Donating blood: The who's who of who's acceptable

[sweetasmeli]

Just wondered what you guys and gals might make of this…

Although I know that we pozzies can’t donate blood, I was interested to discover the line of questioning that would-be-donors in the UK have to complete to be accepted.

The link below is taken from the NHS National Blood Service website; you need to click on where it says ‘Click here’ in red to view the questions in flash form. Answer question 10 with ‘no’ obviously, or you will not be able to continue with the questions; in fact if you want to read all the questions you will have to answer 'yes' to question 1 and 'no' to all of questions 2-18. From question 12 to 18 especially, pay close attention to the wording.

http://www.blood.co.uk/pages/flash_questions.html

Incidentally, for kicks, I answered question 12 with 'yes' just to see what would happen…I was immediately told that I was not able not give blood. So evidently, if you are a man who has had oral or anal sex with another man (even if you used a condom), you are deemed unsuitable as a blood donor.

And question 18 is interesting; I wonder which parts of the world (other than Africa that is already mentioned) the Blood Service people deem “very common” for HIV/AIDS?

The line of questioning left me somewhat befuddled; as well as insinuating that condoms are ineffective protection against STDs, basically, it seems to suggest that HIV/infectious diseases can only be transmitted through gay men, prostitutes or intravenous drug users and in countries where HIV/AIDS is ‘very common’.

Not anywhere is it asked whether the applicant has engaged in unprotected sex with men or women, regardless of sexual orientation. Nor is it asked if the applicant has been recently screened (and been given the all clear) for hepatitis and STDs.

Good to know that HIV education has come so far and the message is getting across that HIV/other STDs don’t discriminate.

---Insert sarcastic emoticon---

Debra

[vokz]

I totally disagree with your take on this .. and I am mightily relieved to see that THT do too.

Several 'high risk' groups are screened out of the process and this supposed discrimination is nothing more than a rational means of significantly reducing the odds of contaminated blood entering the blood supply.

Contrary to popular belief, there is no 100% effective screening process for blood donations.

One unit of donated blood doesn't just treat one person. Blood is processed into various different products, so one unit could treat a dozen or more people.

A unit of blood doesn't stay isolated trough the whole processing system. Units of blood are batched together for industrial processing, so a single unit of contaminated blood entering the supply, and batched for processing, can contaminate blood products given to hundreds of different people.

FACT: More than 70% all heterosexually acquired HIV infections diagnosed in the UK were acquired in Sub-Saharan Africa.

FACT: Unless answering anonymously, men who have sex with men are (as a group) prone to lie about their behaviour.

Give gay men the cover of anonymity (http://www.aidsmap.com/en/news/51CC5AD0-D3EF-440B-9602-4B4A26DF076A.asp) and you suddenly discover that ..

FACT: 50% of sexually active gay men in the UK had unprotected anal sex in the last year.

FACT: 44% of gay men in the UK have never had an HIV test.

FACT: Almost 20% of supposedly HIV-negative gay men in the UK had receptive unprotected anal sex with a man of unknown HIV status.

FACT: Almost 20% of untested gay men in the UK (rising to 30% of untested men with the greatest numbers of partners) had receptive unprotected anal sex with a man of unknown HIV status.

FACT: More than 30% HIV-positive gay men in the UK (rising to over 50% of men with large numbers of partners) had unprotected insertive anal sex with a man who was either HIV-negative or of unknown HIV status.

There is no implication that condoms aren't effective. There is simply an acceptance that a significant number of people are willing to lie and/or engage in very risky behaviour.

Sure, those people who don't lie about their behaviour may very well have a valid reason to feel more than a little frustrated, but they would be better served venting that frustration at those who simply can't be trusted to be honest about their behaviour.

Discrimination is, to my mind, something that is based on ignorance and malevolence. As far as I am concerned, the policy on blood donations is neither.

Peter Tatchell can scream from the rafters about this one, but at the end of the day it just makes him look like an even bigger plonker than most of us already think he is.

[Cerrid]

Several 'high risk' groups are screened out of the process and this supposed discrimination is nothing more than a rational means of significantly reducing the odds of contaminated blood entering the blood supply.

Screening should be based on the behaviour, not on the affiliation to a group. It works: In Italy and Spain, gay men have been allowed again to donate blood a few years ago. The result: A huge increase of donated blood. And there were not more, but fewer numbers of blood units which had to be thrown away because of HIV.

Just to add another oddity: In Germany, all people who had lived in the UK between the mid-80ies and and the mid-90ies for longer than 9 months (and this obviously includes most Brits) are excluded from donating blood. Not because of HIV, but because they're considered potential BSE/CJD carriers. Even if they're vegetarians...

[sweetasmeli]

I totally disagree with your take on this .. and I am mightily relieved to see that THT do too.

Several 'high risk' groups are screened out of the process and this supposed discrimination is nothing more than a rational means of significantly reducing the odds of contaminated blood entering the blood supply.

Contrary to popular belief, there is no 100% effective screening process for blood donations.

One unit of donated blood doesn't just treat one person. Blood is processed into various different products, so one unit could treat a dozen or more people.

A unit of blood doesn't stay isolated trough the whole processing system. Units of blood are batched together for industrial processing, so a single unit of contaminated blood entering the supply, and batched for processing, can contaminate blood products given to hundreds of different people.

