Gays and Giving Blood

Lord Rog · Post by **Lord Rog** » 2005-06-15 06:48pm

I gave blood for the first time in work today, while I was filling out the forms I was given in the waiting room (questions about my health and lifestyle) I couldn't help but notice that the first question was about whether you had performed any sexual acts with another man (even if you used a condom) or if you were female whether you had slept with a man who may have done the above within the last 12 months (in both instances).

Later on when they were actually taking the blood I was chatting to the nurse and I asked her whether the inclusion of that question (and its prominance - it was in a larger font than all the other questions) actually meant that open homosexuals couldn't donate blood. She informed me that this was actually the policy of the Welsh Blood Service but she didn't agree with it.

I can't actually think of a way they can justify this and was wondering whether any of you could shed any light onto how they can get away with this shit. Surely this must be against the UK's anti discrimination laws?

Stark · Post by **Stark** » 2005-06-15 06:53pm

If I assume that they test the blood for disease, there's no reason not to. Unless they think the Curse of the Cock will spread an infect everyone, or something.

*DO* they test donated blood? I think they DIDN'T, and then there were all kindsa diseases spread, so is it tested now?

mr friendly guy · Post by **mr friendly guy** » 2005-06-15 07:05pm

If they test the blood thoroughly, there is no need to know whether you are gay or not. There are limitations for example HIV has a 3 month "window" period where it could be there but undetectable with our present tests. In that case it may be prudent to ask about risky behaviour, (I am not sure if the blood is used straight away) but I don't see why it needs to focus on homosexual sex, since unsafe sexual practices is the culprit.

tharkûn · Post by **tharkûn** » 2005-06-15 07:35pm

For a variety of reasons male homosexual anal intercourse is a more efficient vector for fluid born diseases than vaginal intercourse or heterosexual anal intercourse. Unprotected receptive anal intercourse has the highest transmission rate of HIV. Homosexual men, according to the literature, are more likely to engage in risky sexual behaviour as well as having more sexual partners.

As a predictor of HIV status, men having anal intercourse with men is a stasticly valid question. A better question would be about safer sex practices, number of partners, and so on, but it is not completely invalid to say that excluding sexually active homosexuals leads to a slight increase in the safety of the blood bank.

When the policy was initiated it made a certain amount of sense, some of that reasoning still holds over. However it is becoming less valid with each passing year (particularly in Europe where disparities in sexual practices are half of North American norm).

Pint0 Xtreme · Post by **Pint0 Xtreme** » 2005-06-15 07:47pm

tharkûn wrote:Homosexual men, according to the literature, are more likely to engage in risky sexual behaviour as well as having more sexual partners.

What do you mean by "according to literature"? And if you're arguing that gay men are generally more promiscuous, why don't you back that up before making claims of the validity of denying sexually active gay men the ability to donate blood?

Einhander Sn0m4n · Post by **Einhander Sn0m4n** » 2005-06-15 08:03pm

It's like this stateside. They do this so they can feel good about not having to test blood for infections despite the fact sexual orientation has no bearing whatsoever on STD rates and that some blood diseases can be carried and transmitted by VIRGINS.

tharkûn wrote:For a variety of reasons

Care to enumerate these reasons?

tharkûn wrote:male homosexual anal intercourse is a more efficient vector for fluid born diseases than vaginal intercourse or heterosexual anal intercourse.

Tell me what the difference is between anal sex with another man vs anal with a woman?

tharkûn wrote:Unprotected receptive anal intercourse has the highest transmission rate of HIV.

No shit Sherlock. That's why we invented this thing called a 'condom'

tharkûn wrote:Homosexual men, according to the literature, are more likely to engage in risky sexual behaviour as well as having more sexual partners.

WHAT Literature!?

tharkûn wrote:As a predictor of HIV status, men having anal intercourse with men is a stasticly valid question. A better question would be about safer sex practices, number of partners, and so on, but it is not completely invalid to say that excluding sexually active homosexuals leads to a slight increase in the safety of the blood bank.

Care to back this up?

tharkûn wrote:When the policy was initiated it made a certain amount of sense, some of that reasoning still holds over. However it is becoming less valid with each passing year (particularly in Europe where disparities in sexual practices are half of North American norm).

