Gays and Giving Blood

[Pint0 Xtreme]

Ok, I see. But the larger issue here is whether it is ethically defensible for a blood bank to refuse donations from gays, right?

I would say that there's a solid argument to be made that by excluding homosexuals, you make the blood supply safer. Whether its the "fault" of homosexuals that they have HIV more often seems irrelevant.

The system is flawed (and dare I say discriminatory) if they excluded people based on their sexual orientation and not on other more pertinent questions, such as the number of sexual partners. The way I see it, I would be excluded from blood donation regardless of the fact that I am monogamous with my boyfriend and we are both clean, while some hoe who's fucked ten people is more eligible for blood donation just because they're straight.

[Gil Hamilton]

They ask those questions because male homosexual sex is statistically a high risk behavior. However, before people gnash their teeth about anti-gay bias, it's not like that. On that questionnaire, they ask you if you've done alot of things that have an increased risk of transmission. For instance, if you've spent time in a prison for a certain length of time or if you've ever been in Africa or have had sexual contact with anyone who has, not to mention the long lists of potential diseases and medications that can cause complications. I mean, they ask you if you've gotten tattoos, permanent make-up applied, or piercings within a certain amount of time. That doesn't mean they are biased against people with tats, it's just they are playing statistics and being overly cautious. After all, they don't have time to delve into every donors medical history in a comprehensive fashion. Worse, if they made a mistake (they test the blood, but that testing can be tricky) and someone catchs a disease traced back to them, the backlash and hysterics against the Central Blood Banks could be massive, something they cannot afford.

[DPDarkPrimus]

They ask those questions because male homosexual sex is statistically a high risk behavior. However, before people gnash their teeth about anti-gay bias, it's not like that. On that questionnaire, they ask you if you've done alot of things that have an increased risk of transmission. For instance, if you've spent time in a prison for a certain length of time or if you've ever been in Africa or have had sexual contact with anyone who has, not to mention the long lists of potential diseases and medications that can cause complications. I mean, they ask you if you've gotten tattoos, permanent make-up applied, or piercings within a certain amount of time. That doesn't mean they are biased against people with tats, it's just they are playing statistics and being overly cautious. After all, they don't have time to delve into every donors medical history in a comprehensive fashion. Worse, if they made a mistake (they test the blood, but that testing can be tricky) and someone catchs a disease traced back to them, the backlash and hysterics against the Central Blood Banks could be massive, something they cannot afford.

But this is a bit different, as it's homosexual intercourse, period. You can be in a monogamous relationship and be using a condom, and the both of you are STD-free, but you still can't donate because of this.

[Gil Hamilton]

But this is a bit different, as it's homosexual intercourse, period. You can be in a monogamous relationship and be using a condom, and the both of you are STD-free, but you still can't donate because of this.

And you can go the United Kingdom and parts of Europe and never contract anything, but they still won't let you donate blood either. They do it that way because they don't have time or the resources to delve into each individual donor history in a comprehensive fashion, they make general rules based on statistical averages. It's just them being overly cautious, because in their profession, any problem with the blood supply could become a major public relations disaster for them, particularly after the 80s.

[The Jester]

What is the difference between an individual being in a long-term monogomous heterosexual relationship and a long-term monogomous homosexual relationship which requires one to be discriminated against where the other one isn't? Furthermore, is it in the best interests of those collecting blood to discriminate against potential donors even if they are known to be of no hazard?

[tharkûn]

Part of your argument of placing homosexual men as a high risk factor includes your unsubstantiated assertion of promiscuity. Can you provide any further validation to that claim other than red-herring BS of how gay male couples engage in more anal intercourse than straight couples?

Is this good enough for you?

In 1999-2000 the British did the National Survey of Sexual Attitudes and Lifestyles (NATSAL). According to the NATSAL the mean number of heterosexual sexual partners in the last five years was 3.1 (3.8 for men and 2.4 for women); the mean number of male homosexual partners in the last five years within the MSM group (homosexuals and bisexuals) was 24.1.

"Increasing prevalence of male homosexual partnerships and practices in Britain 1990-2000: evidence from national probability surveys."
AIDS: 18(10), 2 July 2004: 1453-1458
Mercer, C.; Fenton, K.; Copas, A.; Wellings, K.; Erens, B.; McManus, S.; Nanchahal, K.; Macdowall, W.; Johnson, A.