FACT: More than 70% all heterosexually acquired HIV infections diagnosed in the UK were acquired in Sub-Saharan Africa.

FACT: Unless answering anonymously, men who have sex with men are (as a group) prone to lie about their behaviour.

Give gay men the cover of anonymity (http://www.aidsmap.com/en/news/51CC5AD0-D3EF-440B-9602-4B4A26DF076A.asp) and you suddenly discover that ..

FACT: 50% of sexually active gay men in the UK had unprotected anal sex in the last year.

FACT: 44% of gay men in the UK have never had an HIV test.

FACT: Almost 20% of supposedly HIV-negative gay men in the UK had receptive unprotected anal sex with a man of unknown HIV status.

FACT: Almost 20% of untested gay men in the UK (rising to 30% of untested men with the greatest numbers of partners) had receptive unprotected anal sex with a man of unknown HIV status.

FACT: More than 30% HIV-positive gay men in the UK (rising to over 50% of men with large numbers of partners) had unprotected insertive anal sex with a man who was either HIV-negative or of unknown HIV status.

There is no implication that condoms aren't effective. There is simply an acceptance that a significant number of people are willing to lie and/or engage in very risky behaviour.

Sure, those people who don't lie about their behaviour may very well have a valid reason to feel more than a little frustrated, but they would be better served venting that frustration at those who simply can't be trusted to be honest about their behaviour.

Discrimination is, to my mind, something that is based on ignorance and malevolence. As far as I am concerned, the policy on blood donations is neither.

Peter Tatchell can scream from the rafters about this one, but at the end of the day it just makes him look like an even bigger plonker than most of us already think he is.

Vokz
I don’t disagree with you per se, but I think you may be missing a vital point.

I understand that there are ‘higher risk’ groups but it is a fact that they are not the only people that are at risk. It is a fact that seems to be being overlooked by the Blood Service (by not including adequate questioning on their forms) as well as by society on the whole.

I know that donated blood is processed into various products; I was infected by my ex partner who is a haemophiliac infected through contaminated blood products in the 80s.

I don’t know figures but I do know this FACT: Heterosexual men and women lie too.

Do you happen to have any facts and figures on the following?

How many heterosexual men/women had unprotected sex in the last year?
How many heterosexual men/women have never had an HIV test?
How many heterosexual women have had anal sex with a man of unknown HIV status?

The point I’m trying to make is that it is not just gay men, prostitutes and intravenous drug users who are at risk. And one of the huge problems we have as a society is that most of society still believes that it is! Hence if individuals don't fall into any of those categories most of them still believe they're 'safe'.

It is a FACT (that is not getting punched across enough) that heterosexual men and women (who are neither prostitutes nor IV drug users) are also at risk, if they engage in unprotected sex, which many of them do on a regular basis. And it’s not only people who engage in casual sex who are at risk; it’s people in long-term relationships too. As someone who knows first-hand, people lie about their HIV status, even in long-term relationships.

The implication that condoms are ineffective lies in question 12 on the questionnaire:
Are you a man who has had oral or anal sex with another man (even if you used a condom)?

I wasn’t saying that the Blood Service line of questioning was discriminatory (although there are parts that actually seem to be); I was saying that it was displaying ignorance of the facts regarding WHO is actually at risk. The fact remains: Anyone who engages in unprotected sex is at risk.

Think about this: The way the NHS Blood Service questionnaire stands at the moment, I could have completed that form 8 years ago, answering all the questions honestly. At their own admittance, not all infected blood shows up on their screening. I was in a monogamous long-term relationship; my partner simply lied about his status. I’d already had an HIV test done prior to that relationship, so knew I was negative when I got involved with him. Unbeknown to me then, I seroconverted in September 1999; at the time, had I donated (which I thankfully didn't) my infected blood could have slipped past the NHS Blood Service screening.

I know the likelihood of that happening is a long shot, but the point (or points) that I’m trying to make kind of support what Cerrid said about how screening should be based more on behaviour rather than affiliation to a group. Aside from being lied to, part of the reason I became infected was I didn't actually think I was at risk as it wasn't drummed into me by anyone that I was; prior to the truth coming out about my ex's HIV status, the only HIV test I had ever had done was by default as part of a medical study I took part in as a student. 

The message that we as a society should be trying (but are failing) to get across to people is this:
HIV and other STDs do not discriminate. Anyone who engages in unprotected sex, regardless of sexual orientation, is at risk. Practise safer sex and/or get tested regularly.

Debra

[jack]

sorta of reminds me of the security process at US airports, frisking old women,young children,bald irish americans. The blood supply has to be protected at all costs,no matter who is offended.  They are doing the correct thing. Trust no one.

[vokz]

Screening should be based on the behaviour, not on the affiliation to a group

Cerrid,

That is an easy statement to make, and I agree up to a point (but only up to a point) .. if people can be trusted to be honest about their behaviour (although as far as I am concerned, exclusions that target men who have sex with men, IV drug users and prostitutes are very much based on behaviour).

Whether or not it works in Italy and Spain is open to debate. I would question whether it does.

In the UK - with a significantly higher population than both Italy and Spain - the number of HIV infections attributed to infection through blood products is less than a third of the number in Italy and less than half the number in Spain.