Evidence?

Einhander Sn0m4n · Post by **Einhander Sn0m4n** » 2005-06-15 08:04pm

WAGH! Someone fix that missing [/quote] on my second counterpoint please.

Post by **Broomstick** » 2005-06-15 08:23pm

Way back in the early 1980's when HIV first emerged as a Worrisome Disease, there was no test to detect it in the blood (indeed, I remember when they weren't sure if it bacterial, viral, or environmental) and male homosexuals were the overwhelming victims in Europe and North America. It was in those years that the "men having sex with men" questions were added - at that time it was the only reasonable way to keep HIV out of the blood supply, or at least minimize the risk.

It has been retained in part because of the 3 month window. Fresh, whole blood has a shelf life of around 28 days (if I recall correctly), far less than 3 months. Some blood products that undergo processing and can be stored longer could be taken safely from people at high risk because they would allow time for complete testing.

It has also been retained in part, I believe, though fear and bigotry as well. I do think some people believe homosexuality is "catching", or that homosexuals are so impure as to require complete ostracization.

Last time I look as a blood donor questionnaire here in the States there were similiar questions, but not given such prominence and mix in with other questions regardin recent surgery and the like, which are also risk factors for HIV (among other things)

And by the way - there's nothing magic about homosexual anal intercourse. The risk transmitting of disease through homosexual anal play is no more and no less than transmitting through heterosexual anal play. The real risk factor is who you're having sex with, not how or how often. If no one involved has an STD, no sexual practice will transmit an STD. It's sex with infected people you have to worry about.

If you aren't absolutely certain of the health status of the person you're fucking there are things you can do to reduce your risk, and using condoms and refraining from receptive anal intercourse are among them. Abstinence is another. It comes down to what risks are YOU willing to take, and how aware you are that you are taking them.

Utsanomiko · Post by **Utsanomiko** » 2005-06-15 08:30pm

Einhander Sn0m4n wrote:
tharkûn wrote:Homosexual men, according to the literature, are more likely to engage in risky sexual behaviour as well as having more sexual partners.
WHAT Literature!?

Some folks say it comes from some literary sources.

tharkûn · Post by **tharkûn** » 2005-06-15 08:42pm

What do you mean by "according to literature"? And if you're arguing that gay men are generally more promiscuous, why don't you back that up before making claims of the validity of denying sexually active gay men the ability to donate blood?

"Modeling HIV Risk."
JAIDS. 22(3):280, November 1, 1999.
Bell, David C.; Trevino, Roberto A.

I'm argueing that per coital act receptive anal intercourse has the highest transmission rate. Homosexual males, statisticly engage in the most acts of anal intercourse. Further given the disaparity in infection rates a gay couple is more likely to be serodiscordant than a heterosexual couple who is less likely to be so than a lesbian couple.

Care to enumerate these reasons?

Not really no. A quick list includes the fact that the anus is not self-lubricating, that the anal epithelial barrier is more permiable, and a higher pecentage of homosexual engage in both insertive and receptive anal sex. The reason homosexual anal intercourse is a better transmission pathway is that the same individual is more likely to engage in both receptive and insertive anal intercourse.

That's why we invented this thing called a 'condom'

Great and when everyone uses them correctly this effect will diminish. Sadly a large percentage of all inviduals don't or misuse them.

WHAT Literature!?

The Journal of Epidemology, The Journal of Acquired Immuno Deficiency Syndrome, The Archives of Sexual Behavior ...

Care to back this up?

Name your goalpost.

Evidence?

"Evaluation of the de-selection of men who have had sex with men from blood donation in England."
Vox Sanguinis 84(4):265 - May 2003
Soldan, K.; Sinka, K.

However, by using the most probable assumptions, our models suggested that de-selection of MSM for 12 months since the last sexual contact, or complete removal of this selection criterion, would be expected to increase the risk of HIV-infectious donations entering the blood supply in England by approximately 60% (from the current risk of 0·45 per year to 0·75 per year) and 500% (to 2·5 per year), respectively.