Now you will note that those averages are the MEAN. The median differs by a total of 1 partner in the last 5 years (3 vs 4 general male population vs MSM). So what does that entail? It says that the vastly higher mean is due to a distribution skewed at the extreme high end - a very small subset of men who have sex with men are pulling the mean up by a massive amount.

Looking at the median homosexual/bisexual male you still have the fact that he has 33% more partners which does compound with the higher transmission rates of anal sex.

However the health risks of including the MSM population in the blood bank includes those atypical individuals who pull up the mean and their impact on the safety issue is dramatic.

The system is flawed (and dare I say discriminatory) if they excluded people based on their sexual orientation and not on other more pertinent questions, such as the number of sexual partners.

The problem with that is accurate reporting. In a long term relationship the number of partners you have becomes increasingly irrelevent, it is the number of partners the partnership has had. So if one partner cheats the other partner's risk increases alongside - even though they have done and know of nothing. Given how much people lie about sex, particularly cheating, health officials are leary of trusting you knowledge of your partner's sexual history.

The only way to be certain would be to conduct actual experiments to see if other exclusions are as effective as a blanket MSM ban. To date I have no knowledge of any other set of criteria which has passed clinical muster.

What is the difference between an individual being in a long-term monogomous heterosexual relationship and a long-term monogomous homosexual relationship which requires one to be discriminated against where the other one isn't?

Because if the partner of a subject cheats in a heterosexual relationship the new sex partner is most likely from a population with lower risk.

There clinical difference may not actually be appreciable, but until some experiments are done the officials go with "better safe than sorry".

Furthermore, is it in the best interests of those collecting blood to discriminate against potential donors even if they are known to be of no hazard?

Everyone is a hazard, it is only a matter of degrees. The officials are trying to find quick easy questions people are less likely to lie about that screen out the most hazardous donors. Further the perception of risk is important. If the general public perceives the blood banks to be unhealthy then bad things happen - like people refusing transfusions out of fear, parental fear, and all sorts of ill informed activity.

The clinical evidence is fairly clear on a few points:
1. The MSM population is at higher risk.
2. By including the general MSM population the risk of bloodborn infection would most likely go up.
3. No alternative exclusion criteria have clinical evidence of working better.

#3 is subject to immediate change, and most professionals would support changing the rules if something that worked as well could be demonstrated.

[Broomstick]

What is the difference between an individual being in a long-term monogomous heterosexual relationship and a long-term monogomous homosexual relationship which requires one to be discriminated against where the other one isn't?

Bigotry and anti-male homosexual bias (lesbians still qualify to donate).

Is that what you wanted to hear?

No one here condones such bias - recognizing prejudice exists is not the same as accepting it. It would require a different screening system to separate the promiscuous from the monogamous, but it would probably be as reliable as what we have now, which isn't perfect.

Furthermore, is it in the best interests of those collecting blood to discriminate against potential donors even if they are known to be of no hazard?

No, it's not logical - but logic seems to seldom be a motivating factor in human decisions.

[The Jester]

The problem with that is accurate reporting. In a long term relationship the number of partners you have becomes increasingly irrelevent, it is the number of partners the partnership has had. So if one partner cheats the other partner's risk increases alongside - even though they have done and know of nothing. Given how much people lie about sex, particularly cheating, health officials are leary of trusting you knowledge of your partner's sexual history.

Are you meaning to imply that homosexual couples are more prone to cheating and lying than heterosexual couples?

[haas mark]

Everyone is a hazard, it is only a matter of degrees. The officials are trying to find quick easy questions people are less likely to lie about that screen out the most hazardous donors. Further the perception of risk is important.

...Exactly why would the public need to know the sexual activity and/or orientation of a specific blood donor to begin with? It's an invasion of privacy.

If the general public perceives the blood banks to be unhealthy then bad things happen - like people refusing transfusions out of fear, parental fear, and all sorts of ill informed activity.

What does it matter if the public doesn't know? And also, why would the public fear the idea of having blood from someone that is gay? Further, they're no more scared of having blood from a virgin than from someone sexually active, by no knowledge of their own, so what does it really matter, anyway?

[tharkûn]

Are you meaning to imply that homosexual couples are more prone to cheating and lying than heterosexual couples?

No. I'm implying that when homosexual couples cheat and lie, just like heterosexual couples, it carries a higher associated risk because the population of potential new partners is a subset of the population with higher risk factors.

When you try to measure mongamy in any couple there is an error rate where one partner is monogamous and the other is not. In terms of epidemiology both partners carry most of the health risks of being non-monogamous. This error rate could be low enough to be irrelevent from a blood safety point of view, it could be high enough to have a measurable impact. The only way to know for sure is to evaluate it clinicly, something I have not yet seen done.