Unlike Italy and Spain, the UK has no recently documented cases of HIV contaminated blood  and organs entering the supply.

What is the more effective system? At what level do you set the risk as acceptable and deem a system effective enough?

Personally, I am happy to accept responsibility for my own actions; but would rather have a system with certain unpleasant restrictions than I would see even one person single being infected through a medical procedure .. simply because we, as a society, don’t want to upset certain minorities (and one very vocal minority in particular).



Debra

I appreciate what you are trying to say, but I am not missing the point at all. I just don’t agree with you .. and there is a difference.

Given the number of heterosexuals in the UK who have unprotected sex, the risks of them carrying an undetected infection that will not be detected by screening is still extraordinarily low (especially so when you take into account the restrictions intended to weed out the 70% of heterosexual infections that are acquired outside of the UK).

The risk that an undetected infection being carried by one of the 5% of the population that still accounts for almost 50% of newly diagnosed infections (and a far higher percentage of actual infections) is extraordinarily high.

Yes, heterosexuals lie too; but the risk associated with a heterosexual lie is statistically miniscule compared to the risk associated with a lie by a sexually active gay man .. and like it or not, this is a huge game of playing the odds.

This isn’t about sex education and communicating the risks of unsafe sex. It is about striking a fragile balance between the need for a blood supply with the need to maintain public confidence in the Blood Transfusion Service. You have to set the limits somewhere .. and no matter where you set them, you will offend someone.

Granted, in the solution I imagine you are looking for, we could simply reject donations from anyone who admitted to having unprotected sex, being a prostitute or doing IV drugs, in the last six months and otherwise ignore which risk group they belonged to .. but can you imagine what that would do to the blood supply and the number of organs available for transplant? 

[sweetasmeli]

The blood supply has to be protected at all costs,no matter who is offended.  They are doing the correct thing. Trust no one.

I agree. Hence their line of questioning needs to be inclusive of groups of all sexual orientation and behaviour.

[Oceanbeach]

My Dear Miss Melia,

I had this best friend since we met at the baby sitters at 5 years old.  Wes was a Hemophilliac and spent most of his life giving himself blood transfusions at home.  The blood products were delivered in dry ice and on a Greyhound Bus, the Deputy Sheriff was always at the station when it was delivered.  We went through this for over 30 years.  One day, we were driving to the ocean and he told me he had HIV and it came from tainted blood products.  there was his girl and probably many others exposed to HIV without knowing it.  He wasa not gay and not a drug user, he was not high risk in the 1980's.  All Wes wanted was to drive fast cars and ride a Harley.

He died in a small town in Northern California while living on a farm with his parents.  Then his father died and shortly afterward, his mother passed away also.  After their mothers funeral, the family was going through personal things and they found a bank book.  That account had a quarter of a million dollars in it, and was the pay off from the drug company which delivered the tainted blood, so many years before.

Apparently he told his mother to buy herself anything she wanted.  She raised 5 kids and had over 20 grand children and was tired of washing dishes.  She spent about $300.00 for an automatic dish washing machine and the rest of the money was there when she died.

I have known for my entire life that I would be a Pallbearer at Wesley's funeral.  Had not heard from him in a couple years and when asked... my family had forgotten my phone number and address in Los Angeles and made excuses.  I should have at least been given the opportunity to put him in a very fast car for 1 last road trip before he died.  Have the best day
Michael

[keyite]

I used to feel very offended by the ban on gay men donating blood. Instead I donated blood for research purposes. Since my diagnosis - and particularly with the realisation that I wasn't infected via unprotected anal sex - I have to say my views have changed. I now support the ban. Yes, it might be a pretty crude instrument in protecting the blood supply but it is one that does make sense given the way probabilities play out. My single straight sister, who tells me she often 'forgets' about condoms with relatively casual partners, is at nowhere near the kind of risk of exposure that a gay man would be was he to 'forget' about condoms.

44% of gay men in the UK have never had an HIV test? Wow, this totally floored me. I suppose I shouldn't be so surprised it is quite that high but I am nonetheless.

[bocker3]

sorta of reminds me of the security process at US airports, frisking old women,young children,bald irish americans. The blood supply has to be protected at all costs,no matter who is offended.  They are doing the correct thing. Trust no one.

Then I guess the safest thing is to stop all blood donations, except for self donating.  So every few weeks everyone should just go in and some blood drawn and saved for their exclusive use, if they should need it.
The fact of the matter is, the current guidelines in the US give a false sense of safety (I wrote a paper on this grad school).  Your risk of having HIV is not about who you are but about what you do/did.  
Do people really think that only men who have sex with men lie about their sexual history??  What possible rational is there for permanently deferring a man who has sex with another man regardless of either's HIV status, but only deferring a man who has sex with a positive woman for 1 year??
There is no way to make the blood supply 100% safe (from HIV or any other blood borne pathogen), but it certainly makes sense to devise a scientifically sound process to minimize the risk via a survey on behaviors prior to donation and robust testing after.
The current system might have made sense when it is devised back in the 80's and we didn't know as much or have the testing we do now, but it is time to update.  This isn't only about discrimination it is also about ensuring that we have an adequate supply -- too many people are needlessly deferred.

