I have heard the gay community complain that the Red Cross/FDA discriminate against them by refusing to allow men who have sex with other men (MSM) to donate blood.

Here is an article on Wikipedia about the controversy:

Many LGBT organizations view the restrictions on donation as based on homophobia and not based on valid medical concern since donations are rigorously tested to rule out donors that are infected with known viruses such as HIV, Hepatitis B, and Hepatitis C. They state the deferrals are based on stereotypes. Proponents of the lifetime restriction defend it because of the risk of false negative test results and because the MSM population in developed countries tends to have a relatively high prevalence of HIV/AIDS infection.

Does the current US FDA policy of deferring MSM from donating blood for one year after the last sex act decrease the odds of STDs being transmitted compared to open donations? Does it increase the number of lives saved by blood transfusions?

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    Himarm, gerrit, dsollen, and Oddthinking: Do not use this site as a forum. Don't put your "answers" and relative debate in the comments. These will just get systematically deleted and won't earn you any rep.
    – Sklivvz
    Jun 17, 2015 at 16:55
  • @JackAidley please don't use comments for answers, especially right after where I asked you not to... :-)
    – Sklivvz
    Jun 19, 2015 at 12:57
  • @Sklivvz: It wasn't an answer because it didn't address the specific question asked which was about the USA. Hence making it a comment since it informed but didn't answer. Jun 19, 2015 at 13:13
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    Was trying to figure out how the mainstream media (MSM) factors into this... :D Oct 20, 2016 at 19:33
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    @AndrewMattson well you know the extreme-right keeps telling everyone the media is helping to push the gay agenda. so apparently the MSM are in league with the MSM! it's so obvious now, how couldn't we see it!?
    – dsollen
    Oct 20, 2016 at 20:02

2 Answers 2



The FDA has recently (15 May 2015) released a draft guidance:

Revised Recommendations for Reducing the Risk of Human Immunodeficiency Virus Transmission by Blood and Blood Products

This does not necessarily mean a new policy will actually be implemented.

Public comments need to be considered.

The period for public comments ends 15 July 2015

Comments can be filed at this link

The OP is misrepresenting current US government (including FDA) policy.

The current FDA donor questionnaire asks

From 1977 to the present, have you

  1. Male donors: had sexual contact with another male, even once? (Females: check “I am female.”)

Boldface in original text.

On 23 December 2014 the FDA released a statement:

The U.S. Food and Drug Administration is a science-based regulatory agency that works to protect and promote the public health. In this role, it is our responsibility to regulate the blood supply and to help ensure its continued safety for the patients who receive these life-saving products.

Over the past several years, in collaboration with other government agencies, the FDA has carefully examined and considered the available scientific evidence relevant to its blood donor deferral policy for men who have sex with men, including the results of several recently completed scientific studies and recent epidemiologic data. Following this review, and taking into account the recommendations of advisory committees to the U.S. Department of Health and Human Services (HHS) and the FDA, the agency will take the necessary steps to recommend a change to the blood donor deferral period for men who have sex with men from indefinite deferral to one year since the last sexual contact.

This recommended change is consistent with the recommendation of an independent expert advisory panel the HHS Advisory Committee on Blood and Tissue Safety and Availability, and will better align the deferral period with that of other men and women at increased risk for HIV infection. Additionally, in collaboration with the NIH’s National Heart Lung and Blood Institute (NHLBI), the FDA has already taken steps to implement a national blood surveillance system that will help the agency monitor the effect of a policy change and further help to ensure the continued safety of the blood supply.

The FDA intends to issue a draft guidance recommending this proposed change in policy in 2015, which will also include an opportunity for public comment. We encourage all stakeholders to take this opportunity to provide any information the agency should consider, and look forward to receiving and reviewing these comments.

In other words, while the FDA stated that it intends to pursue a change in policy, the change has not yet occurred or even been officially proposed.

The FDA page with the above statement still links to Blood Donations from Men Who Have Sex with Other Men Questions and Answers

which clearly states:

What is FDA's policy on blood donations from men who have sex with other men?

Men who have had sex with other men (MSM), at any time since 1977 (the beginning of the AIDS epidemic in the United States) are currently deferred as blood donors. This is because MSM are, as a group, at increased risk for HIV, hepatitis B and certain other infections that can be transmitted by transfusion.

Why doesn't FDA allow men who have had sex with men to donate blood?

FDA's primary responsibility with regard to blood and blood products is to assure the safety of patients who receive these life-saving products. FDA uses multiple layers of safeguards in its approach to ensuring blood safety, which include donor screening and deferral based on risk factors, blood testing for markers of infection, inventory controls, and deferral registries. The use of these multiple layers helps to assure the safety of the products in the event that one layer fails.

A history of male-to-male sex is associated with an increased risk for exposure to and transmission of certain infectious diseases, including HIV, the virus that causes AIDS. Men who have had sex with other men represent approximately 2% of the US population, yet are the population most severely affected by HIV. In 2010, MSM accounted for at least 61% of all new HIV infections in the U.S. and an estimated 77% of diagnosed HIV infections among males were attributed to male-to-male sexual contact. Between 2008 and 2010, the estimated overall incidence of HIV was stable in the U.S. However the incidence in MSM increased 12%, while it decreased in other populations. The largest increase was a 22% increase in MSM aged 13 to 24 years. Since younger individuals are more likely to donate blood, the implications of this increase in incidence need to be further evaluated.