[haas mark]

What does it matter if the public doesn't know?

That is, if the public doesn't know who the blood came from.

[The Jester]

No. I'm implying that when homosexual couples cheat and lie, just like heterosexual couples, it carries a higher associated risk because the population of potential new partners is a subset of the population with higher risk factors.

Nevertheless, it's not even necessary to show that monogamous male homosexuals are of an equivalent risk factor than monogamous heterosexual individuals. The fact is that a heterosexual individual who has had many unprotected sexual encounters with someone of the opposite sex can pass the questionnaire while maintaining full honesty, while someone who is a lower risk cannot simply because he has slept with another man. Wouldn't be far more prudent to inquire about behaviours which are the contributing factor to the risks of infection as opposed to grouping people and simply assuming they behave in presupposed ways? Or do you contend that a person is far less likely to be honest with his behaviour in the past than he is with the present questionnaire in its current form?

[haas mark]

<snip>

Which brings us again to the point of whether it really matters who it came from. Honestly, you've put this better than I could, kudos.

But the fact of the matter is whether an individual has certain diseases or things that can be transferred through blood transfusion. Whether or not they have had sex with a man or have had sex with a man who has had sex with a man should not matter because if they are clean, then they are clean. Perception is negligible because the information of who the donated blood is from should be something kept in privacy rather than something of public knowledge. It is well known that being homosexual is not contagious. The point being that it boils down to the fact of whether the donor is positive or negative for certain diseases or communicable transgressions.

Thus, I lie about my sexual activity when I donate blood (well, if there were any sexual activity had, or if I could donate blood before February of next year).

[Broomstick]

Everyone is a hazard, it is only a matter of degrees. The officials are trying to find quick easy questions people are less likely to lie about that screen out the most hazardous donors. Further the perception of risk is important.

...Exactly why would the public need to know the sexual activity and/or orientation of a specific blood donor to begin with? It's an invasion of privacy.

Because it matters whether a donor has a disease that can be transmitted through blood transfusion. Asking if someone has had malaria or a history of jaudice or had a birth or miscarriage in the past year invades their privacy, too. It's justified in order to protect the health of the recipient.

This is a non-trivial thing in ANY organ donation (and blood donoation IS organ donation, even if it's a liquid organ. So... the question becomes what is the best way to solicit information about relevant behavior. And perhaps phrasing it as "How many sexual partners have you had in the past two years, and have they had any partners other than yourself that you are aware of?" might be the better question. But then we get into situations where someone thinks sex=intercourse/penetration and thus doesn't count oral sex as sex.

[Broomstick]

What does it matter if the public doesn't know? And also, why would the public fear the idea of having blood from someone that is gay? Further, they're no more scared of having blood from a virgin than from someone sexually active, by no knowledge of their own, so what does it really matter, anyway?

Believe it or not, in this day and age there are still men who don't want blood from women, white people who don't want blood from black people (and vice versa), and other irrational crap going on. Therefore, it would not surprise me in the least if someone was stupid enough to express the idea that they would not want blood from a gay man for fear of catching "fag cooties" or whatever.

[tharkûn]

...Exactly why would the public need to know the sexual activity and/or orientation of a specific blood donor to begin with? It's an invasion of privacy.

The public needs to know nothing about specific individuals, the public does need to know about the risk behaviours of the donor pool. Orientation is completely irrelevent, sexual practice is not.

And also, why would the public fear the idea of having blood from someone that is gay? Further, they're no more scared of having blood from a virgin than from someone sexually active, by no knowledge of their own, so what does it really matter, anyway?

Because the public is irrational and uniformed.

Nevertheless, it's not even necessary to show that monogamous male homosexuals are of an equivalent risk factor than monogamous heterosexual individuals.

It is necessary to show that including self described monogamous homosexuals does not result in increased risk of blood born disease transmission. To date I have seen no clinical evidence one way or the other.

The fact is that a heterosexual individual who has had many unprotected sexual encounters with someone of the opposite sex can pass the questionnaire while maintaining full honesty, while someone who is a lower risk cannot simply because he has slept with another man. Wouldn't be far more prudent to inquire about behaviours which are the contributing factor to the risks of infection as opposed to grouping people and simply assuming they behave in presupposed ways?