Mike

edited to fix typos

[sweetasmeli]

My single straight sister, who tells me she often 'forgets' about condoms with relatively casual partners, is at nowhere near the kind of risk of exposure that a gay man would be was he to 'forget' about condoms.

And therein lies one of the reasons for the continuing rise in heterosexual women testing HIV+ worldwide. Not to mention the risk of exposure to all the other STDs out there. Many (if not most) single straight women think along the same lines or don't even think about it at all.

Keyite, your sister may not be at as high a risk as gay men are but she is at risk all the same. I don't mean to speak out of turn (or hijack my own thread) but you may be doing your sister a favour by having another chat with her about the real risks she's taking when she "forgets" condoms, bearing in mind you said she does it often and with casual partners. If she was my sister, I know I would.

I'm just saying.

Debra 

[keyite]

Keyite, your sister may not be at as high a risk as gay men are but she is at risk all the same. I don't mean to speak out of turn (or hijack my own thread) but you may be doing your sister a favour by having another chat with her about the real risks she's taking when she "forgets" condoms, bearing in mind you said she does it often and with casual partners. If she was my sister, I know I would.

Oh trust me, I have had that chat and more than once. Unfortunately I think it's taken my getting diagnosed for her to really sit up and take notice. She told me a couple of weeks ago she was thinking about getting tested.

[jack]

I don't get the desire to donate blood,I have given enough and continue to give every three months via my labs.  I consider not being able to give blood  one the few positives of being HIV+. Dont take it away from me. Its like a life time pass for jury duty.
To make it fair why dont we just end blood donations for anyone who has ever had any kind of sex?
News bulletin, life isnt fair. Get over it.

[David_CA]

Just wondered what you guys and gals might make of this…

Like Jack says, I think the blood supply needs to be protected at all costs (am I actually agreeing with him?  ).  Perhaps the 'restrictions' need to be a bit greater, but certainly not any less strict.  I'll generalize a bit and say that, from my experiences, gay men are more promiscuous than straight women ('cept for prostitutes, which is why they're excluded as well).  Having sex with another man, unless one is pretty openly gay or honest about being bi, is still pretty taboo.  I think one will find that more men who have sex with other men, but don't identify with being gay, will lie about having had sex with other men.  Most straight men won't lie about having sex with a woman. 

I used to feel a bit discriminated against back when I was HIV- about having 'gay blood' that nobody wanted.  Now, I really don't.  They take enough during labs, anyway!  Perhaps blood donations would be a good time to require one of the quickie HIV tests.  Sure, it would turn away a few people... mostly those who don't want to know their HIV status or those who are HIV+.  My mom gives blood.  I don't think she would have an issue with one of the quick tests prior to donation.  I mean, she's making the effort to donate blood to help others.  Making sure her blood isn't 'bad' would also help others.  Of course, doing this would require all the usual HIV testing procedures to take place, whatever they are (confidentiality, counseling, etc).

David

[sweetasmeli]

This isn’t about sex education and communicating the risks of unsafe sex. It is about striking a fragile balance between the need for a blood supply with the need to maintain public confidence in the Blood Transfusion Service. You have to set the limits somewhere .. and no matter where you set them, you will offend someone.

Granted, in the solution I imagine you are looking for, we could simply reject donations from anyone whoadmitted to having unprotected sex, being a prostitute or doing IV drugs, in the last six months and otherwise ignore which risk group they belonged to .. but can you imagine what that would do to the blood supply and the number of organs available for transplant? 

Hmm...I guess you're right that it isn't about sex education and communicating the risks of unsafe sex. I understand the dilemma faced by the BTS and realise limits have to be set. I think what struck me is the fact that unprotected sex amongst all sexually active people isn't broached at all. I just can't help but think that the way the nature/wording of the questioning as it stands does nothing to help dispel the idea that HIV/STDs are only an issue for gay men, prostitutes and IV drug users. Nor is it as thorough as it could be.

Oh trust me, I have had that chat and more than once. Unfortunately I think it's taken my getting diagnosed for her to really sit up and take notice. She told me a couple of weeks ago she was thinking about getting tested.

Big phew! I hope you didn't mind me mentioning it...

Like Jack says, I think the blood supply needs to be protected at all costs........Perhaps the 'restrictions' need to be a bit greater, but certainly not any less strict.

I agree. I'm actually all for the line of questioning/screening being as strict as possible but in an all-inclusive way.

Debra

[vokz]

Nor is it as thorough as it could be.

True.

For what it is worth, the BTS has already committed to implementing significant changes to the rules when the new screening processes are up and running nationally (it is quite patchy at the moment and they are worried about the confusion that would be caused if different centres have different policies).

[sweetasmeli]

For what it is worth, the BTS has already committed to implementing significant changes to the rules when the new screening processes are up and running nationally (it is quite patchy at the moment and they are worried about the confusion that would be caused if different centres have different policies).

Ooo...now you could have mentioned that earlier! Should be interesting to see what they come up with...

Debra

[vokz]

.

[thunter34]

.

Insightful.  That changes the entire course of this discussion.  Thanks for posting.

 

[Cerrid]

Whether or not it works in Italy and Spain is open to debate. I would question whether it does.

