The Gift of Life

July 23, 2009 at 9:54 am (Politics) (, , , )

Two weeks ago today, I went down to give blood for the Red Cross. When I did so, I was a little worried that any of a number of issues might have prevented me from being able to donate – my blood pressure is high (but not too high for that), I’m on several prescriptions (none of them issues, it turns out), etc. But I didn’t really expect one thing to be on the list.

Quoting from the Red Cross’ donor eligibility page…

“You should not give blood if you have AIDS or have ever had a positive HIV test, or if you have done something that puts you at risk for becoming infected with HIV.”

Well, fair enough, makes plenty of sense there, you’re thinking. But then we read on….

“You are at risk for getting infected if you…are a male who has had sexual contact with another male, even once, since 1977.”

There are a lot of things on the list, but that one flashed out at me with big, bright, neon lights. Now, I wasn’t disqualified by that criteria, but a hell of a lot of my friends would be. And why? Pure homophobia.

Now, some of you might be thinking that it’s not pure homophobia – HIV is more common in the gay community, so it makes sense. Well, no, it doesn’t… and here’s why.

  1. HIV isn’t a ‘gay problem.’ It’s potentially a problem with all sexual contact. Having sex with a man isn’t a risk factor – it’s having unsafe sex with anybody who might be infected, and just about anybody could be infected. They’ve picked it up in the gay community, the straight community, even in the virginal community… so given that, singling out only one of those groups is blatantly discriminatory.
  2. Even if we do make the assumption that HIV is sufficiently more common in the gay community to justify this ban, infection can be prevented through safer sex techniques. But using them doesn’t matter to the Red Cross, despite the fact that somebody who uses condoms properly could practically eliminate their risk factor.
  3. Within 6 months of infection, HIV can be detected. So, even at the most paranoid, you could make this one of your “in the last 6 months” bans, rather than a blanket ban. The Red Cross tests their donors for HIV (among other things) anyways, just in case somebody’s lying (or, oh, I don’t know, falls into the category of ‘people who have it who weren’t part of the communities we ban’), so if you haven’t been potentially exposed in the last 6 months, they’ll know if you’re clean or not.

So, what do we have here? The Red Cross is – I have to think consciously – excluding a very large community of potential donors for no more reason than homophobia. If they wanted to be sure that they excluded anybody with HIV, they’d have to ban anybody who’s had sexual contact with anybody in the last 6 months. If they only wanted to be reasonably certain, they’d have to exclude anybody who’s had unsafe sexual contact with a partner who hasn’t been tested at least 6 months after their last possible exposure.

And yet, I could go out to a bar and hook up with a different woman each night for the week before I donate, and as long as I didn’t pay her for the privilege, they’d take me. On the other hand, if I did a little safe experimentation in college 3 years ago – or 30 years ago – I’m banned, even though they can test my blood and find out whether or not I’m infected.

What’s wrong with this picture?

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3 Comments

  1. H. o'Dagg said,

    I don’t thin it’s homophobia as much as it is plain, simple, STUPID inertia. After all, we’re dealing with what would be one of the largest corporations in the world if they were allowed to make a profit, and haven’t we seen plenty ef evidence of just how fast corporations can make needed changes?

    BTW, I’m proud of you, thanks for donating.

  2. Vorex said,

    Speaking as someone who’s done his fair share of work with blood and other tissues, there’s nothing wrong with the picture.

    Ultimately the gay sex exclusion isn’t about homophobia, just as the intravenous drug exclusion isn’t about drug policy, the born-in-central-africa exclusion isn’t about racism, and the sex-for-money exclusion isn’t about the wisdom or legality of prostiution. They’re all about AIDS, epidemiology, risk factors and the pathological paranoia you have to have about transplant tissues.

    It’s all very well to say that HIV isn’t a gay problem, or a drug-users problem, or a prostitute’s problem, or an african problem, but the epidemiology is that these have been, and remain, the groups in which HIV is most widespread. Eliminating those groups from the cohort is a sensible thing to do from any perspective in which you’re concerned about transmitting a lethal disease to transplant recipients, when you can’t be *entirely* confident of your tests.

    And we can’t. The aggregate false negative rate for HIV testing is in the order of 0.003%. That is, for every 100,000 tests that should return a postive result, 3 will return negative. The rate is higher for strains like HIV-O, which show a reduced response to testing. For testing in the community this isn’t so bad, most HIV testing regimes will actually invovle a number of tests spread over a period of time which dramatically reduces the likelyhood of a false negative result. With blood you don’t really have this option. Most components of blood have a short lifespan once drawn and you want as much of that life spans as possible to happen inside the recipient. This limits the oppourtunity for repeat testing and makes it more important to use other methods to assist in ensuring that the tissue supply is clean. Excluding populations where you could expect to see a higher than usual prevalance of disease is an effective way to do this.

    That, for a tissue authority, is the bottom line. Securing the health of the tissue in the simplest (not neccessarily the most precice, or the most socially just) and most effective way possible. They’ll even be quite calm about the fact they’re excluding heathy potential donors because in the tension between tissue volume and tissue health, health will always win out. It does no-one any good to have vast stores of tissue if medical practitioners and patients can’t both be supremely confident that the tissue is perfectly clean. This is true of any transplant.

    In the end, gay men aren’t being treated any differently here than other HIV risk groups. And none of them is being treated any differently to risk groups for other serious blood-borne conditions. (Such as people who have lived 5 years in Europe. Or people who have ever had unexplained jaundice. Or anyone who’s ever had p-HGH.)

    I really think you’re seeing homophobia where there isn’t any.

    • wolfemann said,

      Thanks for the technical end of this; I admit that I did think about this for a while before posting it (there’s a reason I posted 2 weeks later, not that night, after eating my cookie).

      My issue is this; does it make sense to exclude anybody, even if it’s years and years after a single potential exposure that could actually not have been an exposure at all?

      The false negative rate was good to hear about though. I’m still not sure that flat-out excluding the group is the right answer, but I’m glad to hear your take on it (particularly since I know you’re on the list of people affected by this.)

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