The FDA Has a New Abstinence Recommendation for Gay Men to Donate Blood — But Is It Valid?

Experts say the one-year abstinence recommendation isn’t as arbitrary as it may sound. (Photo: Priscilla De Castro for Yahoo Health/Getty Images)

The FDA released new recommendations on Tuesday that would end a three-decade ban on gay and bisexual men donating blood in the U.S. The ban started in 1983 during the AIDS crisis and has been labeled as discriminatory by several activist groups and medical associations.

The new guidelines recommend that establishments that collect blood revise their donor referral criteria for men who have sex with men (MSM) from a complete ban to allowing men who have abstained from having sex with another man for a year to donate. (Currently, men who have had sex with other men since 1977 cannot donate blood in the U.S.)

The FDA decided to change the recommendation due to more sensitive tests for HIV and after seeing evidence from countries like Japan, the U.K., Brazil, and Australia, which saw no adverse effects on the safety of their blood supply with a one-year abstinence or “deferral” recommendation.

But while many groups say the new recommendation is a good first step, they point out that it’s still discriminatory.

“It still falls far short of a fully acceptable solution because it continues to stigmatize gay and bisexual men,” David Stacy, government affairs director of the Human Rights Campaign, said in a statement.“This policy prevents men from donating life-saving blood based solely on their sexual orientation rather than actual risk to the blood supply. It simply cannot be justified in light of current scientific research and updated blood screening technology.”

Related: US Moves Toward Dropping Lifetime Ban On Gay Blood Donation

GLAAD has taken a similar stance, but has found a humorous angle on the recommended guidelines. The organization issued a Celibacy Challenge in response to the new recommendation, with a spoof video featuring actor Alan Cumming who jokingly recommends all of the things gay and bisexual men can do to make the year of abstinence “fly by.”

But what is the reasoning behind waiting a year to donate blood? Does it really make a difference?

It actually does, says infectious disease and HIV clinician Louis Katz, MD, chief medical officer of America’s Blood Centers. He explains why: When blood is drawn for donation, it’s tested multiple times before it enters a blood bank. It undergoes two tests for HIV, two for hepatitis C, and three for hepatitis B. However, there’s an interval of time after a person has been infected where a test may not be positive, which can be anywhere from a few days to several weeks.

“One year isn’t quite as arbitrary as it sounds,” Katz tells Yahoo Health. “This window period where tests won’t detect certain diseases means that we have to continue with some level of deferral for the behaviors that put you at risk for infection.” Once that time frame is up, Katz says, the tests are “astoundingly good” at detecting diseases.

Related: HIV’s Ability to Cause AIDS Is Weakening Over Time, Study Says

Katz says the recommendations are trying to reduce risk based on data, and notes that there are also restrictions placed on people who have used drugs and those who have had sex with a person who has AIDS.

“It’s doing the best we can with imperfect tools,” he says. “As a physician, I have to be able to make good-faith efforts to protect the safety of the blood supply.” (Currently the chances of contracting HIV from a blood transfusion are 1 in 1.47 million, per the FDA.)

According to the Centers for Disease Control and Prevention, gay and bisexual men are “more severely affected” by HIV than any other population in the U.S. In 2010, gay and bisexual men accounted for 63 percent of estimated new HIV infections in the U.S. and 78 percent of infections among newly infected men.

Katz acknowledges that making recommendations based on safe sex practices makes sense in theory, but points to preliminary data from Europe that found a risk of having infected blood actually increased when people were filtered for blood donation based on safe sex practices. However, he stresses that more testing on this method needs to be conducted.

“We’ve taken an incredible step to go from a lifetime ban to a one-year deferral,” says Katz. “Once we have a data set from this change, we’ll look at what else is possible.”

Per FDA practice, the new draft recommendations will be open for a 60-day comment period from the public, which starts on Friday, May 15.

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