The state’s leading advocacy group for doctors and a Boston-based health care center are urging the US Food and Drug Administration to further ease restrictions on blood donations by gay and bisexual men, calling the practice both discriminatory and problematic amid a national blood shortage.
Massachusetts Medical Society and Fenway Health have partnered to press the federal government to adopt an enhanced screening process for blood donation, instead of excluding men who have sex with men.
Gay men have been barred from donating blood since the 1980s, because of fears over HIV and AIDS. The FDA subsequently revised its policy in 2015 to allow gay and bisexual men to donate blood if they had abstained from sex with other men for a year. In 2020, the FDA again adjusted the abstention window to 90 days.
While the two organizations said they were grateful for the revisions, they said the policy does not go far enough, especially in light of ongoing national blood shortages and a lack of evidence that those donors posed more danger than others.
“The pandemic has rightfully brought about an increased effort to educate the public on the importance of science as it pertains to health care,” said a statement signed by Carole Allen, president of the Massachusetts Medical Society, and Sean Cahill, director of health policy research at The Fenway Institute, the research and policy arm of Fenway Health. “Scientific advances have dramatically improved blood screening and there remains no evidence to suggest that including men that have sex with men in the pool of available blood donors poses an increased risk of adverse outcomes to patients in need.”
A revised policy would enhance individual screening for people by asking potential donors about high-risk behaviors rather than relying on sexual orientation alone. Such a policy would be in line with newer guidelines in the United Kingdom, France, Argentina, and Brazil.
The calls come in the midst of what the Red Cross has said is the worst national blood shortage in a decade. In January, the organization declared its first-ever blood crisis.
According to the Red Cross, overall blood donations in the United States have declined 10 percent since March 2020, both because of concerns about hosting blood drives during the pandemic and also because college and high school blood drives have been stymied during the pandemic, when many campuses went virtual. Although student donors used to make up 25 percent of donors in 2019, during the pandemic that fell to just 10 percent.
The issue became so severe that the state’s largest health system, Mass General Brigham, recently created a policy on how it might ration blood if levels drop below critical thresholds, and instituted new policies to share blood throughout the system and try to reduce demand.
While blood shortages aren’t as worrisome for Mass General Brigham now as they were during the Omicron surge, system officials also advocated for individualized risk assessments.
“Mass General Brigham recognizes the complexity of this topic and deep pain and hurt that discriminatory practices have caused to members of the LGBTQ community,” said Dr. Paul Biddinger, medical director for emergency preparedness at Mass General Brigham.
“We deeply support all efforts to better individualize risk assessment for HIV in prospective blood donors, and encourage the FDA and other national bodies to fund and support this research so that we can ensure no low-risk person is unfairly prohibited from donating to our nation’s blood supply,” Biddinger added.
The Human Rights Campaign, one of the nation’s largest lesbian, gay, bisexual, transgender, and queer civil rights organizations, has also pushed for a policy of individual risk assessments, and urged the FDA to update its questionnaire in January.
The Massachusetts Medical Society, which counts 25,000 members, has advocated for such a change for years, with an internal policy since 2006 calling for blood donation bans or deferrals to be applied to donors according to their individual level of risk and not on sexual orientation. The organization also pushed the federal government to end its lifetime ban of donations by gay and bisexual men in 2012.
MMS has also been at the forefront of policy changes in the past. In 2020, the organization adopted a policy recognizing cannabis as a medical therapy — a massive shift from what were previously prescriptive requirements for physicians to recommend cannabis.
Cahill, of the Fenway Institute, has been advocating for such changes around blood donation for more than a decade. Most recently he published an opinion piece with Amitai Miller, a Harvard Medical School student, in the New England Journal of Medicine in October calling for a policy change.
Blood donations among gay and bisexual men is particularly relevant for Fenway Health, which said half of its 35,000 patients are in the LGBTQIA+ community.
“It’s a policy that was put in place 37 years ago,” Cahill said. “It’s not the appropriate policy for today.”