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FDA proposal to allow gay and bisexual men to more easily donate blood

Even in the snow, the Red Cross trucks in Durham are ready and waiting. Around the state, North Carolina blood banks are currently facing new shortages.

Until he came out as gay in 2010, UNC alumnus Lee Storrow was able to donate 75 units of platelets over multiple years. 

He became ineligible due to the U.S. Food and Drug Administration's policy at the time that restricted gay and bisexual men from donating blood. 

“For me, someone who was eligible for several years, donated 75 units of platelets, to be unable to donate for a decade — that’s a significant number of blood donations and platelet donations that I could’ve made for a number of years,” he said.

The FDA currently restricts blood donations from men who have had sex with other men within the last three months.

But because of a new approach, Storrow could soon regain his eligibility.  

On Jan. 27, the FDA announced a proposal to change its current blood donor eligibility policy and eliminate time-based deferrals that seek to reduce the risk of transfusion-transmitted HIV.

Under the proposal, the donor history questionnaire will be revised to ask questions that are gender-inclusive and based on individual risk, regardless of identity. 

Any prospective donor who reports having new or multiple sexual partners and anal sex within the past three months will be deferred from donation, according to the FDA's proposal. 

This guidance still requires permanent deferral for those who have ever tested positive for HIV or taken medication to treat HIV infection. Individuals orally taking PrEP or PEP to prevent HIV infection will be deferred for three months from their most recent dose, while those taking injectable PrEP will be deferred two years from their most recent injection.

With the FDA now going through a public comment period of 60 days, Troy Dang, the medical laboratory supervisor of theUNC Blood Donation Center, said he believes it may be another six to eight months before new donors are welcomed.

“I think more folks will be able to give back to their community and fewer of our patients in need of blood products will have to wait or be turned away from receiving lifesaving treatment if we expand donor population and eliminate unnecessary deferral,” he said.

Lina Rosengren-Hovee, an assistant professor in the UNC Department of Medicine's Division of Infectious Diseases, said queer people, especially those assigned male at birth, have a higher likelihood of obtaining HIV.

“We need to acknowledge that there is an elevated risk, but also protect this population from the stigma that comes with that,” she said.

Rosengren-Hovee said she believes this new guidance is a step in the right direction, but it needs to continue to be reevaluated from an HIV transmission perspective and a stigma research perspective.

She said other factors like people's sexual behaviors and bodily anatomy play larger roles in transmission risk than gender.

Dang said with the country coming out of the COVID-19 pandemic, blood donation is still very important.

“We are starting to see more and more donors return back to the chairs as they continue to resume their other everyday activities, but we’re still not quite at the level we were before the pandemic started,” he said.

Dang said this process has been a long time coming, as other countries have already implemented this individual risk assessment. Countries that have this policy, like Canada and the United Kingdom specifically, have shown no increased risk to patient populations, he said. 

“Some folks might be hesitant about this change because they think that there’s a greater likelihood of being possibly transfused blood that is positive for HIV,” Dang said. “But the research done in these other countries so far has shown that that is not the case.” 

Storrow, who has been advocating for this issue since the blood policy was up for review in 2010, said he encourages others to do the same and use this period to give feedback.

“I think landing the perfect blood donation policy is probably near impossible, but I think advocates should really celebrate this as a win that has taken years of pressuring and pushing the FDA to reject stigma and focus on science,” he said.

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