STOP the FDA's Gay Lood Donor BanPresentation Transcript
BLOOD DONATIONS in the US A look at a controversial history
BLOOD DONATIONS A history of discrimination
World War II 1940 USA Dr. Charles Drew was the first black person in the U.S. to receive a Doctor of Science in Medicine degree from Columbia University He researched techniques in blood and plasma donation and was named Director of the American Red Cross Blood Bank in New York City At this time, the need for blood was great due to the soldiers fighting in WWII.
American Red Cross WWII Flyer
Red Cross Flyer from WWII
However, in 1941,Dr.Charles Drew resignedfrom his position as Director of the American Red Cross Blood Bank … WHY??? ??????? ??????? ??????? ?
Because , in 1941, the WarDepartment issued a directivestating that blood taken fromwhite donors should not bemixed with that taken fromAfrican American donors."It is not advisable toindiscriminately mix Caucasianand Negro blood for use inblood transfusions for the U.S.Military".
Do you think this was adecision based onscientific research ordiscrimination ?
Dr. Drew called this unscientific and said "the blood of individual human beings may differ by blood groupings, but there is absolutely no scientific basis to indicate any difference in human blood from race to race.“ The US Military still continued to implement this policy, even during the crisis of need for blood to send to the American troops, until 1949. After that, transfusions were allowed, but Black and White blood was still stored separately!So, for nearly a decade (1941-1949), U.S.soldiers were denied blood that might havesaved their lives because of a fear-based, discriminatory policy.
• Fast forward : By September 1982, the CDC began calling a new, deadly disease AIDS (acquired1982 immune deficiency syndrome • Many were dying but no one knew why. • Some doctors were reluctantWHY? to investigate the causes of AIDS at all.
Dr Joel Weisman summed up the generalattitude by describing a conversation:"I remember calling a person [ininfectious diseases] to describe whatwas occurring. He said - and this was atheme very early on – I dont know what youre making such abig deal of it for. If it kills a few of themoff, it will make society a better place‟.”(Black , 1986).
Do you think this was a decisionbased on scientific research ordiscrimination ?
"An entire political movement grew uparound the silence of the Reaganadministration. The AIDS activist movementtook as its call to action silence equalsdeath because literally the silence of theReagan administration was resulting in thedeaths of thousands and thousands of gaymen in our communities across thecountry."Sue Hyde, National Gay andLesbian Task Force (Jacobs, 2004).
The silence of the US government on the topic of AIDS essentiallyendorsed the deaths of gay and bisexual men
Keith Haring graphic art
Atmosphere of fear and panic It was in 1983, during this time of rampant homophobia and panic when the FDA chose to decree its lifetime ban policy on donations from gay/bi men. Billboards and bumperstickers stated things like “Thank GOD for AIDS” This was a climate of fear and uncertainty Blood testing was not yet very sophisticated There was a huge stigma placed upon anyone with AIDS As if an HIV + person was a leper :filthy and unclean Sadly, many of these attitudes still persist today
No one seemed to care… Few seemed to care about these people who were dying until it began to affect the straight communities as well. People had no idea how it was spread and rumors were flying. The first national AIDS education campaign was not launched until 1988. By then, nearly 83,000 cases of AIDS had been identified in America, and Over 45,000 people had died.
1983 FDA GAY BLOOD BAN FDA: Ban is necessary because : Men who have sex with men are at an increased risk for HIV and Hepatitis While it has been historically true that MSM experience higher rates of HIV infection than some other groups-classifying blood donors by their level of risky sexual behavior is a less discriminatory, safer way to screen donors. Additionally, more people with safe blood would be eligible to donate: helping reduce our recurring national blood shortages.
Stop the discrimination Being a MSM does not make someone particularly susceptible to HIV or hepatitis infection. Due to economic and social discrimination, MSM as a group experience increased rates of drug use and unsafe sexual practices, as do many other groups experiencing discrimination. Adding further unnecessary discrimination against MSM is not the answer to addressing the HIV/AIDS crisis. Nor is it the safest way to screen blood donors.
FDA says but other places do ittoo FDA : Other countries also have lifetime/restrictive bans on this group BUT The principal of “everyone else is doing it” does not justify unethical behavior. Discrimination against the (L)GBT community generally and MSM specifically has hardly been unique to America. The FDA‟s attempt to use more socially progressive European countries for political cover is also misguided. Many countries, including European ones, have reformed or are reforming their Gay Blood Bans as we speak. Here is a partial list: Russia, Spain, Italy, the Thailand Red Cross, Sweden, Brazil, Argentina, Japan, Hungary, and New Zealand.
POLAND A very interesting point here is that the AIDS rate in Poland is VERY low and primarily occurs from IV drug use. Poland is a country that DOES NOT BAN anyone from blood donations based solely upon sexual orientation.
FDA FDA:The deferral for men who have had sex with men is based on the following considerations regarding risk of HIV: Men who have had sex with men since 1977 have an HIV prevalence (the total number of cases of a disease that are present in a population at a specific point in time) 60 times higher than the general population, 800 times higher than first time blood donors and 8000 times higher than repeat blood donors (American Red Cross). Even taking into account that 75% of HIV infected men who have sex with men already know they are HIV positive and would be unlikely to donate blood, the HIV prevalence in potential donors with history of male sex with males is 200 times higher than first time blood donors and 2000 times higher than repeat blood donors.