That depends how accurate are your questions going to be about those behaviours. How many people are going to accurately report the sexual history of their partners? People have different definitions of monogamy, for instance. All of the question currently asked are readily obvious, dichotomous, and mostly objective. If you want to propose a new set of questions, then you need to do some clinicals and establish that they are just as a effective.

In principle it would be best to have narrowly targetted exclusions, but until better criteria are demonstrated it is best to keep the ones which have been working well thus far.

[haas mark]

Because it matters whether a donor has a disease that can be transmitted through blood transfusion. Asking if someone has had malaria or a history of jaudice or had a birth or miscarriage in the past year invades their privacy, too. It's justified in order to protect the health of the recipient.

That doesn't answer my question; why should the public know or have right to that knowledge? The people taking the blood? Okay, understandable, but I don't see any logical reason why the people recieving the blood need to know.

This is a non-trivial thing in ANY organ donation (and blood donoation IS organ donation, even if it's a liquid organ. So... the question becomes what is the best way to solicit information about relevant behavior. And perhaps phrasing it as "How many sexual partners have you had in the past two years, and have they had any partners other than yourself that you are aware of?" might be the better question. But then we get into situations where someone thinks sex=intercourse/penetration and thus doesn't count oral sex as sex.

See, that would actually, you know, MAKE SENSE. Something people in this world are not known for doing. But again, it doesn't answer the question of why people should publicly know about the sexual activity and/or orientation of donors.

Believe it or not, in this day and age there are still men who don't want blood from women, white people who don't want blood from black people (and vice versa), and other irrational crap going on. Therefore, it would not surprise me in the least if someone was stupid enough to express the idea that they would not want blood from a gay man for fear of catching "fag cooties" or whatever.

While well aware of this, why does it matter? At least, in terms of the health of the blood donated?

The public needs to know nothing about specific individuals, the public does need to know about the risk behaviours of the donor pool. Orientation is completely irrelevent, sexual practice is not.

Public perception is only gained from their knowledge, so... you just completely backpedaled what you said previously. You said that risk is higher because of orientation, and tried to use it as justification as why gays should not donate blood. At least, that's how it looked to me, so please, correct me if I am wrong.

Because the public is irrational and uniformed.

Doesn't answer the questions presented. If you need them again, here they are:

And also, why would the public fear the idea of having blood from someone that is gay? Further, they're no more scared of having blood from a virgin than from someone sexually active, by no knowledge of their own, so what does it really matter, anyway?

[Justforfun000]

That doesn't answer my question; why should the public know or have right to that knowledge? The people taking the blood? Okay, understandable, but I don't see any logical reason why the people recieving the blood need to know.

I don't think it's the people at ALL. I just think that when AIDS broke out they had such a scandal regarding it all that the idea of the "gay plague" being the main vector of the disease just persisted. Realistically they HAVE to test all blood anyway to my knowledge, so it's the biggest hypocritical bullshit/discrimination imaginable in my mind. They shouldn't give a flying FUCK who's donating because they will verify the safety of the blood before it's used anyway.

Back when this was new I can understand the caution because it DID look like it was particularly selective in the people that were infected, but of course that was more coincidence and behaviour as to the specific way it is transmitted and the unfortunate fact that STI's are wonderfully succesful because they count on the sex drive to spread. Since the demographic for homsexuals is quite low compared to the sheer number of heterosexuals, naturally the exponential infective rate is going to be far far greater as to a measurable influence. Even if 5 times the number of straight people were fucking around in the mid 80's being hiv positive, they would vanish quite easily into the sheer number of people because of dispersion. You could even look at things from a different point of view and be thankful that the concentration of the homosexuals brought the disease to light decades before it would likely have been identified and contained if this did not happen in their demographic.

Of course Africa would have had the problem, but it's debatable if it would have been found because their poverty conditions combined with malnutrition and exotic diseases is also a huge contributing factor to their situation. It's still arguable in my mind how many are TRULY dying from AIDS and how many are simply hiv-positive and dying from the other equally life threatening conditions. There is no way to prove this without testing each person and their current t-cells, and other supporting evidence that this was truly AIDS causing the death. The money is not there to do so obviously, so it's truly a mystery as to the real morbidity from AIDS.

In any event, they should accept blood from anyone on good faith that the average person would not donate if they knew their blood was dangerous, and they will screen it anyways to discover for themselves. Every excuse they give is ultimately irrelevant because there is no NEED to exclude.

[Thinkmarble]

They shouldn't give a flying FUCK who's donating because they will verify the safety of the blood before it's used anyway.

Stop being stupid.
No test is perfect.

