A Stitch in Haste

I have to admit I’ve been rather ambivalent about the American Red Cross and their policy of blanket exclusion of anyone who has had gay sex, um, ever.

I had two reasons for giving the Red Cross a bye:

--The policy is actually a Food and Drug Administration policy rather than a Red Cross policy.

--In terms of giving aid to international disaster relief, such as the Boxing Day tsunami, I am adamant that my charitable giving abroad be clearly and unequivocally labeled “American” money.

But after further review, inspired by this story about a student government boycott of American Red Cross blood drives at the University of Maine, I find that the Red Cross isn’t as unwilling a participant in the gay blood ban as one might hope.

Dr. Rebecca Haley, interim chief medical officer for the American Red Cross, told the committee that the Red Cross did not support changing the current ban on blood donation by from men who have engaged in homosexual behavior during the past 24 years because of the risk of introducing HIV-positive blood into the national blood supply. Although Dayton's risk analysis found that "introduction of a five year floating deferral for male-to-male sexual behavior, even using conservative estimates, would result in minimal increased morbidity in the blood supply by HIV," the Red Cross urged caution in changing a policy that so far has kept the blood supply virtually free of tainted blood.
...
"If the Public Health Service could assure us that introducing previously deferred donors into the pool could be accommodated without increasing risk, the American Red Cross would support appropriate actions to do so," Haley said.

Dayton estimated that there are 62,300 men who want to donate blood, but are prohibited from doing so by the current law.

Considering the known incidence and prevalence rates of HIV infection in this population, he said, changing to a five-year deferral policy could potentially introduce 1,246 units of HIV-positive blood into the system to be screened. Testing done on each of these units would likely result in an added 1.7 units of HIV-infected blood into the nation's blood supply, experts said at the meeting.

On the one hand, that “62,300” figure is a joke — there are probably that many gays in New York City alone who would give blood if allowed. On the other hand, 1.7 units! What exactly is the difference between “virtually free” and 1.7 units? (Remember, all donated blood is tested for HIV — we are talking here about mistaken transfusion due to testing failures, the rates for which are obviously miniscule.)

Of course allowing gays to donate blood increases the hypothetical risk that a less-than-negligible amount of HIV+ blood makes it way into the blood supply. But what of the very real offsetting risk of having a severe chronic blood shortage? This is not about risky versus riskless, it’s about a (small) potential risk versus a (large) actual risk. What unbiased observer would choose the latter?

That’s not science. That’s not public health. That’s politics. And it’s a politics that kills.

Still not satisfied? How about this: Allow anyone to donate blood if they meet all the other screening criteria and can produce lab results indicating that they tested HIV negative within the past year? That would reduce the 1.7 units estimate to essentially zero. Anyone who would be opposed to that (which would still be discriminatory, but better than a blanket exclusion) is clearly more interested in keeping the blood supply gay-free rather than HIV-free.

I still can’t say without reservation that boycotting the American Red Cross’ disaster relief work is necessarily the proper course of action when disaster strikes abroad. But it’s time for the junk science and political undertows at work in the gay blood donor ban to stop. Not just in the name of gay dignity, but also in the name of alleviating the public health crisis spawned by this unwarranted hysteria.

Gay doctors, nurses and public health specialists need to speak out. Symbolic protests like that at the University of Maine can't hurt either. Education is the weapon; we need to start using it.