Response to FDA claims Right off the bat, it‟s not fair or useful to compare gay men as a group to repeat blood donors. Repeat blood donors have actually had their blood tested for HIV – the FDA requires it! That‟s a self-selecting HIV negative subset of the population. Adopted from: http://www.gayblooddonation.org/against.html. If 75% of HIV+ MSM know they are infected, some portion of that 25% who doesn‟t “know” their status likely have strong inclinations about their risk of infection based on their past sexual behavior. These MSM who don‟t “know” their HIV+ status in the sense that they haven‟t confirmed it through medical testing are also less likely to donate blood. We suspect that MSM who truly have no idea they are HIV+, who also may have had limited sex education, would also be a subset less likely to attempt to donate blood than MSM who do already know their HIV status. The FDA could further discourage all individuals who practice risky sexual behavior from donating with a questionnaire based upon risky behavior rather than sexual orientation.
FDA is ignoring : 1) the number of gay men with HIV is only a miniscule fraction of the overall number of gay men, 2) the overwhelming majority of gay men have not and will not acquire HIV because they do practice safe sex, 3) the cause of HIV infection in almost all cases is unsafe behavior - unsafe sex or use of dirty needles, 4) while HIV may be slightly more prevalent amongst gay men than in the general population it is also more prevalent amongst other social groups which are not barred, as groups, from blood donation, 5) higher prevalence in any particular group, does not mean that individuals within that group are at higher risk. In short, it is wrong to conclude that all gay men are at high risk from HIV infection simply because the majority of HIV infections occur through male-to-male sex.
Possible blood shortages ignored It may be easy to lump all MSM together, but administrative convenience is not an excuse for discrimination. This risk analysis also fails to account for the very real benefits of increasing the blood donor pool. The U.S. has experienced repeated blood shortages that are only projected to worsen as the population ages. The FDA needs to consider the benefits of an increased donor pool, especially in mass-casualty scenarios, when conducting its cost- benefit analysis. Furthermore, the FDA can meet its safety obligations more effectively and efficiently by using behaviorally – based intake questionnaires.
Ignorance is NOT bliss Men who have had sex with men account for the largest single group of blood donors who are found HIV positive by blood donor testing. True, but only because the FDA chooses to categorize donors based on sexual orientation and refuses to categorize donors by the risk level of their sexual behavior. We suspect that a group of potential blood donors who admits to practicing unsafe sex with multiple partners would have a higher prevalence of HIV infection than MSM. BE AWARE OF RISKS
About „window periods‟….. There are many less discriminatory, more effective ways to reduceunknowing “window period” donations. The FDA could (privatelyand anonymously) ask all potential donors about their recent sexualhistory and whether/when they have been tested for HIV. The FDAcould impose a short-term, rather than permanent, deferral onsexually active MSM. The FDA could educate potential donors aboutsexual safety, the risks and effects of HIV/AIDS, and the varioustesting methods available. The FDA‟s MSM policy is underinclusive in that it fails to accountfor heterosexuals who unknowingly donate blood during the“window period” of their infections. It is also overinclusive because the rate of infection within theMSM grouping varies drastically based on the risk level of theirsexual behaviors.
The stigma of AIDS remains and many still think of it as aWhite, gay man‟s disease. However- this is no longer true:as of 2008, cases of AIDS have dramatically risen in theBlack population.Black women have 18-20 times the rate of HIV of whitewomenBlack men have over six times that of White men. What does this mean ?Do we revert back to the racist ideas of the past ? NO!
• Choosing to use IV drugsRisk • Choosing to travel toRisk certain countries • Choosing to have unsafe sex with multiple partnersRisk • THESE ARE ALL RISKY BEHAVIORS!!!!!
A few words from Mr. Schaefer of the Gay Men‟sHealth Crisis in New York City:“…A better policy could be like that of Spain orItaly, in which ALL potential donors are askedhow many sex partners they have had in thepast six months. Anyone, gay or straight, whosays they have had only one partner, candonate blood, while others are deferred for aperiod of time. That would ensure that „high-risk heterosexuals‟ are deferred too.”
Simply being a sexually active gay or bisexual man, on its own, is NOT ahealth risk. The idea that their bloodwill automatically be HIV positive is a sad relic from the 1980s epidemic-when no one cared how many died. Small minds tainted by homophobia are the biggest threat that gay and bisexual men face today. End the ban.
REFERENCES 1.)Carlson, K. (2011, March 31). Saving lives with helpful guy:safely andsensibly reforming the fdas gay blood bans. Retrieved fromhttp://www.savingliveswithhelpfulguys.com/ 2.) Starr, D. (Writer), Segaller, S. (Director), Read, N. (Producer), & DelGuercio, G. (Director) (2002). Blood and war [Television series episode]. InMarengo, A. (Executive Producer), Red gold the epic story of blood:i. New York, NY:Thirteen/WNET. Retrieved fromhttp://www.pbs.org/wnet/redgold/innovators/bio_drew.html 3.) Black , D. (1986). The plague years: A chronicle of aids, the epidemic of ourtimes. New York, NY: Picador, USA. Retrieved from http://www.avert.org/aids-history-america.html 4.) Jacobs, E. (2004, June 18). Activists recall reagans record on aids. BayWindows. Retrieved from http://www.baywindows.com/activists-recall-reagans-record-on-aids-59558 5.) WHO, UN AIDS,UNICEF, WOrld Health Organization. (2008).Epidemiological fact sheet on hivand aids:core data on epidemiology and responsepoland. Retrieved from website:http://apps.who.int/globalatlas/predefinedReports/EFS2008/full/EFS2008_PL.pdf 6.) CDC Centers for Disease Control, (2012). Expanded hiv testing and africanamericans. Retrieved from website: http://www.cdc.gov/hiv/resources 7.) Wetzstein, C. (2012, May 16). Study could end ban on gay men donatingblood would make a subset eligible. Washingtom times. Retrieved fromhttp://www.washingtontimes.com/news/2012/may/16/study-could-end-ban-on-gay-men-donating-blood/