The Food and Drug Administration (FDA) has announced significant changes to its donation policy, allowing gay and bisexual men or men who have sex with men (MSM) to donate blood.
For decades, restrictions prevented MSM from donating, citing concerns that their blood could lead to the spread of HIV/AIDS. Although blood is screened for disease and infections before use, virtually all gay and bisexual men were still prohibited from donating.
Under updated FDA guidelines, MSM in monogamous relationships will not need to abstain from sex before giving blood. All donors will be asked the same set of questions under the new risk-based policy, regardless of how they identify.
Read on to understand background about the blood donation ban, why the FDA has made this significant policy change and what it means to you.
Why was there a ban on blood donations for gay and bisexual men?
During the 1980s, there was a lot of fear surrounding the HIV/AIDS epidemic.
“When the epidemic first became known, HIV (human immunodeficiency virus), the virus that causes AIDS, had not yet been discovered, but studies revealed that people in the MSM community were at the greatest risk of contracting HIV and spreading it to others,” said Christopher J. Gresens, MD, medical and laboratory director for Vitalant, West Division.
In 1983, the FDA issued a lifetime ban on blood and plasma donation for MSM based on its limited knowledge about HIV and how it was spread. While perceived by many as harsh and discriminatory, the rule was intended to keep HIV out of the blood supply.
“At that time, medical experts did not largely understand HIV/AIDS and the technology and procedures to test donated blood for HIV were very limited,” said Randy S. Gelow, MD, a family medicine physician with Banner Health, who specializes in HIV and LGBTQ+ specialty care. “While the ban was intended to help stop the spread of HIV, it appeared to have been made to exclude a subpopulation of people completely.”
What questions will I be asked if I want to donate blood?
Under the new guidelines, all prospective donors will be asked about their recent sexual history. The more targeted questions will focus on whether someone has had new or multiple partners and anal sex in the last three months.
Potential donors will be turned away if the answer is “yes” to the questions. Prospective donors who answer “no” to the questions may be eligible to donate, provided they meet all other eligibility criteria.
People can also be considered ineligible if they have:
- Exchanged sex for a form of payment in the last three months
- A history of non-prescription injection drug use
- Had a positive test for HIV or taken any medication to treat HIV infection
- Recently had certain tattoos, or ear or body piercings
- Taken PrEP (pre-exposure prophylaxis) or PEP (post-exposure prophylaxis) for HIV prevention
If you take oral medications to prevent HIV, such as PrEP or PEP, you must wait three months from your most recent dose to donate. If you take injectable PrEP to prevent HIV infection, you must wait two years from your most recent injection.
“The available data shows that the use of these preventive medications could delay the detection of HIV by licensed screening tests for blood donations, potentially resulting in a false negative result that is associated with an HIV-infectious unit of blood,” Dr. Gresens said.
Why make the changes to blood donations now?
Over the years, much has changed in our understanding of how HIV is transmitted, and the risks associated with different activities. Advancements in testing and stricter protocols have helped nearly eliminate HIV transmission through blood transfusions.
In 2015, the total ban was eliminated, and MSM were allowed to donate blood if they abstained from sex for one year. Then, in 2020, during the height of COVID-19, it was lowered to complete abstinence from sex for three months.
“We’ve come a long way during recent years, owing largely to the strong work by scientists and policymakers of goodwill and the communities who have urged and championed progress,” Dr. Gresens said.
This change is important as the United States’ blood supply has been critically low, and an influx of new donors could save millions of lives.
“There is an estimated 7% to 10% of the population who identify as LGBTQ+, and removing this ban increases the potential pool of people by millions,” Dr. Gelow said. “Removing gender and sexual orientation discrimination from the risk assessment for blood donation will take us in the right direction to address stigmas and discrimination against MSM and help save more lives.”
When and how often can I start donating blood?
You should wait at least eight weeks between regular whole blood donations and 16 weeks (about 3 and a half months) between double red blood cell donations to allow your body a chance to recover and produce more blood cells to replenish what you lost.
However, Dr. Gresens noted, “You may be able to come in more often if you solely donate non-red blood cell-containing blood products, such as platelets and plasma.”
“Waiting these periods can help your body recover the blood cells and nutrients needed to avoid you from becoming anemic or having any long-term effects from frequent blood donations,” Dr. Gelow said. “If you are donating regularly, eating a well-balanced meal or supplement with a multivitamin that contains iron is important.”
Gay and bisexual men or MSM will soon be able to donate blood without having to abstain from sex for months, after decades of being banned. The FDA has updated its recommendations, so all potential donors are asked the same screening questions.
This change will expand the number of people who can donate blood in the U.S. by millions.
Are you interested in donating blood? Contact your health care provider or nearest blood donation center to discuss your eligibility.