Beyond the Blood Ban

We need to get creative and empowered about HIV testing

by George M. Johnson

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It’s been seventeen years since President Clinton first declared June to be Pride Month in the United States, commemorating and highlighting the historical achievements of LGBTQ persons. A month which includes Pride celebrations across the country, now forever scarred with the remembrance of one of the deadliest shootings in the history of the United States. This year, we celebrated the one-year anniversary of the Pulse nightclub shooting, remembering those who have passed, and celebrating the lives of those still here. However, we also remember that day after the shooting—of long lines of LGBTQ persons trying, and not being able, to donate blood—and how, one year later, we’ve seen no progress towards creating change in the discriminatory practice.

The history:

In my article “The Orlando Massacre Revealed Hyper-Homophobia and HIV Stigma Outweighing Need for Blood Donors,” I discussed the history of this ban. To quote: “In 1983, at the beginning of the AIDS epidemic, the U.S. Food and Drug Administration (FDA) placed a ban on blood donated by any man who had sex with another man since 1977. This was seen as a precautionary measure due to a lack of reliable tests to screen blood for HIV and the disproportionate number of those affected coming from this particular community.”

This ban lasted for almost thirty years, when the FDA finally decided, in December of 2015, to make a “groundbreaking” decision to lift the total ban and allow MSM who hadn’t been sexually active for at least one year to donate blood. Although this move was seen as progress, it inherently promotes homophobia and perpetuates the stigma that those who are LGBTQ are more likely to have “tainted” blood. Now almost eighteen months into the new regulations, there is still concern around whether this ban does more harm than good, and if the FDA’s approach should be evaluated differently as the HIV epidemic is still a problem for marginalized populations in this country and worldwide.

Blood that is donated is tested for several abnormalities, including HIV. According to TheBody.com, “Blood donations are screened for several different infections that could be passed on to the recipient of the blood—including HIV. If donated blood appears to have HIV or any other abnormality, the donor will be notified within a few weeks. This may be by letter or telephone. It will be necessary to be tested again to confirm that the first test done was accurate and not a false positive.” This is a topic that is rarely discussed if ever, and hasn’t seen much in the way of statistics that discuss how many people find out they are HIV-positive through this medium. However, the American Red Cross urges “people who are concerned about their HIV status and those who may have undiagnosed HIV not to donate blood.” The tests are extremely sensitive but may miss early transmission of the virus, meaning it could be passed on through blood transfusion. Although this is a major concern, what if the FDA were able to streamline a process of testing blood that could not only reduce the risk of transmission but improve upon the notification process?

Should the ban be lifted, the natural thing to expect would be an increase in blood donations from the LGBTQ community. With the newest HIV technology, the antigen test is able to detect HIV much earlier than prior tests, which required the body to wait for antibodies to form. Using this test on blood donations could significantly reduce the concern for blood possibly having HIV in the early stages of detection and prevent it from going into a transfusion. If blood donations were treated as a means of testing, the HIV community could potentially reach clients that wouldn’t typically get tested due to stigma and belief in self-screening and protection methods. I would then suggest creating a position within the Red Cross and other blood donor depositories that would work as Community Healthcare Workers and Linkage to care specialists to contact these preliminary positives to work with the health departments in their cities to get a confirmatory test and finish the linkage to care process.

However, this attempt does provide some cons, most importantly the fear that people would reject the idea of donating blood if they knew that the FDA had measures in place to link them into care, instead of the current process of notification of potential exposure. Weighing out these scenarios is important as we strive to see a generation free of new HIV transmissions, and with less burden of discrimination and criminalization placed on those who are HIV-positive.

Although this measure could bring a fear of donating blood, I do believe that fear should be outweighed by what is in the best interest of the public, donor, and those needing blood. Which is creating a country working towards the reduction of HIV, while removing the discrimination, stigma, and the criminalization of the past.

We are now thirty years into fighting the epidemic, and although we have seen much progress, there is much concern moving forward as we continue to work through an administration looking to reduce HIV funding, with no real HIV strategy. Now is the time that we take radical action and put the systems in place necessary to detect new infections, using every method we have available.


George M. Johnson is a black queer journalist and activist. He has written for Ebony, TheGrio, JET, Teen Vogue, Huffington Post, Black Youth Project, and several HIV publications. Follow him on Twitter @iamgmjohnson.