Especially with the country in great need of donation, science should speak louder than stigma in determining who can help.
I gave blood in the caucus room. That sounds like a Bob Dylan song, but it's actually a description of my experience donating blood to the Red Cross at the U.S. House of Representatives this summer. The bruise on my arm has healed, but the injury to my sense of justice has not. In the weeks following my donation, I have been preoccupied by the fact that while I as a heterosexual woman am encouraged to give blood, others are barred from making the same vital contribution. If I were a man who had sex with another man after 1977, I would have been turned away.
I decided to heed the call for blood after power outages paralyzed the Washington, D.C. metro area in June. A story on National Public Radio informed listeners that blood banks in Virginia were running dangerously low because regular donors were unable to travel to donation sites. Imagining patients suffering when a simple solution existed led me to sign up that afternoon.
It was the least I could do. I'm healthy, haven't left the country in a couple of years, and don't mind needles. The fact that the site closest to me was the House of Representatives only strengthened my conviction. Here was an example of the government doing its job--helping those in need; encouraging civic participation. And the atmosphere in the Caucus Room on the day of my donation -- thick drapes, gilded ceiling, good-hearted staffers dropping in to give a pint -- instilled the appropriate combination of nerves and excitement.
But as I sat in a makeshift Red Cross booth, answering questions that would determine my eligibility to donate, alarm at an emerging pattern crept over me. There were the usual health and travel-related queries: have you left the U.S. in the past twelve months; have you ever had Chagas's disease. Then came a disproportionate number of questions relating to potential HIV infection. After several inquiries about needle use and contact with potential HIV carriers, I was asked: had I ever had sexual intercourse with a man who has had sexual intercourse with another man, even once? Well, no, not that I know of. But then again, so what if I had? Would they turn me away on the spot? Should I have prepared an inventory of all past partners?
I had plenty of time to ponder these questions while sipping my orange juice and waiting for my blood bag to fill. As I sat there, needle in arm, images of the recent AIDS Quilt display on the National Mall drifted through my mind. I had visited the Quilt the week prior and helped fold the patchwork for the night. A young girl read the names of the deceased as I held the worn fabric in my hands -- silk, cotton, wool -- stitched thick with cloth flowers. This 5.4-ton piece of community folk art, the largest in the world, is a living testament to those who survived the years when AIDS was stigmatized and the infected were pariahs. More squares are added each year, thanks to the diligence of the Names Project.
Since 1983, Food and Drug Administration (FDA) guidelines have disqualified men who have ever had sex with men (MSM) from donating blood. The policy has been heavily criticized recently for misrepresenting 21st Century scientific realities; and the American Red Cross, alongside senators, universities and other organizations, have called for an updated policy that reflects the realities of modern science and technology.
The United Kingdom and Brazil have a one-year deferral period, allowing MSMs to donate blood if they have not had intercourse with a new partner within that time.
In talking to friends about my experience, I learned of nation-wide efforts requesting that the FDA update the Red Cross questionnaire. Schools around the country have responded with petitions challenging the legality of the policy and calling on the FDA to change the policy's outdated origins so as to reflect modern science and medical literature on HIV. Both San Jose State University and Southern Oregon University have cancelled campus blood drives in protest. In an example of a collaborative move to influence the FDA, members of the Middlebury Open Queer Alliance engaged the Vermont Red Cross in an open forum in 2008. David Carmichael, head coordinator for the Vermont Red Cross, was a proponent of the forum, which attracted 200 students, faculty, staff, and administrators.
Intending to overcome the acrimony that deters potential donors, Ryan Tauriainen, then Middlebury Alliance president, "hoped the meeting would inspire cooperation between the Red Cross and Middlebury College in order to petition the FDA to rethink its discriminatory policy." Inspired by the University of California, Berkeley's "Sponsor Drive," Middlebury encouraged eligible donors to "sponsor" a gay student by giving blood in his name. Donors were asked to sign a petition to the FDA to lift the ban on MSM donations. The drive's success -- 55 students were sponsored and 140 people signed the petition -- speaks to the enthusiasm behind making the policy more inclusive. Tauriainen created a guide -- "The Middlebury Model: An Educated Approach to Protesting Blood Drives"-- that he hopes will encourage Red Cross-university partnerships across the country in an effort to eliminate the lifelong ban on MSM blood donations.
The FDA maintains that despite available screening technologies that can detect HIV within days of infection, there is a risk, however marginal, that the virus will go undetected. Ease and accuracy of testing sharply contradicts this assessment. According to Donald McNeil writing for The New York Times, the over-the-counter mouth swab OraQuick Test by OraSure Technologies, approved by the FDA in July, yields results in 20 to 40 minutes and represents "yet another step in the normalization of a disease that was once seen as a mark of shame and a death sentence." When medical professionals administer the test it is "extremely accurate," says McNeil. The one drawback to over-the-counter test kits, McNeil adds, is that precision in HIV detection declines with consumer use; the level of accuracy for consumer kits presently hovers between 92% and 99%.
The truth is that all donated blood, once collected, undergoes substantial testing to determine whether HIV or other diseases are present. Screening technologies have seen significant improvements over the past few decades, says Dr. John G. Bartlett, an HIV specialist and former chief of Infectious Diseases at Johns Hopkins University. Dr. Bartlett notes that while there remains an opening in the "window" between exposure and when antibodies--the body's response to HIV--are detectable, as infections can bypass detection within the first few days, the lag time between transmission and detection has diminished. Nucleic acid testing (HIV RNA screening), used in conjunction with antibody testing, looks for presence of genetic material of the virus and can usually detect infection after eleven days. These technologies suggest that the blanket lifetime exclusion perpetuates a thirty-year-old bias, one that medical advancements have taken important strides to eliminate.
Dr. Michael Busch, Director of Blood Systems Research Institute (BSRI), suggests that based on current risks of HIV transmission, a move to a one-year deferral for MSMs is "reasonable." Advances in screening technologies have resulted in an "extremely low" risk of HIV passing undetected, according to Dr. Busch, and a deferral period of three to six months should be sufficient to prevent exposure to a high degree of certainty.