Pint0 Xtreme · Post by **Pint0 Xtreme** » 2005-06-15 08:46pm

tharkûn wrote:
What do you mean by "according to literature"? And if you're arguing that gay men are generally more promiscuous, why don't you back that up before making claims of the validity of denying sexually active gay men the ability to donate blood?
"Modeling HIV Risk."
JAIDS. 22(3):280, November 1, 1999.
Bell, David C.; Trevino, Roberto A.

I'm argueing that per coital act receptive anal intercourse has the highest transmission rate. Homosexual males, statisticly engage in the most acts of anal intercourse. Further given the disaparity in infection rates a gay couple is more likely to be serodiscordant than a heterosexual couple who is less likely to be so than a lesbian couple.

Well, no shit sherlock. Males don't have vaginas so it would simplistically logically follow that gay male couples would engage in anal sex more than heterosexual couples. What the fuck does this have anything to do with promiscuity?

Lord Rog · Post by **Lord Rog** » 2005-06-15 08:47pm

According to the nurse that I was speaking to they do test the blood for a long list of STDs including HIV, If you are positive they will contact you.

The reason that the nurse gave for disagreeing with this policy was that she felt it was not a reliable indicator of promiscuity and that this was more important than the type of sex involved or the gender of the participants in the spread of infections. The fact that they go to such lengths (even excluding women who have slept with bi men) to keep gay blood out of the blood bank leaves me highly suspicious of their motives.

People are not paid to give blood in the UK and they often have difficulty in attracting people to donate. Excluding a section of the population in these circumstances is stupid.

Their were already questions on the form about whether you had participated in unsafe sex, surely this should sufice, or are gay not to be trusted to answer this question honestly? I must point out that this crucially important question in the process of screening blood supplies was in a smaller font and no where near as prominent as the gay question.

The implication that I drew from this is that whoever implemented this policy must for some reason believe that their is no way gay men can practice safe sex.

Finally with reguards to the question of whether gay men are more promiscuous I would like to quote what a gay friend once said to me;

"the gay scene is very promiscuous however this only represents a small minority of homosexual people, unfortunately they often give the rest of us a bad name as this is often what people think of as what it means to be gay"

Plekhanov · Post by **Plekhanov** » 2005-06-15 09:24pm

Lord Rog wrote:I gave blood for the first time in work today, while I was filling out the forms I was given in the waiting room (questions about my health and lifestyle) I couldn't help but notice that the first question was about whether you had performed any sexual acts with another man (even if you used a condom) or if you were female whether you had slept with a man who may have done the above within the last 12 months (in both instances).

Later on when they were actually taking the blood I was chatting to the nurse and I asked her whether the inclusion of that question (and its prominance - it was in a larger font than all the other questions) actually meant that open homosexuals couldn't donate blood. She informed me that this was actually the policy of the Welsh Blood Service but she didn't agree with it.

First of all congratulations on giving blood I hope questions about NBS policy aside you found everything uneventful and plan to do it again in 16 weeks time. I’m surprised at the emphasis placed on it in your form but that same question has been on all the forms I’ve filled in before giving blood in England.

I can't actually think of a way they can justify this and was wondering whether any of you could shed any light onto how they can get away with this shit. Surely this must be against the UK's anti discrimination laws?

Here is the rationale for the rule given by the Joint United Kingdom Blood Transfusion Services and National Institute of Biological Standards and Control Professional Advisory Committee (snappy name) link

Why we ask gay men not to give blood

A guide for donors

Securing the safety of the national blood supply is our number one priority. We follow strict rules and regulations when collecting and processing blood to make sure we supply the safest possible blood.

We use two main strategies to keep blood donation as safe as possible.

1. Selecting ‘safe’ donors
2. Testing every donation

Selecting ‘safe’ donors means that we have to ask some people not to donate their blood. This includes all men who have had sex with other men.

Principles of selecting donors

There are over 450 rules guiding donor selection and there are many groups of people who we ask not to donate either for a short period or forever.

Some people in these groups may have a very low risk of blood-borne infections and their blood would probably be safe to give to patients, but it is safest to ask everyone within the groups that have been identified, not to give blood.

