In the aftermath of Sunday’s tragic mass shooting in Orlando, one positive story was the overwhelming response of local residents to donate blood for the victims. Blood donation is a simple yet critical measure to support recovery efforts during a mass casualty event. Unfortunately, as blood donation is one of the most regulated medical procedures in the United States, it is also a source of confusion and misinformation for both donors and the general population alike.
On the day after the shooting, rumors spread on Twitter and other outlets that Orlando donor centers had waived the donation ban on sexually active gay men. After these rumors had been quashed, what remained in the gay and allied community was outrage that gay men were banned from donation in the first place. Based on this confusion and frustration, it is important to dispel some active myths about blood donation.
- Men who have sex with men (MSM) may donate blood if their last sexual contact with a man was over 12 months ago. This is little consolation to sexually active gay men, but the FDA’s decision to revise its policy on MSM—originally a lifetime ban on donation—is a sign that the FDA is actively reviewing data about the changing risks of MSM donors to the blood supply. However, a recent study in blood donors showed that a history of MSM sexual contact still presents a 62-fold increase in the risk of being HIV-positive.
- Infectious disease testing is neither rapid nor 100 percent accurate. Blood donors in the U.S. are tested for blood-borne viruses such as HIV after donation, not before. Unfortunately, this testing can miss recently contracted cases, and thus blood centers must also rely on questionnaires about donor behavior to assess viral transmission risk.
- The nation’s blood supply is not in crisis. Blood transfusion is one of the most common medical procedures in the country, with almost 14 million units of red blood cells transfused in 2011. Despite this high demand, the nation’s blood centers are able to maintain more than adequate supplies with only a small number of donors. A healthy, dedicated donor may donate up to 6 units of blood per year; theoretically, the entire nation’s blood supply can be supported by less than 3 million donors, or less than 1 percent of the American population. The actual number of donors is much higher, but it demonstrates the fact that the FDA would be willing to turn away a dozen safe donors if it meant preventing one unsafe individual from donating.
- Regional blood centers rarely run out of blood. The fact that donation centers in Orlando have hit capacity this week and were forced to turn away donors is proof of the resilience of our blood supply in times of tragedy. If a local area ever faces the chance of a true shortage, blood can quickly be mobilized from other regions of the country.
- Blood deferral rules are a matter of supply vs. risk, not bigotry. When reviewing donation restrictions on an at-risk group, the FDA considers whether it can maintain adequate blood supply without that group. Evidence, from years of observation and collection, demonstrated that the increased supply of blood that could be provided by MSM was not worth fully eliminating the ban. This is not to say that a gay man in a long-standing monogamous relationship is less safe than a heterosexual man, simply that there is no need to expand the pool of blood donors at this time.
This will sound harsh to those men (and other individuals ineligible to donate blood), but ultimately, blood donation is not a right. The needs of the individual blood donor are secondary to the principles of patient safety. While in the world of public policy this may come off as yet another form of stigmatizing gay men, it is merely a practical application of cold, hard science. Gay men can still support those in need in other ways, including encouraging others to donate blood, as well as volunteering at blood drives. And, as the American Red Cross says in its advertisements: “the need is constant.”
Ronald Jackups Jr. is assistant professor of Pathology and Immunology at Washington University School of Medicine.