In Italy, gays were excluded from blood donations until 2001 when there was a reform on this topic. So since 2001, italian gays were allowed to give blood. And what happened? The percentage of infected donations went slightly down (from 2,2% in 2000 to 2,1% in 2001), but the total number of donations increased from 1.615.877 (2000) to 1.910.430 (2001). That's almost 20% more donations in just one year.

Nowadays, the testing methods for blood are very reliable and sufficient to ensure a safe blood supply. We're not in the 80ies anymore where the techniques were by no means as elaborate as they're now. People may lie in their questionnaires, but the automatic testing methods give solid results. Who do you trust more?

[vokz]

Insightful. 

Yeah .. I somehow (don't ask me how) managed to post a reply to a personal message from Debra 

[bocker3]

I'm actually quite shocked to hear gay men say it's "ok" to discriminate against gay men.  Banning an honest man for saying that he has sex with men, even if it is within the confines of a monogamous relationship is simply sticking your head in the sand.  It gives a false sense of security.  Being gay does NOT put you at higher risk for contracting HIV -- it is your behavior that does.  Look at it this way -- if a guy experimented back in 1976 and had sex with another man, but has never done so again (and perhaps is now asexual) he is deferred for life.  Yet, a str8 man can have sex with a different woman every night, not use condoms, and they will suck that blood out of him in a  minute.
Additionally -- everything I read says that African-American woman are the fastest growing demographic turning up positive, so should we ban them for life?  Of course not -- and if they tried, holy shit -- can you imagine the blow up.
The bottom line is that it is behavior that increases someone's risk.  Surveys should be used to defer folks based on that.  Yes, people will always lie on the surveys, so they need to be backed up with the most advanced testing techniques available.   Keeping the blood supply as safe as possible is achieved by using the most advanced technology, not by continuing old, out-dated techniques.  No matter what is used, it will never, EVER be 100% fool proof.
The argument that excluding MSM is for the sake of the public's health is as ridiculous an argument as saying that MSM should be banned from the Armed Service for the sake of Military cohesion.
Let's all move into the 21st century!!

Mike

[sweetasmeli]

Nowadays, the testing methods for blood are very reliable and sufficient to ensure a safe blood supply. We're not in the 80ies anymore where the techniques were by no means as elaborate as they're now. People may lie in their questionnaires, but the automatic testing methods give solid results. Who do you trust more?

Umm, don't mean to be an alarmist but that's not strictly true. Although testing methods have indeed improved immensely since the 80s, they are still not fool proof. There is still that window period where newly infected blood could slip past screening. By the National Blood Service's own admission (quoted from their website: https://secure.blood.co.uk/c11_cant.asp):

•    Infected blood isn't used in transfusions but our test may not always detect the early stages of viral infection.
•    The chance of infected blood getting past our screening tests is very small, but we rely on your help and co-operation.

As Vokz has said the BTS are currently working on changing the rules around blood donor screening; hopefully the issue of the window period risk will be addressed too.

Debra

[sweetasmeli]

Incidentally, does anyone happen to know where things stand on the screening for BSE/CJD now? It's just that I heard the other day that that little bugger is still managing to slip through...

Debra

[vokz]

Banning an honest man for saying that he has sex with men, even if it is within the confines of a monogamous relationship is simply sticking your head in the sand.  It gives a false sense of security. 

Bocker

Monogamous relationship? Pull the other one. If I was to list the number of my friends who were infected with HIV from within a supposedly monogamous relationship I would be here all day.

The idea that I should object to something simply because it happenes to affect a minority that I am a part of – not because it is morally wrong – is really quite offensive .. and the fact that ANY gay man in the 21st century would try to invoke that Neanderthal argument and expect me to put my minority interests before those of society as a whole is even more offensive.

As for technology – that costs money and takes time to implement .. and there are priorities in society that offers universal healthcare (like free treatment to anyone with HIV). There isn’t an unlimited budget that allows you to buy an unlimited supply of the latest and greatest of everything as soon as it becomes availiable.

Reality (especially when you have a government that likes to waste untold billions supporting a pointless and dishonest war in Iraq) is that you prioritise - accept that better treatment for cancers, amongst many other things, may just be a little more important than a few gay men with bruised egos - and stop the gaps with policies that are actually far more effective than the technology we are supposed to replace them with. That is what happens outside of the bizarre narrow-minded world of single-issue politics.

As for the rest of the preposterous tangents you have gone off on, I am not even going to credit them with a response.

[thunter34]

Yeah .. I somehow (don't ask me how) managed to post a reply to a personal message from Debra 

EEP!  Been there...done that.   

[Cliff]

I'm on the side of being cautious and have no major issue with a blanket gay ban.  However at some point testing technology will progress to a point to where such a ban is unnecessary.  But I do think Bocker is correct in that this ban isn't just about risk.  It's political as well, since not all groups who are at higher risk for contracting HIV are categorically excluded from the ban.

But I do believe that public confidence in the blood supply is important.  I also think it would be counterproductive to restrict donors even further.  So while the argument that they should remove the gay ban and replace it with a ban on anyone who has been at risk, sounds good....if it results in 80-90% of the public being eliminated as donors, I think the unintended consequences may be too severe.  Plenty of people, including folks with HIV, depend on us having an ample blood supply.

Vokz, I think your response to Bocker was unnecessarily patronising.

Cliff

[vokz]

Vokz, I think your response to Bocker was unnecessarily patronising.