This request can be disappointing and frustrating to some people who wish to donate blood. Our decisions are based on information and research about the effects our policies will have on ensuring the safest blood supply possible, not out of a desire to discriminate against any particular group.

The aims of selecting donors are to:

1. select donors whose blood, as far as we can tell, is most unlikely to transmit any infection
2. collect enough blood to meet patients’ needs.
3. make sure that donors themselves come to no harm through giving blood.

We have to balance these three aims while also keeping the selection process clear and simple.

Why do we ask gay men not to give blood?

We ask gay men not to give blood because gay men, as a group, are known to be at an increased risk of acquiring HIV and a number of other sexually transmitted infections (STIs), many of which are carried in the blood.

It is specific behaviours, rather than being gay, which places gay men at increased risk of HIV infection.Safer sex will keep most gay men free from infection,however research shows that allowing gay men as a group to donate blood would increase the risk of HIV infected blood entering the blood supply.

Testing does not detect all infections

We test all blood donations for HIV, hepatitis B and C , syphilis and HTLV. However, no testing process can be ‘perfect’. We may miss infected donations because of the ‘window period’ between getting an infection and the test showing a positive result. There is also always a small risk of mistakes being made in the laboratory.

Selecting donors that are already in a low-risk group for these infections means that we will reduce the number of infected donations that could be missed by testing.

How the rule improves the safety of blood transfusions

Many gay men have not given blood since the AIDS epidemic began, and this has prevented many HIV infections being transmitted through transfusion. Also, the number of hepatitis B infections transmitted by blood transfusion fell considerably after this rule was introduced.

Abolishing the rule for gay men would increase the risk of HIV infected donations entering the blood supply in England by about five times , and changing the rule to allow gay men to donate one year after they last had sex with another man would increase the risk by 60%, . (Reference: K Soldan & K Sinka, Vox Sanguinis (2003) 84, p265-273 - To read an abstract of this reference, please click here).

Keeping our rules simple

The rule about gay men is clear and simple. You can decide whether it applies to you without the need to discuss your personal life with our staff. The rule is based on an impartial assessment of available evidence. We ask that you observe it for the sake of blood safety.

It seems pretty persuasive to me, I’m instinctively against any such ban but so long as it’s based in science not in politics I’m ok with it. I’m not qualified to make such judgements though so until somebody can show otherwise I’ll take the JUKBTS…’s word for it.

Frank Hipper · Post by **Frank Hipper** » 2005-06-15 10:25pm

tharkûn wrote:The reason homosexual anal intercourse is a better transmission pathway is that the same individual is more likely to engage in both receptive and insertive anal intercourse.

Anything to show that this is anything but assumption?
Just because having a penis means means both activities are an option shows in no way that those options are exercised.

tharkûn · Post by **tharkûn** » 2005-06-15 11:06pm

Anything to show that this is anything but assumption?
Just because having a penis means means both activities are an option shows in no way that those options are exercised.

"In a minority of gay men, sexual risk practice indicates strategic positioning for perceived risk reduction rather than unbridled sex."
AIDS Care 14(4); August 1, 2002
Van de Ven, P.; Kippax, S.; Crawford, J.; Rawstorne, P.; Prestage, G.; Grulich, A.; Murphy, D.

Numerous indidivuals in their survey (voluntary self selecting response at the annual Gay and Lesbian Mardi Gras Fair Day) reported engaging in both receptive and insertive anal intercourse. Most HIV postive individuals engaged in receptive anal sex in serodiscordant pairings or did not engage in anal intercourse to the point of ejaculation. I have been unable to find good statistical study of homosexual sexual habits above the metropolitan level since the 80's, but I beleive studies like thise are representative enough to generalzie without being terribly off.

It is a minority of homosexuals who are engaging in the most risky habits, however their epidemiological impact is not to be underestimated. As these individuals become educated, die out, or otherwise cease their risky habits, then the gay population as whole sees improvement.

The blood question comes down to this, if you drop those questions how many new cases of transmission are expected? The article I cited puts a fairly large percentage increase on it, a cursory examination of the article reveals no glaring faults. Could a better set of questions be substituted? Perhaps; however the public health burden requires that said alternate be clinicly validated before dropping the MSM questions.

