A college frat boy who has had unprotected sex with a different girl every week for the past semester can give blood/marrow, but monogamous, healthy gay men can't. I don't get it.
Someone else's life is on the line. They need to be sure.
Though I must admit, I'm surprised the policy is in place with marrow donations. With blood donations, sure, transfusions are a routine thing and your blood is highly replaceable. With marrow donations, though, someone may need your marrow or they'll die. I'd think a match, even if it carried a slight statistical chance of HIV, would be something they'd want to know about.
If, however, I had sex with a man once in the last 30 years I am not eligible.
Why is it more sensible to turn away gay people then it is to turn away people who have regularly exposed themselves to HIV?
On the other hand, many people who need a marrow transplant have some flexibility as to when they can get the donation. This is why the guidelines are so strict: the risk/reward ratio is balanced in favor of caution.
I'm pretty sure if my life was on the line I'd rather get both bone marrow and HIV than neither. HIV is essentially a chronic disease nowadays in the developed world, and if there was any suspicion of HIV in the donor they could add antiretrovirals into the cocktail I'd already be taking.
It's not as if gay men are the only ones to get HIV, anyways.
And no, it is not for health issues because they don't turn away gay women.
Of course you could register if you want to and then if called upon show up eagerly with your partner for moral support. Then flat out ask if they are going to kill their own patients just to pretend that it is still the fifties.
Of course don't do it if they can't get a donor in time.
Couldn't find all the numbers I was looking for, but it turns out 61% of infections in US are through male-to-male sexual contact. This probably translates into over 60% of HIV carriers being male and gay.
Now, if I was a guy in a position to decide things, and I could reduce by more then half the risk of HIV in transfused blood by reducing the donation pool by 7-10%... I'd do it in a heartbeat.
If you have some time you could try to calculate how many more people would get HIV if gay people would donate blood. You could subtract the people who wouldn't die because of the increase blood supply. But the result would still be positive.
The point of the whole blood donation thing is not to be politically correct, but to solve a problem. Making it politically correct, in this particular case, would mean solving the problem worse, possibly significantly worse then if we just let them do their jobs.
I think you both imagine that transfusions are 1 on 1. (1 donor, 1 recipient). In this case, the numbers you present kind-of work out. And sure, a risk of HIV (or whatever) infection versus certain death is worth it in any scenario. (Especially now that HIV/AIDS is chronic and treatable rather than terminal).
Many scenarios involve heavy blood loss and require more than what is normally given by a donor in a single donation. This means drawing on the pool of available blood, so multiple donations will be used of the same type, but they won't be from the same donor.
This raises the risk of transfusing infected blood significantly which is one of the reasons that the screening for blood donation harshly excludes anyone who fits in one or more higher risk groups.
I'm a donor and where I live you can't donate blood if you've received blood (inter-species tissue exchange), lived in UK in the 90s (mad cow disease risk), were born in sub-Saharan Africa (HIV risk) and a couple of others. This includes ever having had male/male sex (very high risk group). Ever been paid for sex? Out. Ever exchanged drugs for sex? Out. The list goes on and on.
The 'in the last 12 months' items are again a form of risk management (they include new partners, tattoos, piercings, infections, illness, surgery, travel to risk countries, etc).
All blood gets tested and though false negatives are still possible, most infections are statistically close enough to 100% detectable after 6 months.
Where I live it's also illegal to sell parts of your body (which includes your blood). The idea behind that is that legalizing this would create a predatory market between people with money and those on the bottom rung of the ladder (poor, addicted, high-risk, all of the above). That's not a hard sell, but it also acts as a filter in the blood donation system. People who are most likely to sell blood are the people you don't want giving blood in the first place.
A detail in my country is that the donation forms don't ask about your sexual orientation, which is irrelevant. If you identify as homosexual (male/male or female/female) but have never had male/male sex, you're good to go.
Blood donation is a region where you're just harshly subjected to selection based on statistics which place you in one risk group or another. Discrimination doesn't factor into it.
It's a question of perspective. You might be certain enough of your and your partner's fidelity over the last year to bet a stranger's life on it. But they aren't confident enough in a stranger's assertion of marital fidelity to bet their patient's life on it.