Isn't the HIV test accurate enough to identify all HIV positive blood donors?

HIV tests currently in use are highly accurate, but still cannot detect HIV 100% of the time. It is estimated that the HIV risk from a unit of blood has been reduced to about 1 per 2 million in the USA, almost exclusively from so called "window period" donations. The "window period" exists very early after infection, where even current HIV testing methods cannot detect all infections. During this time, a person is infected with HIV, but may not have enough virus or have developed sufficient antibodies to be detected by available tests. For this reason, a person could test negative, even when they are actually HIV positive and infectious. Therefore, blood donors are not only tested but are also asked questions about behaviors that increase their risk of HIV infection.

Collection of blood from persons with an increased risk of HIV infection also presents an added risk to transfusion recipients due to the possibility that blood that has already been collected and is being stored in a blood bank may be accidentally given to a patient in error either before testing is completed or following a positive test. Such medical errors occur extremely rarely, but given that there are about 17 million Whole Blood and red blood cell donations collected each year in the USA, they can occur.

So the FDA agrees the current policy is wrong, and intends efforts to change the policy, but the current policy is still any time since 1977, not just in the last year.

If the FDA does follow through on its intention to propose draft guidance, it will be listed at Recently Issued Guidance Documents.

Even if there is such a proposed draft guidance, it will still be accompanied by the statement "Draft regulations and guidances are documents that have been proposed, but FDA has not made a decision as to whether the proposal will be adopted in whole, in part, or not at all." (emphasis added) and followed by a time period (such as two month) for comments.

  • That is true, however, I was wanting to focus on the new policy, since it's about to take effect this year. No reason discussing old policies that are already going away :)
    – dsollen
    Jun 17, 2015 at 19:47
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    @dsollen but they haven't even officially proposed the new policy yet. They need to officially propose, collect public comments for a period after proposing, consider all the comments, and then publish a final rule (if still appropriate considering the comment) and responses to all the comments.
    – DavePhD
    Jun 17, 2015 at 20:09
  • my understanding was that this was already proposed and accepted, with the policy change scheduled to be put in effect by the end of 2015; essentially were only being held up by the time it takes to change procedures and systems to implement the policy change. Is my understanding wrong?
    – dsollen
    Jun 17, 2015 at 20:13
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    @dsollen Wikipedia might imply the policy takes effect this year, but FDA merely said "intends to issue a draft guidance recommending this proposed change in policy in 2015", which is much different than taking effect in 2015.
    – DavePhD
    Jun 17, 2015 at 20:15
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    I'm putting my hand up to say I edited the question, and if it misrepresents the FDA position, I may be to blame. I don't think clarifying the FDA position answers the base question though. It may make it unnotable though.
    – Oddthinking
    Jun 18, 2015 at 3:26

The waiting period absolutely decreases the chance of HIV transmission; HIV can take up to six months to become detectable.

Once a person is infected with HIV, it generally takes about 3 months for the body to produce enough antibodies to be detected by an HIV antibody test. (For some people, it can take up to 6 months.) Some HIV tests can detect HIV directly in the blood before HIV antibodies are detectable Aids Info

As gay men are the most at-risk group for HIV, it only makes logical sense to give them the wait period, though not doing so for any sexually active individuals is a point of contention, but the original FDA policy was a lifetime ban.

The wait period is a vast improvement from a ban (no source necessary for this; this is a group which could not donate before so all blood donated after the wait period is a net gain), and it also serves to lessen the chances of HIV infected blood going through, which saves lives in its own right.

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    The question isn't 12-months deferral versus ban, it is 12 month deferral versus open donation. If there is a shortage of blood, accepting the higher risk of undetected HIV may outweigh the risks of running out. Your answer does not address this. Appealing to "logical sense" isn't a robust argument.
    – Oddthinking
    Jun 17, 2015 at 19:09
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    @Oddthinking The value of a human life isn't quantifiable in any way that would be acceptable on this forum. Half a million gay men have HIV (see CDC link), there's roughly 6 million known gay men (CDC, again), so there's a roughly 8% chance of a gay male donor giving a tainted donation. By the eighth gay male donor, there's roughly a 50% chance that at least one blood donation is tainted, and someone's life could be ruined by it. Jun 17, 2015 at 20:33
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    @dsollen To add to the above, for comparison, straight men have a roughly 0.1% chance of having HIV (they make up 24% of the HIV cases in males, they are also 24 times larger a group than gay males). So gay men are 80 times as likely to give tainted samples without this screening. Jun 17, 2015 at 20:38
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    Additionally, your numbers make sense only if you assume that either a) most of those infected gay men do not know they are HIV positive or b) they do know but still offer to donnate blood (in other words, there is no correlation between HIV positive people and blood donnors). While there may be a number of people in either a) or b) cathegories, I would say that most of that infected 8% will not donate blood. The numbers also rely in HIV not being detectable by test (which they are, unless it is in its early stages).
    – user21355
    Jun 17, 2015 at 21:59
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    @Axelrod: You haven't addressed my comments. You have not shown that more lives would be lost with a (slightly?) higher number of HIV+ donors. Take issues about whether we accept "logic" to Meta, where they have already been debated to death.
    – Oddthinking
    Jun 18, 2015 at 3:23

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