Lord Pounder · Post by **Lord Pounder** » 2005-06-16 02:07pm

Lets rephrase that then. How about a source you can link to and not random bullshit from your diseased mind? Perhaps something recent?

Joe · Post by **Joe** » 2005-06-16 02:19pm

That is not the way it works. By your your logic every scientific paper ever published that cites a source without actually duplicating a copy of that source is "random bullshit."

tharkûn · Post by **tharkûn** » 2005-06-16 02:38pm

LP:

I'm sorry when did citing peer reviewed journals become "random BS from my diseased mind"?

I've cited the papers, if you have better research or actual grounds for discounting their data, then let's frigging hear them. When you don't like the results of studies in peer reviewed journals you need more than a one liner to say they are crap.

Pint0 Xtreme · Post by **Pint0 Xtreme** » 2005-06-16 03:44pm

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?

Sean Howard · Post by **Sean Howard** » 2005-06-16 04:16pm

The nurse could be misinformed. It could just be on there for data gathering purposes.

Like when you get an HIV test at the doctor, they will often give you a big list of questions to answer about all kinds of data points.

The only real reason for exclusion would be that 3 month window in which HIV is undetectable. I don't think that just holding the blood for three months would make it detectable, because it goes into cold storage, or is treated with preservatives.

Steven Snyder · Post by **Steven Snyder** » 2005-06-16 04:26pm

Sean Howard wrote:The nurse could be misinformed. It could just be on there for data gathering purposes.

Like when you get an HIV test at the doctor, they will often give you a big list of questions to answer about all kinds of data points.

The only real reason for exclusion would be that 3 month window in which HIV is undetectable. I don't think that just holding the blood for three months would make it detectable, because it goes into cold storage, or is treated with preservatives.

I have given blood several times now...

Carter Blood Center the most frequently, there is a question that asks if you have ever had a homosexual encounter, and saying "Yes" to that won't stop them from taking your blood, but they just won't use it.

They aren't asking your sexual orientation, but they seem to feel it is a significant risk.

In the end it is probably a legal/insurance situation more of any a moral question.

Sean Howard · Post by **Sean Howard** » 2005-06-16 04:27pm

Pint0 Xtreme wrote: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?

It is well accepted that anal sex has a much much higher risk per act than vaginal sex.

http://www.hivinsite.com/insite?page=ask-01-01-21

It is also well accepted that, outside Africa, a random homosexual is far more likely to have HIV than a random heterosexual. Is it because homosexuals are more promiscuous? Is it because the acts they engage in are inherently more risky? A combination of both?

For purposes of blood donating, it really doesn't matter. The fact is, homosexuals are just more likely to have it.

Sean Howard · Post by **Sean Howard** » 2005-06-16 04:49pm

Sean Howard wrote:It is also well accepted that, outside Africa, a random homosexual is far more likely to have HIV than a random heterosexual.

That's actually inaccurate. I'm talking about men here. Lesbians have a lower incidence than hetero women.

Pint0 Xtreme · Post by **Pint0 Xtreme** » 2005-06-16 05:50pm

Sean Howard wrote:
Pint0 Xtreme wrote: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?
It is well accepted that anal sex has a much much higher risk per act than vaginal sex.

http://www.hivinsite.com/insite?page=ask-01-01-21

Yes, we already know that. That is totally irrelevant to the argument that tharkun made. He said 'according to literature', homosexual men are more likely to have more sexual partners. I am demanding him to provide evidence for this baseless assumption, not irrelevant articles about anal sex.

Sean Howard · Post by **Sean Howard** » 2005-06-16 06:40pm

Pint0 Xtreme wrote:
Sean Howard wrote:
Pint0 Xtreme wrote: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?
It is well accepted that anal sex has a much much higher risk per act than vaginal sex.

http://www.hivinsite.com/insite?page=ask-01-01-21
Yes, we already know that. That is totally irrelevant to the argument that tharkun made. He said 'according to literature', homosexual men are more likely to have more sexual partners. I am demanding him to provide evidence for this baseless assumption, not irrelevant articles about anal sex.

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.