In 1983, the U.S. Department of Health and Human Services and the Food and Drug Administration instituted a blood-donating ban for any man who had had sex with another man since 1977.
After years of debate, the FDA finally proposed easing the rules to allow donations from men who have not had sex with another man for at least a year. As a gay man and public health professor specializing in HIV/AIDS prevention, I am disheartened by the FDA's suggested modification on the 32-year ban.
Even in its latest iteration -- the FDA proposed the change last month -- the rule still has stigma and discrimination written all over it.
For 12 years, I have dedicated my career to working with vulnerable and at-risk communities on safe-sex behaviors and sex-positive messaging, researching ways to expand rapid HIV testing into less traditional settings such as the dentist's office and local pharmacy, and preparing the future public health workforce to use evidence-based methods and tools when working with marginalized and medically underserved communities. Although I understand our government's early response to the HIV/AIDS epidemic, times have changed. Now, in the United States, a gay man living with HIV who takes his medication regularly can enjoy a life expectancy of 77 years, about the same for an HIV-negative man.
A fundamental principle we teach students is that public health should achieve community health in a way that respects the rights of individuals in the community. Does the FDA value the rights of the lesbian, gay, bisexual, transgender, and queer community it serves? The short answer is when it is convenient to do so. Why is it acceptable for heterosexual men or women to have sex with sex workers and other high-risk populations like intravenous drug users and still potentially donate blood, but any man who has had sex with another man cannot? Many members of the community, including myself, are left trying to make sense of policies that are conflicting and difficult to enforce.
HIV is no longer a "gay disease." People with HIV who are on antiretroviral therapy enjoy long, healthy lives. Effective prevention strategies include biomedical advances such as pre-exposure prophylaxis (better known as PrEP), a daily pill to prevent HIV infection in high-risk behaviors. Sensitive and specific diagnostics are available to detect acute HIV infection. Additionally, all donated blood is tested numerous times for HIV and hepatitis B and C. This policy needs to fit the reality of the world we now live in.
I recommend that everyone, regardless of gender or sexual identity, be allowed to donate blood. Long Island, as well as most parts of the country, is experiencing shortages of donated blood. The New York Blood Center requires more than 2,000 volunteer blood donations each day to meet the transfusion needs of patients in close to 200 New York and New Jersey hospitals. If all blood undergoes testing for transmissible diseases, why discriminate against some populations?
I applaud the FDA for initiating the process to revise this archaic policy, but would remind the agency that its own parent organization, the DHHS, states that it works "to improve the health and well-being of all Americans, including those who are lesbian, gay, bisexual and transgender."
My message to the DHHS and FDA: It's is time to make good on your commitment.
My message to the gay community: We have until July 14 to have our voices heard through the FDA's public comment period. Now is the time to raise your voice!
Anthony Santella is an assistant professor of health professions at Hofstra University in Hempstead, and a former director of HIV Policy, Planning and Implementation at the New York City Department of Health and Mental Hygiene.