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Blood Feud: Bay Doctor, AIDS Program Director Question Rules That Ban Gay Men, Some Members of Military From Donating Blood

Posted on: Monday, 24 April 2006, 12:00 CDT

By Ryan Burr, The News Herald, Panama City, Fla.

Apr. 24--In Bay County, the national restrictions on who can give blood delivers tough circumstances to both the gay and military communities.

There is a permanent deferral on donating blood for anyone who has lived in Europe for more than five years since 1980. This cuts out some military personnel and their families more than any other demographic as potential donors, said Christa Hild, a spokeswoman for Bay Medical Center.

At Bay Medical, the independent Southeastern Community Blood Center runs a donor site, and Hild said their staff is frustrated with the deferral for European residence because of the strong military presence Tyndall Air Force Base brings to the area.

"They like to donate," Hild said of the military. "They have that willingness."

Those who haven't spent more than five years in Europe may be eligible, so only a segment of the military population is restricted from donating blood.

For a gay person, however, there isn't much chance for donating. In 1985, amid fears about the spread of AIDS, the Food and Drug Administration banned any man who has had sexual contact with another man since 1977 from giving blood. The standard questionnaire for blood donors doesn't ask if the sex was protected or not.

The issue of gay men donating blood has regained attention since the American Red Cross, the American Association of Blood Banks and America's Blood Centers have asked the FDA to revise the deferral policy. Those groups met on March 8 with the FDA and suggested that the lifetime ban be changed to a one-year deferral -- meaning a man could donate after a year of having no sex with another man.

The recommendation to change the lifetime ban follows advances in testing for HIV and AIDS, specifically a quicker method that tests for the virus itself and shows results within several days, rather than testing for anti-bodies, which could take six weeks or more.

A local doctor and an AIDS program director support amending the FDA's policy on men who have sex with men, Dr. Dan Finley, who teaches emergency medicine at Gulf Coast Community College, questions the scientific premise for keeping the lifetime ban.

"Extending yourself to be overly precautionary is OK, but it needs to be based on science," he said.

There is logic, Finley said, to enforcing a one-year deferral. "It makes some sense as a safety cushion, but there is a need for blood. There are good, caring, decent people that want to help our community."

Finley said he thinks some gay men lie about their sexual history when giving blood. He said he understands why.

"Some questions are intrusive, on the edge of social acceptability," he said of the donor questionnaire.

Data from the Centers for Disease Control and Prevention shows that since the beginning of the AIDS epidemic in the early 1980s until 2004, men who have sex with men have accounted for 44 percent of AIDS diagnoses. The other main methods of transmission in this time period have been injection drug use, causing 24 percent of AIDS cases, and heterosexual contact, 13 percent. Other transmission categories contributing to AIDS cases were hemophilia, male-to-male sexual contact and injection drug use, receipt of a blood transfusion and unidentified risk factors.

Finley, who completed his doctoral dissertation on HIV and AIDS, said one of the compelling reasons the FDA should revise the policy on gay men is that male-to-male sexual contact used to account for nearly 70 percent of new AIDS cases in the early 1980s. "That shows more gay men have been taking precautions and practicing safe sex," he said.

A statement on the CDC Web site confirms that this trend existed, but it appears to be less true in recent years.

"The number of HIV diagnoses for MSM (men who have sex with men) decreased during the 1980s and 1990s, but recent surveillance data show an increase in HIV diagnoses for this group," the CDC says.

Valerie Mincey, executive director of BASIC NWFL Inc., a Panama City-based organization that offers free testing and case management and promotes HIV and AIDS awareness, sees the lifetime ban on gay men from donating blood as an extension of a stigma.

"It's what you do, not who you are that should be the determining factor," she said.

Heterosexual couples engaging in anal sex is just as risky a behavior as gay couples doing it, said Dale Bone, a local infectious disease doctor.

"They ought not to be giving blood, either," he said. "Anal receptive intercourse is the risk factor, and men who have sex with men is just a subdivision of that."

