Should Homosexually Active Men Give Blood?

The BBC is reporting today about a petition to change the rules in Scotland on blood donation.

A petition by gay rights campaigners against what they believe is discrimination over who can give blood is to be considered by MSPs.

The LGBT Network said safe sex practices meant men who have had sex with other men could give blood.

The group stressed that there were no restrictions on heterosexual people who have unprotected sex giving blood.

The Scottish National Blood Transfusion Service said it had a duty to make sure patients got the safest blood possible.

A spokesman for the LGBT (Lesbian, Gay, Bisexual and Transgender) Network said: "The blanket ban on gay and bisexual men giving blood is an outdated policy that was put in place decades ago when people believed Aids was an exclusively gay disease. We now know that this is far from the case. "There is no clinical reason for the blanket ban on gay and bisexual men giving blood.

"It is a policy from a bygone era, which unfairly discriminates.

I think this is the important point. Is the policy a hangover from previous, more promiscuous eras or a judgement made upon up-to-date scientific data.

I think it’s also important to point out that the phrase "The blanket ban on gay and bisexual men giving blood" is highly misleading. The ban is actually on any man who has engaged in penetrative sex with another man. In fact, on the ScotBlood website, the reason is explained as:

If your lifestyle puts you at risk of HIV or hepatitis

That means then that if you are gay but engage in non-penetrative sex with a single partner your lifestyle doesn’t put you at risk of HIV or Hepatitis.

"The SNBTS should instead focus on all donors’ unsafe sexual practices, rather than single out gay and bisexual men."

But Dr Brian McClelland, from the Scottish blood service, said: "Even the highly sensitive tests for hepatitis and HIV that are performed on every donation cannot completely exclude all risk of infection, so an essential first step – and a requirement of UK law – is to avoid collecting donations if there is evidence that the risk of blood-transmissible infections may be raised.

"The Blood Services of the UK, like those in most European countries, USA and Canada, do not accept donations from men who report that they have had sex with another man.

"Over 60% of all the HIV diagnoses where the infection was likely to have been acquired in the UK were in gay men.

I think this is the key. Since the testing of blood cannot give a 100% guarantee of spotting HIV infection, one way to limit the chance of infection is to not take donations from clearly definable groups who, on average, have a higher rate of HIV infection than the normal population. That has nothing to do with homophobia and has everything to do with good public health.

"Other infections that are sexually transmitted and also transmitted by blood, such as hepatitis B and syphilis, are also increasing among men who have sex with men. Syphilis increased 117% from 2002 to 2006."

Dr McClelland said research continued to show that removing the current bar on donations by men who have sex with men would lead to an increase in the very small risk of HIV transmission due to infections in the very early stage that may be impossible to detect.

It would be interesting if any of my readers could point to UK data that showed relative infection rates amongst gay identifying men and other groups.

He added that donor selection rules were kept under regular review by the UK national advisory committee and any anticipated developments in testing and processing would be taken into account in these reviews.

The issues are to be examined by the Scottish Parliament’s petition committee on Tuesday.

Let’s see what the committee’s reponse was. I’ll report here as soon as I find out.

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17 Comments on “Should Homosexually Active Men Give Blood?

  1. Peter – this is from the International AIDS charity, Avert.

    Men who have sex with men remain the group at greatest risk of becoming infected with HIV in the UK. Throughout the 1990s, there were modest falls in the number of new HIV diagnoses among this group, except in 1996 when highly active antiretroviral therapy first became widely available and the advantages of early diagnosis became clearer. Since 1999, the figures have risen again from fewer than 1,400 to more than 2,500 per year – the highest levels ever recorded. It is likely that this trend is mainly due to an increase in HIV testing, though a rise in high risk sexual behaviour may also be a contributory factor.

    As of the end of 2007, 41,520 men who have sex with men have been diagnosed with HIV in the UK, including those who have died. It has been estimated that, at the end of 2006, about 41% of all people living with HIV in the UK were men who had sex with men.

    http://www.avert.org/uksummary.htm

    See also this item. In the US and South Africa gay activists are already donating blood.

    A recent CDC (Centre for Disease Control) study rocked the homosexual community in finding that although MSM comprise only 1-2 percent of the population, they account for an epidemic 64 percent of all syphilis cases.

    Although the risks extend far beyond potential HIV infection, the FDA notes, “All donated blood is tested for HIV, but the virus can go undetected until the immune system has produced a testable amount of antibodies.” This would pose a “small but definite increased risk to people who receive blood transfusions if the policy were changed.”