[Broomstick]

Because it matters whether a donor has a disease that can be transmitted through blood transfusion. Asking if someone has had malaria or a history of jaudice or had a birth or miscarriage in the past year invades their privacy, too. It's justified in order to protect the health of the recipient.

That doesn't answer my question; why should the public know or have right to that knowledge? The people taking the blood? Okay, understandable, but I don't see any logical reason why the people recieving the blood need to know.

The people receiving the blood aren't told anything about the donor(s) - by that time it's completely anonymous. Where did you get the idea the receipients are told anything?

[Rye]

That doesn't answer my question; why should the public know or have right to that knowledge? The people taking the blood? Okay, understandable, but I don't see any logical reason why the people recieving the blood need to know.

They don't. The people handling the blood in haemotology just know the name of the donor (and they take it that they probably weren't lying about having sex with other men, but that never actually enters their mind as they handle the stuff), and then the technical details of the blood. That blood then gets transfused to patients. The patients don't know dick, they just get transfused blood.

See, that would actually, you know, MAKE SENSE. Something people in this world are not known for doing. But again, it doesn't answer the question of why people should publicly know about the sexual activity and/or orientation of donors.

Blood donation information is confidential, just like anything else. Only those that need to know, know. You could make the argument that by trying to make sure they only get clean blood, you could work out that the donors did not have gay sex, or take drugs, but that would just be asinine since you have no idea who it came from.

While well aware of this, why does it matter? At least, in terms of the health of the blood donated?

There's no "are you homosexual" question, there's "have you had sex with another man" which is all about the transmission method, since male to male sex is a leader when it comes to transmission of a lot of diseases.

And also, why would the public fear the idea of having blood from someone that is gay? Further, they're no more scared of having blood from a virgin than from someone sexually active, by no knowledge of their own, so what does it really matter, anyway?

There are probably sections of the public that would fear getting blood from virgin gay guys, but for no logical reason. However, that's not what the health service is fearful of, the health service is fearful of risky behaviour, like drug use and male to male sex. What does it matter what the public is fearful of? They're not the haemotology dept.

[haas mark]

The people receiving the blood aren't told anything about the donor(s) - by that time it's completely anonymous. Where did you get the idea the receipients are told anything?

tharkûn is giving the idea that there is some kind of 'perception' behind the idea that men who have had sex with men - as a whole - are somehow dangerous to society. I'm curious as to why.

There's no "are you homosexual" question, there's "have you had sex with another man" which is all about the transmission method, since male to male sex is a leader when it comes to transmission of a lot of diseases.

See the above. If that's the case, then if clean blood is clean blood, then what does it matter if it comes from a man that has had sex with another man?

What does it matter what the public is fearful of? They're not the haemotology dept.

Again, this is what I tried to ask tharkûn, but he has yet to answer the question.

[Justforfun000]

Stop being stupid.
No test is perfect.

Oh don't be a dumbass! If it's not perfect against homosexual blood, it's just as imperfect against heterosexual. Their blood tests are accurate ENOUGH to be considered beyond a reasonable doubt, and they have the means to test it repeatedly beyond whatever time window they wish. They probably have to and DO test it this way even now because as others are trying to make clear, heterosexuals are STILL capable of the same risk regardless of the level of commonality.

I have a 413 word post giving an opinion in detail and you answer me with a 7 word insult and nitpick?

[Tsyroc]

Stop being stupid.
No test is perfect.

Speaking of which. I can't give blood.

Heterosexual male who had been tested as HIV free for 6 consequtive years. A couple of years later, without having done anything that would be considered high risk for HIV infection I triggered one of the multiple (six ??) tests that they were screening blood with at the time I donated.

8 years after that I still can't give blood (by law) because of a false postive on a test that they knew the time triggered a lot of false positives.

So, IMO they could easilly accept homosexual males who met the other criteria and be reasonably sure that the blood they are getting is clean.

[tharkûn]

Public perception is only gained from their knowledge, so... you just completely backpedaled what you said previously. You said that risk is higher because of orientation, and tried to use it as justification as why gays should not donate blood. At least, that's how it looked to me, so please, correct me if I am wrong.

Public perception comes from which populations are allowed to donate. When AIDS first broke out it was known in some circles as Gay-Related Imunodeficiency Disease. By including the MSM population, at all, there will be a subset of people who have perception issues. Said people will be morons, but it is important that the blood supply be above reproach. If you are going to change the exclusions then you need clinical data to allay the fears everyone but the most bigoted morons.