Another CDC report on the behaviors and groups of people who contracted HIV and AIDS from 2001 to 2004 shows that high-risk heterosexual contact -- defined as "contact with a person known to have or at high risk for HIV infection" --has been responsible for about 35 percent of those cases each of the four years. Male-to-male sexual contact accounted for about 41 percent of the cases in 2001 and increased to 47 percent in 2004. Injection drug use saw a decrease in the four-year period, from 21 percent to 16 percent.

One reason the lifetime ban has lasted as long as it has, said BASIC health planner Ron Brown, is that the effort to inform people on the truths of HIV and AIDS and see their actions reflect that in behavior and policy has been painstakingly slow.

"Oftentimes, we find ourselves facing the same perceptions here that we faced 20 years ago," he said of the disease. "There are people still afraid to shake hands with an HIV-positive person."

Brown also said he thinks a one-year deferral is justifiable for men who have sex with men, but the lifetime deferral "seems to have outlived its usefulness."

The Central Panhandle Chapter of the American Red Cross did not comment for this article because it "has no input or involvement in American Red Cross Biomedical policy," said Executive Director Bob Pearce. Bay County Health Department Director Peter Sylvester also declined to speak until the FDA had made a decision on whether to change the deferral period for men who have sex with men.

The FDA defends its policy in a statement, saying "scientific surveys have indicated that the overall prevalence of HIV infection in men who have sex with men (MSM) is 60 times greater than the non-MSM general population and 800 times greater than first-time blood donors."

Recent studies, according to the FDA, estimate that current behavior-based deferral policies are 85-percent to 99-percent effective in preventing donations from persons at a high risk for having a known infectious disease.

But the FDA is constantly working with other agencies to assess new information on infectious diseases and blood safety, and FDA spokeswoman Susan Cruzan said the agency "is open to possible alternatives to deferrals."

The FDA's Blood Products Advisory Committee will meet later this year to consider changing the policy that prevents gay men from donating, Cruzan said.

Meanwhile, nothing has improved with the nation's blood shortage, blood agencies say.

The Northwest Florida Blood Center, which provides blood to 20 hospitals from Pensacola to Panama City, has suffered recently from this problem.

In February of this year, typically when the least number of people donate, the center had to import 700 pints of blood from other donor sites, said Betty Roberts, vice president for donor services.

There was also a special case recently where the Northwest Florida Blood Center was asked to provide more blood than usual. Roberts said her management made calls to 36 other blood centers, but none of them had blood to spare. The next step was to make an emergency request for communities to donate, which resulted in a satisfactory turnout to accommodate the situation, she said.

The blood shortage may worsen, Roberts added, because many of the Northwest Florida Blood Center's elderly donors "are having health issues as they're getting older, so they can't donate. But our population is increasing."

Roberts said her center's goal for the entire Panhandle is to collect 175 pints of blood per day, a modest amount considering that several automobile accidents can wipe out a whole day's inventory. Roberts said for each car accident, it takes at least five pints -- or as many as 100 -- just to stabilize an injured person.

Bay Medical doesn't receive enough blood at its donor site sustain its demands, so it has to purchase additional blood from the Red Cross and the Southeastern Community Blood Center, Hild said. Last year, 7,000 units of blood were used, but less than 40 percent of that came from donations.

Better results are hoped for this year since the hospital is getting a mobile unit in the summer that will allow community blood drives to be hosted, Hild added.

No blood bank tracks the number of gay men who are turned away. At Bay Medical and other Southeastern Community Blood Center, Hild said, "a lot of people walk out after reading (the questionnaire) before we know why."

If the lifetime blood donor ban on gay men was switched to one year, blood banks would have a tremendous job in updating communities of the change, said Carol Daws, communications director for the Southeastern Community Blood Center in Tallahassee.

"There would have to be a whole education process because many gay men would assume that they can never donate again," she said.

The blood donor policy affecting gay men also gained attention in Tallahassee on April 5, when students from Florida State University came to a blood drive to hand letters to staff with the Southeastern Community Blood Center. All of the 122 letters were in support of changing the ban on gay men, Daws said. Those letters have been forwarded to the FDA.

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Copyright (c) 2006, The News Herald, Panama City, Fla.

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Source: The News Herald

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