Changes Weighed for Blood Donation Policy

By Ian Lovett

April 15, 2010

Nurse Maria Pineda draws blood from a patient at a recent Red Cross mobile blood drive. (photo by Ian Lovett)

Mark is a gay man in his early 30s. He lives in West Hollywood, and he's out of the closet to everyone in his life. But two years ago, when there was a blood drive at the labor union where he works, he donated.

"I felt morally obligated to donate," Mark said. "The need for blood in this country is big, and I was healthy. At the time, I was in a monogamous relationship, and I was getting tested for HIV. I knew it was better to donate than to be truthful with the organization that I was a gay man."

Since 1983, in the early days of the AIDS crisis, the Food and Drug Administration (FDA) has banned blood donations from any man who has had sex with another man since 1977. Recently, a group of prominent national elected officials, led by Sen. John Kerry of Massachusetts, has begun advocating for a lift of the ban, which they call outdated and no longer supported by science.

Last week, the West Hollywood City Council adopted a resolution in support of changing the FDA policy. But some segment of the population of men who have sex with other men already donates blood.

Mark, who insisted that both he and the organization he works for remain anonymous out of fear that the Red Cross would stop holding blood drives at his place of employment, said about 10 openly gay coworkers also donated blood when he did.

"There was a gay couple that's been together for thirty years that donated," Mark said. "That's as safe as you can get. Obviously the rate of HIV infection is a lot higher in the gay community, but I never have unprotected sex, and I get tested regularly. I think that makes me safer than a lot of straight people who donate."

This explanation — I practice safe sex; I get tested; I know I am healthy; I feel a moral obligation — is common among gay men who donate blood. Bradley Coffman, an openly gay law student at University of California, Los Angeles (UCLA), said that was his reason for donating blood in the past, though he does not donate at the law school because his classmates know he is gay. But he also noted other circumstances in which he's seen men who have sex with men donate blood.

"I've had conversations with friends who donated blood before they were out of the closet," Coffman said. "People were accosting them about donating, and they didn't feel comfortable revealing their sexualities, so they just gave blood. They weren't necessarily safe and getting tested, either. I think it's a privacy concern, because it forces people to reveal their sexual identities. They do two screenings of the blood, so I just don't think it's necessary."

Daryl Cummings, chief of staff at the L.A. Gay & Lesbian Center, called the current policy requiring gay men to disclose their sexuality blatantly discriminatory.

“People are under a lot of pressure to donate blood, whether in the workplace or on college campuses,” Cummings said. “The current policy requires people to either come out or to hide their sexual orientation, and blood banks shouldn’t be putting anyone in that position.”

According to the Red Cross of Southern California, of the 100,000 people who donate blood to the organization every year, only 45 are deferred because they are men who have had sex with other men. Some know they are disallowed, and don’t bother going to blood drives; others decline to donate as a political statement, unwilling to give blood until they can be honest about who they are; still others find out they can’t donate when they read the questionnaire at the blood bank.

Because gay men who donate blood can’t admit their sexuality to the blood bank, it’s difficult to know just how prevalent the practice is. Maria Pineda, a vocational nurse with the Red Cross who participates in blood drives all over Los Angeles County, said the organization has to take donors at their word when discussing sexual history.

“Sometimes I have wondered about people, but we really have to go with what the person says,” Pineda said. “Also, you never know if the person is sexually active.”

Pineda emphasized that the blood is tested for HIV and other infections after the donations are collected, and added that there is a line donors can call afterwards if they think their blood shouldn’t be used.

Both Pineda and the Red Cross support a revision of the current ban on gay men donating blood. Still, rates of infection among men who have sex with men in Los Angeles County far outpace those in any other demographic. According to AIDS Project Los Angeles, men who have sex with men account for 69 percent of the roughly 63,000 people in the county who are HIV-positive. In addition, men who have sex with men account for 77 percent of infections diagnosed within the last year.

In spite of these statistics, Dr. Michael Gottlieb, an HIV-specialist at Olympia Medical Center who has worked to treat the disease since it was discovered, said it’s time to change the policy.

“The policy had its place at the time, 25 years ago,” Gottlieb said. “It probably spared some instances of HIV-transmission. But advances in technology and detection of HIV make that policy obsolete. The policy should apply to heterosexuals as well. All people with high-risk sexual behaviors should exclude themselves. People in stable relationships with HIV-negative partners are in my opinion perfectly good blood donors. There are other populations besides gay men at increased risk of HIV. It seems obsolete to use a population base as an exclusion rather than the blood test that’s proven.”

Still, Gottlieb reiterated that practicing safer sex and getting tested for HIV does not guarantee that someone is HIV-negative — or a safe blood donor.

“It seems to me there’s a huge responsibility involved in donating blood, and people should abstain if they’ve had multiple partners,” Gottlieb said. “Protection doesn’t work, sometimes, and there is a three to six month window for seroconversion. Someone with three or four partners in a year or who’s been in a stable relationship for at least six months seems like a safe donor to me. People who have had many partners, or who haven’t used protection, or who use drugs should exclude themselves. And of course the extra layer of protection should be testing the blood.”