Cliff,

That is your right .. just as it is my right to think you are wrong.

[bocker3]

Bocker

Monogamous relationship? Pull the other one. If I was to list the number of my friends who were infected with HIV from within a supposedly monogamous relationship I would be here all day.

The idea that I should object to something simply because it happenes to affect a minority that I am a part of – not because it is morally wrong – is really quite offensive .. and the fact that ANY gay man in the 21st century would try to invoke that Neanderthal argument and expect me to put my minority interests before those of society as a whole is even more offensive.

As for technology – that costs money and takes time to implement .. and there are priorities in society that offers universal healthcare (like free treatment to anyone with HIV). There isn’t an unlimited budget that allows you to buy an unlimited supply of the latest and greatest of everything as soon as it becomes availiable. Reality is that you stop the gaps with policies. .

As for the rest of your preposterous tangents you have gone off on, I am not even going to credit them with a response.

So Vokz, while I am not here to debate you specifically -- I must respond.  There ARE monogamous gay couples, and to dismiss this is patently absurd.  Yes, there are some couples that are assuming monogamy, when it isn't the case -- but guess what, that happens with straight people too.  I also suspect that you weren't answering my "tangents" because you can't.  These aren't preposterous at all, they show that a blanket ban on someone simply for having had sex with another man is unjustified in the current age.  The blood supply IS NOT SAFE simply because HONEST gay men are banned.  You are absolutely entitled to your opinion and 10-15 yrs ago, I would have been in your camp too.  The fact is, it is an outdated and unneeded way to do things today.  Additionally, if it is so important to public health that we unnecessarily ban groups of people, why on earth would we not spend money to use the best possible detection tests.  This is what will do the most good for protecting the public health.  Believe me, I do not make my points based on news reports or fear, I make them based on education and experience.  I have a BS in Medical Technology, worked in clinical labs for many, many years (including a year at a blood donor collection lab.  I have a Master of Public Health degree and did much research on the blanket ban of MSM while getting my degree.  So I am approaching this from a very scientific point of view.
So, while I will repeat that you have every right to feel differently, if you are going to debate this, please use science vs. emotions and do NOT lecture me on how to protect the Public's Health.

Mike

[GSOgymrat]

Vokz, I agree with your argument about screening blood donors. I want to point out though that many of your "facts" are not facts but results of self-reporting surveys, which are notoriously inaccurate especially when the subject is sexual behavior. A more accurate way to express your argument would have been "research indicates".

[vokz]

Bocker,

Did I say there aren’t monogamous couples? No, I didn’t .. and if you have really sunk to the depths where you have to misrepresent what has been said, then you must be very desperate indeed.

There is only one reason that I am not answering your preposterous tangents, and that is that they are preposterous and wholly irrelevant.

The fact is, I am using science whilst you are using the flawed and exhausted emotional argument of gay solidarity .. and that simply doesn’t wash with me.

[vokz]

I want to point out though that many of your "facts" are not facts but results of self-reporting surveys

You are quite right .. the most comprehensive and authoritative research on the sexual behaviour of gay men in the UK says …

I stand corrected.

[bocker3]

Here is another possibility that has been championed for a number of years.  Instead of saying you can NEVER donate if you've had sex with another man, how about saying you can't donate for 3 months or 6 months -- or even a year.  I think this still misses the point that it is behavior and not who you are or who you sleep with, but it is closer to be reasonable.  If a str8 man is only deferred for 1 year after having sex with an HIV+ woman, how can anyone justify banning someone for life if they haven't had sex in a year or more??
This ban remains, not for the public's health, but for political reasons.  It makes people feel like "something is being done".  Additionally, there is a fear out there that if the evil gays were allowed to donate, others would stop donating and refuse getting blood out of fear.

Mike

[vokz]

This ban remains, not for the public's health, but for political reasons.  It makes people feel like "something is being done".  Additionally, there is a fear out there that if the evil gays were allowed to donate, others would stop donating and refuse getting blood out of fear.

No, it remains because the UK’s publicly funded Blood Transfusion and Donor Service is halfway through a five year rollout of new technology .. on completion of which it has already committed to changing its existing policy.

The rest of the “evil gays” argument is un-scientific, paranoid and politically motivated speculation on your part.

Is it also discrimination and fear of evil sick people that motivates the rule that states people who have received a blood transfusion can’t donate blood? .. or is it perhaps only discrimination when the rules affect organised minorities?

It may surprise you to know that some of us live in countries that allow gay unions, allow openly gay men and women to serve in the military and have laws that prohibit discrimination on the grounds of sexual orientation.

Instead of looking for discrimination and homophobia where there is not a single shred of credible evidence that it exists; we should be trying to find ways of encouraging the 95% of the eligible people who don’t donate blood to come forward. Even if each of them only did it once in a lifetime, it would plug the gap between supply and demand.

[bocker3]

First off, I have been speaking about the US, as I would be speaking from a point of ignorance about the UK. 

Now people being likely to stop giving blood and refusing to get blood if gays are allowed to donate is NOT paranoia nor speculation.  Remember, I told you that I did research on this topic -- admittedly 8 years ago -- if I can pull that paper out of stored stuff I will give you the names of my sources.