Really this is no difference than the British exclusions in the American blood bank. Vegan Britons are excluded from the American blood bank because there are mad cow fears. No known case of mad cow has been shown to have come via transfusion, likewise the incidence of the disease is ludicriously low. Yet the health officials who make the calls opt to be "better safe than sorry" and have blanket bans on those who have spent 6 months on the British Isles from donating. The majority of the reasoning here is that danger of a perceived (if irrational) danger outweighs the cost of excluding otherwise acceptable donors.

And also, why would the public fear the idea of having blood from someone that is gay?

Because there is leftover fear from when AIDS was GRID and too many people remain ignorant.

Further, they're no more scared of having blood from a virgin than from someone sexually active, by no knowledge of their own, so what does it really matter, anyway?

Virgins are not excluded in the blood bank, the exclusion is men who have sex with men, not men with homosexual orientation.

In any event, they should accept blood from anyone on good faith that the average person would not donate if they knew their blood was dangerous, and they will screen it anyways to discover for themselves. Every excuse they give is ultimately irrelevant because there is no NEED to exclude.

And why should we take your word over the haematology experts already cited in a peer reviewed journal? The truth is the is a window where the tests give false negatives, there WILL be cases when the tests give the wrong answer so it behooves the blood bank to exclude those individuals who represent a greater risk. According to the data of the experts removing the MSM exclusion would result in a 500% increase in transmission, unless you have some peer reviewed findings of your own - there is a need.

tharkûn is giving the idea that there is some kind of 'perception' behind the idea that men who have had sex with men - as a whole - are somehow dangerous to society. I'm curious as to why.

Public health perception matters because people make stupid decisions based off of irrational fears. When AIDS first broke out a subset of the homosexual population were the face of AIDS and there is scientific data showing that the average gay male has a higher risk than the average heterosexual. The magintude of that difference is completely misunderstood by the population, but the blood supply must be above reproach.

See the above. If that's the case, then if clean blood is clean blood, then what does it matter if it comes from a man that has had sex with another man?

Clean blood isn't clean blood. When you run the standard tests there are false negatives. The vast majority of those are because the viral load hasn't built up enough to be detectable. At the present time a small number of people get 'dirty' blood and a much smaller amount get infected (according to the statistics). MSM is just another category - like travelling in Africa and Latin America, paying for sex, etc. - that has statistical evidence of increased risk.

Again, this is what I tried to ask tharkûn, but he has yet to answer the question.

The general population knows the exclusion rules, these are designed to maximize public confidence in the blood supply, minimize the real risk of bloodborn infection, and maximize the donor pool. There is a tradeoff among these three objectives. If you change the rules without establishing the validity of the new exclusions, then you have problems with people thinking the blood supply is unsafe. That is a very bad thing as precious time is lost dickering when a blood transfusion should be happening. The answers are: optimally to educate the populace about the safety of the blood supply and suboptimally keep the blood supply above reproach. If you want to change the exclusion rules without a perception problem - and hence SAVE LIVES - then you need to have rock solid clinical data showing that the new exclusions are superior to the old.

If it's not perfect against homosexual blood, it's just as imperfect against heterosexual.

The tests have equivalent accuracy, however given the greater risks associated with MSM the DATA points to a 500% greater incidence of false positives within the MSM population.

Their blood tests are accurate ENOUGH to be considered beyond a reasonable doubt

They are not. They are accurate enough to greatly increase safety, however they are NOT beyond a reasonable doubt. This is exactly why exclusions for all manner of things exist: receiving an organ transplant, travelling to Latin America, living in the UK for 6 months, using injectable drugs, paying for sex, etc. because the tests are NOT good enough and the exclusions SAVE LIVES.

hey have the means to test it repeatedly beyond whatever time window they wish.

The tests currently used have a well known 3 month long window where false positives are likely, repeated testing within this time period does NOTHING to reduce the rate of false positives. Waiting until the test is completely effective isn't an option as the blood GOES BAD before that is possible.

They probably have to and DO test it this way even now because as others are trying to make clear, heterosexuals are STILL capable of the same risk regardless of the level of commonality.

It's all about the bell curve. The heterosexual peak is at a lower level of risk than the MSM curve. While there will be individual cases where part of the heterosexual curve overlaps the MSM one. Excluding the entire MSM population results in a 500% decrease in risk, according to the literature.

A better exclusion might be craftable, fine. Purpose whichever one you like, do some clincals, and then publish the data. Until someone does that you do NOT risk changing the exclusions to be "fair".