    But risking lives is apparently of little consequence to Joe Solmonese, president of the “Human Rights Campaign” (HRC), the nation’s largest homosexual pressure group. Solmonese recently placed politics over science, falsely declaring this commonsense public health precaution to be “discriminatory.” He has called for the ban to be lifted with the wildly irresponsible claim that, “[T]here is no medical or scientific rationale for this discriminatory policy.”

    “Joe Solmonese’s demand is incredibly reckless and selfish,” said Matt Barber, Policy Director for Cultural Issues with Concerned Women for America (CWA). “Unfortunately, it’s a common demand among his fellow extremists.

    “In South Africa, militant homosexual activists have been deliberately and surreptitiously violating that nation’s blood ban, planning to flood blood services with 70,000 units. Who knows how much blood has been contaminated or how many innocent people have been infected,” said Barber, “This isn’t a protest; it’s an act of violence.

    http://christiannewswire.com/news/694626045.html

  2. Peter,

    The Government just published the latest Social Trends survey for 2006. STIs are covered around p 105. You can download it here: http://www.statistics.gov.uk/statbase/Product.asp?vlnk=13675
    You can calculate relative infection rates in MSM and heterosexuals from it. They seem to be very high. For instance, “40% of people who contracted HIV in the UK were MSM and 60% were heterosexual” (p 105).
    But MSM are, I guess, only 1-2% of the population (as no women are MSM!). So, in 2006, MSM were about (40/60*98.5/1.5=) 44 times more likely to have contracted HIV than the average heterosexual person.
    That said, it IS irresponsible sex that is the problem – it’s just a lot more of a problem among MSM!

    David

  3. Peter and Jill,

    Like you both, I am concerned about the spread of HIV among gay people and its connection to blood donation. In the light of the correlation between this and anal intercourse, I am quite concerned about the prevalence of anal sex amongst heterosexuals. Did you know?

    The most recent U.S. data from a national representative sample on heterosexuals and anal sex comes from the 2002 National Survey of Family Growth (NSFG), which was conducted on over 12,000 men and women aged 15 to 44. Results show that 34 percent of men and 30 percent of women reported engaging in anal sex at least once.

    Is this a representative sample? It is worrying if it is.

    There are also some interesting studies out there that suggest that heterosexuals engaging in anal sex are much less likely to use condoms than homosexuals.

    In the light of this, it would not seem unreasonable for the government to stop anyone engaging in anal sex from donating blood. I guess you might agree?

    By the way, I am desperate to find the original source for the Gay and Lesbian Alliance, South Africa – the militant homosexuals who are going to flood the blood banks of South Africa. They do not seem to exist in cyberspace. It would be good to know their numbers etc. I would like to tell them what I think of them if they intend to carry out their threat.

  4. Thanks for the figures David. Frankly, I’m amazed that the MSM (men who have sex with men) figures for HIV infection are so much larger than then heterosexual average. I thought the rates were 4 or 5 times as much, not 44 times. You can see can’t you why blood banks would be super-cautious in taking donations from this sub-group.

    Winston, I think I’m with you on the South Africa statement. Perhaps Jill can provide a source for her quote?

  5. Hello all,

    very quickly (note the time!) it’s interesting to compare the ScotBlood website with the blood.co.uk site. The latter says that you can’t donate if you’re a man who’s ever had oral or anal sex with another man – so not just penetrative sex. It also says that you can’t donate if you have ever worked as a prostitute – ScotBlood doesn’t mention this on the page you link to (don’t know if that’s relevant really, just something i spotted…). Also thought it noteworthy that the blood.co.uk site now has (it’s dated 10th Apr 08) a separate pdf document, explaining the reasons for excluding ‘MSM’ and answering some f.a.q. Interestingly it admits that France and Italy have overturned this ban (doesn’t give any details tho’) but maintains that what’s right for one population isn’t necessarily right for another, so the ban should remain here.

    in friendship, Blair

  6. Not wanting to be slightly off-topic, but I also can’t give blood under my situation. I don’t have sex with men, but I do live in a certain country that has decided that just because I am English and lived in the UK during the 80s and 90s, there is a possibility that I may be carrying the agent that causes vCJD.

    Just think of that – almost an entire country banned from giving blood…

  7. Derek, I have been a blood donor for 35 years, but the blood service has decided that I can no longer donate because I had a blood transfusion 21 years ago!

    Peter, here is a link to the South African ‘blood flood’ from which you will see that the gay activists plan to flood the country’s blood service with 70,000 units.

    http://news.bbc.co.uk/1/hi/world/africa/4610196.stm

    Winston, I thoroughly agree with you. It is high time the government did update the blood donation service to exclude anyone who engages in anal sex – the most effective means of transmission of the HIV virus. It has rather compromised itself, though, in granting extra benefits to men who have sex with men. This has effectively given the green light to anal sex, don’t you think? I expect they are reluctant to make themselves look stupid by now saying ‘stop’!