> All blood gets tested and though false negatives are still possible, most infections are statistically close enough to 100% detectable after 6 months.
This kind makes irrelevant all the outrage over them accepting blood from donors who have had wildly unsafe sex over 12 months ago. At this point it's only a matter of risk management surrounding the possibility of recent infection. You may say that in that case, it shouldn't matter if you had a same-gender sexual encounter 30 years ago, but this really just boils down to statistics, and having a same-gender sexual encounter puts you in an entirely different statistical category than people who restrict themselves to strictly heterosexual encounters.
You seem to be saying, in essence: allowing gays to donate doubles the number of instances of transfusing HIV while only increasing the number of lives saved by 7-10% (or 20%, or 2% - it doesn't matter). But that's the wrong way to look at it. Even if 10% of all transfusions from gays resulted in an additional HIV infection (thanks to testing etc., I'd guess it'd be well below 1%), that still means that, for any given transfusion candidate, you have a 90% possibility of saving their life without transfusing HIV.
Excluding certain categories is a simple and effective administrative solutions - and doesn't really make any sense to confuse it with anything else.
So, gay men and women may be treated very differently by health officials with some valid reason.
[1]The CDC actually tracks the objective category "men who have sex with men", and not the fuzzy labels "gay" and "straight".
[2]http://www.cdc.gov/nchhstp/newsroom/docs/fastfacts-msm-final...
http://www.cdc.gov/hiv/topics/surveillance/incidence.htm
CDC estimates MSM represent approximately 2% of the US
population, but accounted for more than 50% of all new
HIV infections annually from 2006 to 2009.
Yeah. I thought it was implied that we were talking about that, though. I mean, even the casual reader should be able to infer that gay men do not make up anything like half the general population. That would mean there were no straight men at all.
If we have several small populations of people with a high incidence, though, I think the raw contribution is actually the right number to talk about. Consider the following thought experiment:
I have 100 people, and 6 HIV infections. 10 of the people are gay men, and 3 of them are infected. 2 of the people are female prostitutes and both of them are infected.
The general population has a 6% infection rate. The gay men have a 50% infection rate and account for 50% of the infections. The prostitutes have a 100% infection rate and account for 33% of the infections.
The exclusion of which group improves the resulting donor pool more?
If we exclude the men, we are left with 3 infections / 90 people = 3.3%. If we exclude the prostitutes, we are left with 4 infections / 98 people = 4.1%.
Even though the prostitutes have a much higher rate of infection than the gay men, excluding the men helps the final result more because they account for more of the overall infections.
Either is fine. "50% of HIV positive people are gay" is not. For all we know, there are only two HIV positive people, and one is gay and one straight. That's hardly a reason for excluding all gay people from donating...
There is probably some testing regime that could be implemented that would allow tissue and serum donation programs to be blind to sexual behavior.
The problem, as I see it, is that most countries place an unreasonable bias against _all_ gay men rather than _some_ gay men. The appropriate way to handle donor screenings is to ask about sexual behavior in general, such as whether or not you are monogamous, how many partners in the past year/two years/five years, how often condoms are used, etc.
Instead, we blatantly exclude all gay men but do not exclude other high risk demographics. For example, black women are eligible despite being an extremely high risk group compared to white women (1 in 58 vs 1 in 588, respectively).
Unfortunately, the FDA is so afraid of alienating existing donors by asking them for a sexual history profile that they would rather stick to the status quo and continue excluding gays altogether.
Which could actually make sense. If (if!) it's correct that asking about sexual history would alienate existing donors, and if (if!) it would alienate enough to compromise the blood supply, it might be "safer" to keep the current rules in place instead of trying to be somehow more objectively "fair".
Wait, doesn't that exactly refute your point? Presumably, gay men and gay women have different health profiles, whereas they have similar "moral" profiles to an up-tight conservative. I think the statement makes more sense like:
> And no, it is not for moral issues because they don't turn away gay women.
[0] http://www.redcrossblood.org/donating-blood/eligibility-requ...