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Mon August 1, 2011
Questions about blood donation screening
The American Red Cross says they're facing a critical shortage to the nation's blood supply. And blood donations often drop in the summer when people are busy or traveling.
So they want you to give.
When we posted information about the appeal on our Facebook page, it sparked a debate about blood donor screening.
Not everyone can give blood. Only about 37% of us can. Donors are pre-screened for potential exposure to diseases to keep the blood supply safe.
But many people feel some healthy donors are needlessly kept from donating blood.
It had been more than fifteen years since I donated blood, so I decided it was time to give again and see what the process was like today.
My local Washtenaw County Red Cross has a brand new building. (It's brand new to me anyway.)
And when you go in to donate blood, one of the things they ask you to do is sit in a room by yourself and answer some questions.
A lot of questions. More than 45 questions on a computer screen
This is known as the self-deferral questionnaire.
And depending on your answers, they might not want your blood.
They ask questions like:
- In the last year, have you had an accidental needle stick?
- In the last year, had a tattoo or a body piercing?
- In the last year, have you come into contact with someone else's blood?
- In the last year, have you had sexual contact with anyone who has HIV/AIDS?
The list goes on.
And then there's the question that many say needlessly keeps some men from donating blood:
- Male donors: from 1977 to the present, have you had sexual contact with another male… even once?
Kyle Carlson is a second year law student in Chicago:
"When I was a junior in high school, I knew I was gay but I wasn't out at the time," says Carlson. "And I went to a school blood drive and I was shocked to be asked about my, you know, same sex sexual history. It was kind of a shocker and it always stuck with me."
Carlson says he wasn't sexually active then, so he was able to give. At the time, he thought there must be a good reason for keeping all gay men from giving blood.
"So it kind of just simmered until after I came out and had an opportunity to study it in a little greater detail where I found out that the scientific underpinnings of the policy are kind of… not there," says Carlson.
Today, Carlson runs the website "Saving Lives with Helpful Guys" and is working to change the lifetime ban on blood donations from gay men.
The policy does not come from the American Red Cross.
It comes from the U.S. Food and Drug Administration, the agency responsible for making sure the nation's blood supply is safe.
The policy was put in place in 1983. The acronym for the disease "AIDS" had just been coined the year before, and scientists were struggling to understand the emerging epidemic.
At the time, there were no reliable tests to detect the virus, so the FDA decided that banning all gay men from donating was the safest way to protect the blood supply.
But many medical professionals, politicians, and others say a lot has changed in thirty years. We know how the disease spreads - primarily through unprotected sex and unsterilized needles.
The disease still disproportionately affects gay men, but the FDA says prevalence of the disease is rising in young heterosexual women. Today's blood tests can detect the virus in a little over a week after exposure.
Dr. Barry Siegfried is the Medical Director for the American Red Cross Great Lakes Blood Services Region. He says the Red Cross supports changing the lifetime ban for gay men.
"We feel that it is not supported by the evidence," says Siegfried. "That it is discriminatory in the sense that it's different for other high risk groups."
Siegfried says the Red Cross supports changing the policy to at least reflect the one-year deferral period for other groups.
Under the current policy, gay men who are in a monogamous relationship and have protected sex are still banned for life, but people who have had sex with a prostitute or an intravenous drug user are only deferred from giving blood for one year.
The deferral period gives a potential disease enough time to show up on a test, and one year is plenty of time for today's HIV tests.
A one year deferral still would prevent sexually active gay men from donating blood, but advocates say it would at least end the lifetime ban.
(The UCLA Williams Institute for Sexual Orientation Law and Public Policy estimates that if the ban were lifted, "it could add 219,000 pints each year to the nation's blood supply, an increase of 1.4%.")
Others say protection of the blood supply is not about the donor, it's about the people who get the blood.
People with hemophilia are at risk for excessive bleeding. They are dependent on the blood supply, and they take injections to help their blood clot normally.
In the 1980s, people with hemophilia were devastated by the AIDS epidemic. Around half of them contracted HIV. As a group that is dependent on the supply, they're cautious about making changes to the FDA's screening policies.
Mark Skinner is the president of the World Federation of Hemophelia. Last year, a federal advisory group was considering whether or not to change the lifetime ban on gay men. Skinner testified in front of that group.
"We said right up front in our testimony that we recognize the policy is discriminatory," says Skinner. "We fully appreciate that, and we are willing to work to remove a discriminatory practice if it does not harm the public health, and that's why we called for a research agenda to do that."
The federal advisory group called the lifetime ban on gay men quote "suboptimal." They recognized the self-deferral policy allows some high risk individuals to donate, while turning away some low-risk individuals, but they voted 9 to 6 to keep the ban in place and called for more research.
Just last week, the Department of Health and Human Services announced plans for studies that could eventually lift the lifetime ban on all gay men. Those studies are dependent on funding and they could take years to complete.