  8. Jill,

    Sort of off topic.

    I think you raise something for me that is very interesting. If taking part in an activity opens up one to the risk of illness, should we try to stop that activity or try to make it safer? I think that this applies to alcohol, certain foods etc. It would be interesting, for example, to see the correlation between smoking and cancer, drinking and its associated consequences, food and obesity, diabetes. I wonder how this compares to unsafe sex and Aids? I am sure that this correlation is not as high as the latter scenarios, but where would we draw the line? When do the statistics warrant a ‘do not do this anymore!’

    Jill, I have seen the link from the BBC – still no wiser who this organisation is. I am concerned because it could be another Changing Attitude and Gafcon – something you were very annoyed about. We do not want ‘homosexuals’ to be tarred as people who want to deliberately pollute the blood stocks if this is a spurious claim with no connection to real people.

    Yours.

  9. Winston, we have been through this before. If the activities you mentioned are found to be injurious to health, then it is the responsibility of Government to actively discourage them, which it has, to a greater or lesser degree. If ‘by making it safer’ you mean by more public acceptance of homosexual practice, I would argue strongly with that. In the most gay-affirming societies, such as those in San Francisco and New York, the behaviour is far, far worse – with their bathhouse culture and high levels of drug dependency, alcoholism, mental illness and suicide rates – not better. Even Changing Attitude have admitted that the model of fidelity to one partner for life is unrealistic for most people who self-identify as gay, and no amount of ‘acceptance’ is going to change this.

    Condom use merely encourages more risk-taking and higher levels of sexual activity, as can be seen across all strata of society with the rapid increase of STIs and teenage pregnancies. Condom use is not the answer. This should be blindingly obvious to everybody by now.

    The Christian message on morality is quite straightforward – sexual activity outside of marriage (between a man and a woman) is wrong. Simple as that. This is the best way to ensure the survival of mankind – if you take into account the myriad social ills which have befallen us since this stance was more or less abandoned – abortion, euthanasia, single parenthood, STIs – all contributing to the ‘culture of death’. This is how Gafcon came about. Some groups with vested interests might want to read ‘homophobia’ into this, but that would be quite wrong, it is nothing of the sort. If any of the Gafcon organisers are promoting any other sort of sexual activity outside of marriage, I have yet to hear about it!

    I have only managed to find one name in connection with GLA, which is their media director David Baxter. An address was provided on one site but the organisation was found to have moved. Very wisely, probably. I have no doubt that a great deal of anger was aroused after their behaviour was announced – one man with full-blown AIDS having admitted to donating blood after lying about his sexual proclivities. David Baxter has declared that his aim was to get the blood service closed down if they would not accept ‘gay blood’. This is terrorism, and should be condemned in the strongest possible terms, for it is they who are stirring up ‘homophobia’, not the Gafcon organisers.

  10. A few points:

    Your arguments against homosexuality in relation to places like San Francisco are not enough in my mind to damn homosexuality as a phenomena. It seems to me, at best, they are indicators of an unhealthy homosexual lifestyle. Could we not envision something differently? Have we had enough time to make such a judgement? Do you have the statistics say for practising homosexual Christians and their lifestyles in relation to these things? Maybe, that could be the missing variable. You also have no idea what acceptance will do long term – you cannot possibly know. We have neither defined what ‘acceptance’ might mean nor any idea what it will result in.

    I also think the criteria that you use to argue that homosexuality is intrinsically wrong could also be used, using similar variables, to argue that contraception is wrong. Do you agree with the Roman Catholic Church on this? I think Peter is right – experiential evidence is not enough on its own.

    Also, on the basis of the evidence, fidelity to one partner could be seen to be not working for heterosexuals as well – sex before marriage, divorce rates, infidelity in marriage amount to some pretty damning evidence. In fact, fidelity and heterosexuality is a pretty spurious idea anyway.

    When you say ‘the Christian message on morality is quite straightforward – sexual activity outside of marriage is wrong’, you seem to be making a spurious claim. The Christian message is a matter of interpretation, it is not a neutral agent in its own right – your interpretation is also subject to a great deal of debate. The whole concept of ‘marriage’ in the Christian tradition is likewise highly problematic – see Adrian Thatcher’s work in this area.

    I still think your South African example is pretty tenuous, and even if true leads to conclude that one person is bad and not a whole group of people which I always suspect is your reason to use these examples. By the way, did you read Girard and the scapegoat mechanism stuff.

  11. Winston,

    I think that in the general argument you are correct. We cannot hang our ultimate condemnation of homosexual practice on the dangerous behaviour of a portion of the “gay community”, however large or small that portion is. Even if 99% of gay men were promiscuous, the 1% who aren’t and who don’t have any STDs and are monogamous for decades present a “model” for “good” gay relationships. On that basis the ultimate argument against the 1% is theological, not experiential.

