Every November, the University of Michigan hosts an annual Blood Battle against The Ohio State University in a joint effort to increase the national supply of blood and bone marrow. Dr. Martino Harmon, the University’s vice president for student life, directs this initiative through day-long blood drives at various locations on campus nearly every single day in November. This year’s battle, the 40th of its kind, was kicked off in the Diag — accompanied of course by plenty of food, merchandise and sign-up information. Harmon’s promotional emails are filled with the necessary jargon to get students in the spirit of giving — “keep bleeding Maize and Blue,” “eat lots of iron-rich food” and “be a part of the fight to save lives across the state and country!”
Oddly, the battle cry to replenish America’s blood stores, which are at a record low, is not targeted at all viable donors. The U.S. Food and Drug Administration (FDA), the agency responsible for regulating blood donations, bans all men from giving blood within three months of having sexual intercourse with another man. This policy is the result of a 2020 change that reduced the donation deferral period from a year to three months. The FDA notes in this policy that given the advances in HIV detecting technology, this change is supported. But as recently as 2015, just a few years before this improvement, all men who have sex with a men were subjected to a lifetime ban on giving their blood.
In their guidance document, the FDA claims that up to 90% of potential donors that may be harboring blood diseases are ultimately deemed ineligible by their responses to a questionnaire about health history. However, deferring a man from donating just because he has had sex with another man is a gross reflection of the limited, under-researched and surface-level knowledge that the FDA had in their toolkit during the 1980s HIV/AIDS pandemic. It is now understood that there doesn’t exist, and never had existed, an exclusively “gay-related immunodeficiency,” and any eligibility question that uses sexuality as a way to preclude all gay men from donating blood for a given period time is simply based in prejudice and non-science.
As it stands, a gay man in a 40-year monogamous relationship with another man is labeled as a higher risk for blood-borne diseases than a woman who has recently had unprotected sex with several partners. This juxtaposition of risk is substantiated, in part, by a nearly decade-old research finding from the National Heart, Lung and Blood Institute (NHLBI) stating that a history of male-to-male sex was associated with a 62-fold risk increase whereas a history of multiple partners of the opposite sex was associated with 2.3-fold increase. But given that other activities such as routine drug injection, prostitution and travel to malaria-prone countries are associated with both large multiplicities of risk and deferral periods of their own, it makes more sense to use individual risk assessments, not blanket deferral periods, as a way to determine blood donation eligibility. In this way, a gay man who is also a routine drug user and travels to malaria-prone countries has a higher risk score — and ultimately receives an individual ineligibility penalty that reflects engagement with these activities — than a gay man who does not partake in any other activities of high blood-borne disease contraction.
The key to rectifying this injustice is cold, hard data. Most available information shows that individual risk assessments, not time-based deferral strategies, are the right ways to counteract the spread of disease in the blood donation process.
It is clear that the artificial dichotomy between gay blood and healthy blood, a perception hand-crafted and unmoved by the FDA, only serves to stigmatize the LGBTQ+ community further. Moreover, giving heterosexual individuals the green light to engage in multiple forms of unsafe sex (which is a risk factor in itself) and donate blood in the same breath is a double standard, and one that people are not addressing in the correct manner. Half-hearted responses are a large reason why the policy still stands in 2022.
The U-M Blood Battle emails state that “Blood donation eligibility should not be determined based on sexual orientation and policy change is needed in order to achieve this goal. At the University of Michigan, we strive for our drives to provide as inclusive an atmosphere as possible.” These emails link to the Red Cross — an organization that actively opposes the FDA policy — for information about how LGBTQ+ men can contribute to the cause. The primary method through which these men are able to participate, though, is manning blood drive booths, recruiting donors and other administrative tasks.
Frankly, deferring to the Red Cross and vague DEI statements about inclusive atmospheres is a mismanagement of our resources here at the University of Michigan. As a research-heavy institution, we have the labs, researchers and money to get projects off the ground that would give the FDA’s Blood Products Advisory Committee indisputable evidence that our current understanding of risk assessment is wrong. Instead of cutting whole segments of the populace off from their ability to donate to blood, we should be focusing on data-intensive individual risk assessments that actually help in determining risk of disease.
While the FDA is researching alternative methods other than time-deferral, the University of Michigan has the finances to make these same investigations, as well as other kinds of advancements in blood testing, risk assessment accuracy and false-negative donor origins. Furthermore, we must do our due diligence by conducting research that supports exclusion criteria for heterosexual activities in which a similar causal relationship between the type of sex and infectivity exists.
Lobbying, letter writing or protesting to get the FDA to stop cherry-picking which activities are and are not best practices for blood donation is hardly the tangible change we need. The FDA was created to be a research-driven entity of the U.S. Department of Health and Human Services. The only way to take a crack at their petrified policy is through generating social and biomedical research, fields to which the University of Michigan devotes entire portions of campus. For next year’s Blood Battle against Ohio State, I believe all healthy blood will be eligible for donation so long as we support the knowledge we have of blood-borne disease incidence with an individual’s entire profile of risk, not lazy policies that shackle all men to the same length of deferral.
Namratha Nelapudi is an Opinion Columnist & can be reached at firstname.lastname@example.org