because of the deferment policy, I wasn't eligible. And that led to not a tense conversation, but definitely a little bit of an awkward one, where I had to say, you know what, I can't. I wish that I could. But that's kind of the reality of the situation. And that's the impact of this policy.

  • Amna Nawaz:

    There are still a number of exclusions in place with the new policy too, as you mentioned, anyone taking oral medication to prevent HIV or the injectable PrEP treatment is still subject to months-long deferrals.

    Do those make sense to you?

  • Cole Williams:

    I'm going to say yes, I'm going to say no.

    I'm not entirely sure of the results of the advanced study, which enrolled around 1,800 participants. And then they looked at the effectiveness and safety of an individual risk assessment. So, when we are not having a blanket deferment policy anymore, I think that we still need to be looking at factors like, how else are you having sex while using PrEP and Truvada and other means of preventing HIV?

    Because HIV isn't the only thing that we are looking for when we're testing blood donations. There's also hepatitis and countless other sexually transmitted diseases that can still be transmitted through blood donation. So, until we see the results of the advanced study and potential new research studies on this specific issue, I can't really say whether it is justified or not.

  • Amna Nawaz:

    Cole, we spoke to Sean Cahill, who is the director of health policy research at the Fenway Institute. He has been on the front lines of this fight, fighting for equal rights for 14 years. He pointed out like the FDA was haunted by the experience in the 1980s, when thousands of people were given blood that had HIV in it.

    And he says they're trying very hard to balance these two things, right, allowing more people to donate, but also protecting the nation's blood supply. And he says they're doing a good job.

    Do you agree?

  • Cole Williams:

    I do agree.

    The testing and understanding of HIV that we had in the 1980s is vastly different decades later. In 1999, we implemented nucleic acid testing on a national level. With that, the current risk of HIV transmission through a blood transfusion is one in 1.5 million. So, we don't need to differ people based on their sexual orientation, not that we ever really needed to, but it was a lot more understandable back then.

    So I'm glad that the FDA is taking steps forward to discriminate a little bit less.

  • Amna Nawaz:

    There have been incremental steps over the years. But when you look back at when they have been taken, why they have been taken, why do you think it's taken the years that it has for these changes to be made?

  • Cole Williams:

    I think that one of the biggest reasons is just decreased stigma within the LGBTQ community within our country.

    But, also, when we saw the reductions in 2015 and 2020, from my understanding, there was not new research data. The advanced study was groundbreaking, not only in the number of participants that it had, but what it was talking about. We didn't have that beforehand. All the previous reductions were just based on public opinion.

    So, when we see that we don't have a blanket deferment policy or even a policy that looks at an individual's sexuality and sexual orientation, we just hadn't asked that question before and hadn't had evidence to back it up.

  • Amna Nawaz:

    When we're looking at these kinds of restrictions and how they're put into place, who they restrict, is this just about blood donations to you?

  • Cole Williams:

    Absolutely not.

    The FDA also handles tissue donation, which that includes your heart valves, your dura mater, your skin, tendons, bones, ligaments, a whole bunch of different tissues that people are waiting for in hospitals, that patients are in desperate need of. There's a five-year deferment policy for any man who has had sex with another man, regardless of the form, regardless if it was protected or safe, and whether that individual has been tested for STDs.

  • Amna Nawaz:

    Cole Williams, the founder of the organization Pride and Plasma, joining us tonight.

    Cole, thank you for your time.

  • Cole Williams:

    Thank you for letting me come on.

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