    However, on the specific subject of the ban on giving blood for those men who sleep with men, we can use these figures and observations to make statements of the like of “on average, homosexually active men are more likely to have STDs”. That’s not a bigoted statement, it’s a statistical fact. I think until these kind of figures change the blood donation ban is going to need to stay in place, especially given that answering “yes” to one simple question indicates that, on average, that person is 44 times more likely to be HIV infected than someone who answers “no”. Let’s however try and find ways to express that that aren’t knee-jerk or ungraceful.

    I’ve read Adrian Thatcher’s work. Methinks he doth protest too much.

  12. The title of the article is slightly misleading. The ban is not merely on actively homosexual men. It is a blanket lifetime ban on any man who has ever had oral or anal sex, protected or not with another man, even if that was a one off years ago and subsequent testing long after any antibodies from a STD could possibly have arisen.

    Now by the rule that precludes Michael Portillo because of his dalliances as a student. It also should preclude a number of my “straight” former school friends if some of the things I have since heard are true, some of whom I am aware are actually blood donors.

    I’m not campaigning necessarily for the right of myself to give blood I do fit into the active category, of course that is an monogamous relationship based on trust and like many heterosexual couples that means that portection is no longer deemed to be necessary. I am someone whoever that beleives that the absolute blanket ban is excluding a number of men who pose no addition risk to the tranfusable blood supply, it why I advocate that common sence prevails and the basis of exclusion is based on real risk rather than assumed risk, practice not orientation (ever experience MSM being the key phrase that is discriminatory) merely because of something that may have happened many years ago for some.

  13. Thanks for your comments Stephen.

    If it could be demonstrated that men who had slept with other men, but promiscuously a “long time ago”, had a lower HIV infection rate then the average man who slept with other men, then I would support your argument. The problem is, being able to discern whether someone who says that they are monogamous is telling the truth. I can see increasingly how average statistics is the only way to make judgements, because unfortunately human beings lie through their teeth.

  14. Peter you said “The problem is, being able to discern whether someone who says that they are monogamous is telling the truth.”

    However that is not merely a delimma defined by sexual orientation. If anything when that relates to sleeping with another man it is far more likely to be harder to discern from those who claim to be heterosexual, even dare we admit it on a questionaire regarding blood donation.

  15. True Stephen, but your comment has no bearing on the fact that men who sleep with men, on average, are over 40 times more likely to have HIV than a man who sleeps with woman, all other things being equal. That’s why the blood donation groups take the stance they do and the (immoral) promiscuity of some heterosexual activity has no bearing on the statistic in question (HIV infection rates among men who sleep with men).

  16. Fair enough Peter but you keep changing the goal posts you initial reposonse to me was:

    “The problem is, being able to discern whether someone who says that they are monogamous is telling the truth.”

    Now you’re reverting back to the statement that irrepective of current behaviour/orientation, history recent/past, which may even be backed up by blood testing beyond the recognised medical incubation periods for the deceases you harp back to.

    As I said above I recognise that I myself may not come under any change and be able to rejoin the donor pool but there are others who should based on different criteria rather than those the blanket ban imposes especially on those who are classed as ‘bisexual’ even if only on a short, fleeting experimental ground. The rigidity of the blanket ban on the basis that you may at one point have had oral or anal sex with another man is the issue. If a man who has slept with a man’s former partner is allowed donate after 12 months from last sexual encounter with said why does the same not apply to the man who has not slept with another man for the same period? you may wish to impose blood testing restriction in that period but why exclude for life?

  17. Hi Stephen,

    Sorry for the delay in replying to your comment – been v busy!!!

    I don’t think my goalposts are changing, I think what is happening is that we are talking about different things.

    At present the research shows that men who have had sex with other men are, on average, 44 times more likely to be infected with HIV. That’s undisputed. If we could find statistically a clearly defined subset of those men who had an infection rate similar to the national average the I would fully support the removing of the ban on that group of men.

    Unfortunately HIV testing *isn’t* the answer (though I wish it was) as it’s not fool-proof and can’t pick up really recent infections.

    I recognise that my comment about lying over monogamy is changing the terms of the debate slightly (and that men going to donate blood might lie about same-sex activity) but the blood authorities would only lift the ban on monogamous gay men *if* the statistics showed that their infection rate was similar to the national average. Same goes for “bisexual men”.

    You do raise a good point though about recency of sexual contact. I believe there is a very good case for men who haven’t slept with another man for a year or more AND are HIV negative to be allowed to give blood. I wonder though how many such men there are.

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