You seem hell bent on attacking me, yet you have not refuted any of points -- you simply have been grabbing one or two comments in each post and lambasting me on those.  Which would be fine (I admit "evil gays" was an unnecessary choice of words) if you actually addressed my points. 

What you seem to fail to grasp -- or at least fail to acknowledge -- is that I am not saying that gays do not have a higher likelihood of being positive, they do.  My point is that lifetime bans based on someone's sexual orientation is not making the blood supply safer.  Cerrid pointed out in an earlier post that Italy saw a slight decrease in infected donations after the blanket ban was removed.  This resulted in a 20% increase in donations.  I keep asking why someone who hasn't had sex in a year should be banned because he had sex with another man at some point, but that doesn't get answered.  The survey questions should be reworked to address behaviors and deferrals should result from that.  The whole point of the surveys and subsequent deferrals is to help identify folks who truly represent risks before any blood is drawn.  It serves an important function and helps reduce the costs associated with testing donations.  However, it is the testing that is ultimately responsible for keeping the blood safe as safe as possible.

As for you equating the banning of someone who has had a blood transfusion with someone who has slept with another man, well now who is going off on tangents.  I will address it though -- according to the latest rules from the American Red Cross -- receiving blood products results in a 12 month deferral -- not a life long one, so there ends the comparison.  Although, there is a life time deferral if you received blood in certain African countries, due to HIV Group O or from the UK due to variant CJD.

Finally, I do not find only the MSM ban unnecessary, I also find the lifetime ban of people who have received money for sex (but have stopped for at least a year), people who have injected drugs (but have stopped for at least a year), etc.  to be unsupported by science in 2007.  So, no, it's not only "organized minorities".  I am a public health professional and would not wish to put the public's health at risk.  However, where we seem to differ is that I think we need to take steps based in science.  Here in the US, there are always pleas for more donations in the summer -- the public's health is definitely impacted when someone needs blood but there isn't any to give.  I agree with you that we should find ways to get more people to donate, however in the meantime, why turn away people willing to give, when there is no legitimate reason to do so.

Mike

[vokz]

Bocker,

It may have escaped your attention, but the discussion was specifically related to the rules that apply to blood donation in the UK.

You didn’t qualify a single one of your statements as applying to the United States. You just launched into a sweeping attack on gay men who dare to support rules that you have decided are discriminatory (although you haven’t actually shown us why they are - you have just said that they are and expect us to accept that) .. and you then proceeded to make a ludicrous and tangential comparison between supporting those rules and supporting a ban on gays serving in the armed forces.

I didn’t equate banning of someone who has had a blood transfusion with someone who has slept with another man. The rules we are discussing equate them (did you actually bother to look at them before you passed comment on them?). I simply commented, so yet again you choose to misrepresent.

The rise in donations in Italy lasted exactly one month. There was also a big increase in the same month of the year before. Why? Because the increase had nothing to do with the change in the rules (rule changes that didn’t just affect men who have sex with men, so we need to be wary about what we attribute any claimed ‘safety’ improvements to) .. the change in the rules just happened to coincide with a regular seasonal fluctation and more people being available to donate.

The other factor that has been neatly evaded about the situation in Italy and Spain is that both those countries have numerous instances of infected blood and organs entering the supply. There have been no such instances in the UK since the current rules were implemented in the UK.

So, I return to the questions that those against the ban keep evading: What is the safer system and how many accidental infections is safe enough? How many unintentional infections are an acceptable price to pay for weakening the qualification process by more than the used technology can compensate for? .. or do we really think that the availabilty of PEP can make up for the distress that these acceptable risks (if identified in time) would cause?

Finally, the UK’s blood transfusion service actually trialed a more complex and sensitive behaviour based pre-donation screening questionnaire for several months.

The reason it wasn’t implemented was that – despite it having been written in plain English, by an organisation that specialises in removing jargon and simplyfying language - it ended up being so complicated that people in high-risk groups, who should have been disqualified, unintentionally made themselves eligible to donate .. and people who were eligible to donate, and had no risks associated with their behaviour, ended up disqualifying themselves.

The simple truth is that it was shown that it would actually have decreased both the volume and the safety of the blood supply. Sweden had exactly the same experience when they ran similar trials. That is why the deliberate decision was made to delay any new qualification rules until new testing technology was available and a simplified questionnaire could safely be used.

There is nothing I would love more than to see a system that allowed as many people as possible to donate .. but I want to see that done on the basis of safety provided by better technology, rather than compromise for the sake of political correctness.

[David_CA]

Without starting another argument, what's so bad about keeping MSM's from donating blood?  There are a LOT more people who are not MSM's or IDU's.  It may give a somewhat false sense of security, but surely it gives some security.  What if I'd donated blood 18 months ago... I was HIV+ and didn't know it.  I know that blood is screened and that we're not the only at-risk group. When we get to a point where we can do a fingertip test, like some of the blood sugar tests, that will give a yes or no response (red light / green light, perhaps?) as to whether a person's blood is acceptable (not HIV+ or having any other bad characteristics), I'd say that the ban should be lifted.  As it is, there are far more serious and important things to worry about in my opinion.

David

[bocker3]

So, I will conclude my contributions to this thread with the following:

Bocker,

It may have escaped your attention, but the discussion was specifically related to the rules that apply to blood donation in the UK.

You didn’t qualify a single one of your statements as applying to the United States. You just launched into a sweeping attack on gay men who dare to support rules that you have decided are discriminatory (although you haven’t actually shown us why they are - you have just said that they are and expect us to accept that) .. and you then proceeded to make a ludicrous and tangential comparison between supporting those rules and supporting a ban on gays serving in the armed forces.

Actually, if you read my first post (#9), I do state that I am talking about the US.  Also, I'm not sure that saying, "I'm actually quite shocked to hear gay men say it's "ok" to discriminate against gay men." constitutes a sweeping attack on anyone.  I used the gays in the military to show that there are a number of areas where people use tenuous arguments to keep gays out.  This wasn't ludicrous -- it is a fact.  This was not to fully equate the two situations, but to show that it is very easy to use a sweeping generality against a group that is not held in high regard by the general public.

I didn’t equate banning of someone who has had a blood transfusion with someone who has slept with another man. The rules we are discussing equate them (did you actually bother to look at them before you passed comment on them?). I simply commented, so yet again you choose to misrepresent.

Actually, you did equate -- you asked if this was discrimination or was I only referring to "organized minorities".  And yes, I did read the rules (again, the US rules, as I quoted guidelines from the American Red Cross), that showed that most people who get blood donations in the US are only deferred for 12 mos.

So, I return to the questions that those against the ban keep evading: What is the safer system and how many accidental infections is safe enough? How many unintentional infections are an acceptable price to pay for weakening the qualification process by more than the used technology can compensate for? .. or do we really think that the availability of PEP can make up for the distress that these acceptable risks (if identified in time) would cause?

Basing qualifications on science will not endanger the blood supply.  Simply put, these questionnaires only work when people are honest.  What makes the blood supply as safe as possible is using the most accurate testing technology available, because people will lie and "high risk" individuals will donate.  They will be caught with testing.  Yes - there is a window period and an infected blood unit may slip through -- giving lifetime deferrals to MSMs does not solve this.

Finally, the UK’s blood transfusion service actually trialed a more complex and sensitive behaviour based pre-donation screening questionnaire for several months.

The reason it wasn’t implemented was that – despite it having been written in plain English, by an organisation that specialises in removing jargon and simplyfying language - it ended up being so complicated that people in high-risk groups, who should have been disqualified, unintentionally made themselves eligible to donate .. and people who were eligible to donate, and had no risks associated with their behaviour, ended up disqualifying themselves.

The simple truth is that it was shown that it would actually have decreased both the volume and the safety of the blood supply. Sweden had exactly the same experience when they ran similar trials. That is why the deliberate decision was made to delay any new qualification rules until new testing technology was available and a simplified questionnaire could safely be used.

I'm glad to see that some country's are moving to try and use behavior based screening.  I hope they stick with it and come up with a workable questionnaire. 

There is nothing I would love more than to see a system that allowed as many people as possible to donate .. but I want to see that done on the basis of safety provided by better technology, rather than compromise for the sake of political correctness.

It is not political correctness -- this is what you are calling it -- I'm talking about using science and facts that are available in 2007 and not relying on a system that made sense with the knowledge and technology of the 1980's.  Infected units get drawn every day -- they are almost always caught in the testing phase.  Some likely do get through -- some of which get discarded by outdating without being used and, unfortunately, some get transfused.  If blood donation labs would use the most sophisticated tests, this would be exceedingly small.  Yes, even one is too many, but there is no current way to make the supply 100% safe -- that is the sad truth.  All I am advocating is that we use reason and science.  A lifetime deferral for a "risk" that may have happened a year or more ago is plain and simply nuts.  If they want to call men having sex with men too high risk to donate -- what is wrong with making the deferral in line with others?  A year seems more than reasonable as a compromise.

So, all I ask, as I sign off, is please read what I have written and think about what I am advocating before you start planning your reply.  Our goals are the same, our approach at getting there is different.  I have tried my best to remain civil in my responses to you, I respectfully request that you do the same.

Good night!
Mike

[Matty the Damned]

Matty the Damned supports the prohibition on homosexuals donating blood.

MtD

[vokz]

Bocker

So asking a question is likening .. and - since not a single person contributing to this discussion (let alone a single gay person) has actually said that it is “OK” for a gay man to support “discrimination” against gay men - you weren’t commenting on what had been said in this discussion, your expression of shock wasn’t uncivil, it didn’t misrepresent and it wasn’t directed at any users of this forum.

I am so pleased to learn that this is obviously just one long and unfortunate series misunderstandings

I still maintain that discrimination is something that is based on ignorance and malevolence .. and that, as far as I am concerned, I haven’t seen anything that comes even close to persuading me that the crude rules in force (anywhere in the world) represent anything other than simple, easy to understand, commonsense and statistically sound logic used to plug the yawning gap left by the technology deployed in the field.

Quibbling aside, we agree on the final goal and will just have to agree to disagree on just about everything else

Take care, have a nice weekend, over and out.

Mark x

(who is now off to research the BSE / CJD issue, which he is ashamed to admit he hasn’t ever given much thought to)

[puertorico2006]

http://www.usatoday.com/news/health/2007-11-16-hiv-transplant_N.htm?csp=34

It doesn't relate to donating blood...but its a story about a woman infected with HIV the other day by an organ donation from someone "high-risk"