Many individuals from the LGBTQ community in Southern California remember getting the letter. The one that said they were prohibited from donating blood for life.
“Yeah, I was banned about 15 or 20 years ago,” said Frank Guzman on Feb. 21, a gay man who is president, co-founder and executive director of the Pomona Pride Center. “I went in with the intention to donate blood. I filled out a questionnaire and they said, ‘We don’t allow individuals who are gay to donate’.”
On Jan. 27, the U.S. Food and Drug Administration (FDA), which oversees the nation’s blood supply, issued draft guidelines that would allow gay men in monogamous relationships to donate blood. The proposal is aimed at increasing the number of potential blood donors and upping supplies while maintaining a safe product.
Many see it as an attempt to ease blanket restrictions that were placed during the 1980s AIDS epidemic on those who faced a potentially higher risk of spreading HIV.
The draft would do away with a requirement for men who have sex with men to abstain from sexual activity for a minimum of three months before being allowed to give blood. Instead, all potential donors would be screened with a new questionnaire that evaluates their individual risks for HIV based on sexual behavior, recent partners and other factors.
“We feel confident that the safety of the blood supply will be maintained,” FDA’s Dr. Peter Marks told the Associated Press.
While the draft rule was supported by the Los Angeles County Board of Supervisors in a letter to the FDA on Feb. 7, it has raised questions and more opposition than support from the LGBTQ community, who say the FDA proposal doesn’t erase the stigma placed on potential gay blood donors and retains decades-old bans based on sexual orientation alone.
One of those questions is whether those who received deferral letters banning them for life from giving blood will be allowed to donate under new guidelines. The issue was raised last month during a virtual meting with FDA officials, White House officials and LGBTQ leaders across the nation.
As a senior at Baldwin Park High School and an Associated Student Body member back in 2012, Camila Camaleon, at the time a gay male who is now a transgender female, remembers being unable to give blood at a school blood drive she organized as an 18-year-old.
After being asked about her sexual partners, she was turned away. The next day she received a letter invoking a general ban for life. “It was something that really impacted me,” said Camaleon, 28, the trans president of the San Gabriel Valley LGBTQ Center.
Camaleon, who participated in the call with the FDA, asked whether those like her and Guzman would get letters rescinding the ban. She hopes the FDA will consider such a reversal.
Guzman, who served on the Pomona Unified School District board of trustees from December 2011 to December 2020, always voted against allowing Red Cross blood drives on school campuses, saying he didn’t want to support discriminatory practices.
“There was no reason for me to try again. My blood was not welcome,” Guzman said, echoing the feelings of most in the LGBTQ community today.
Joey Espinoza-Hernandez, director of policy and community building at the LGBT Center of Los Angeles, said that while the FDA is moving toward dismantling the bias, they need to go further, including reevaluating lifelong bans on some individuals.
“Our recommendation is to completely repeal the ban and trust the science,” Espinoza-Hernandez said on Feb. 21.
Gay rights groups have long opposed blanket restrictions on who can give blood, saying they are discriminatory. Medical societies including the American Medical Association have also said such exclusions are unnecessary given advances in technology to test blood for infectious diseases.
Dr. Michael Gottlieb, a staff physician at APLA Health (formerly known as AIDS Project Los Angeles), has worked with AIDS patients since the onset of the disease in the 1980s and was actor Rock Hudson’s doctor. As a young researcher at UCLA in 1981, Gottlieb was the first to identify and describe AIDS as a new disease, which led to a team of researchers in France identifying the virus in 1983.
The Pasadena resident was asked about the attempt by the FDA to ease restrictions on blood donations from men who have sex with men. He noted that blood used for transfusions has been screened for HIV since 1985.
Now, HIV testing is more sophisticated. Testers look for antibodies, antigens and the nucleic acid material unique to HIV, he said. Testing for nucleic acid is necessary because the presence of antibodies could show up days or weeks after the presence of HIV.
“The testing is definitive. The science supports relaxing the restrictions,” Gottlieb said on Feb. 20.
Regarding the removal of the abstinence period to replace it with a list of questions, he said, “I can see where people still view the questionnaire as stigmatizing.”
Under the new proposal, men who have sex with men will be asked if they have had new or multiple partners in the last three months. Those who answer affirmatively to either question and also report having anal sex would be barred from donating until a later date. The policy would also apply to women who have sex with gay or bisexual men.
Anyone who has ever tested positive for HIV would continue to be ineligible to donate blood, as would those on anti-retroviral drugs.
Lambda Legal, a gay rights organization that has long pushed to change the FDA policy, welcomed the change.
“We think these are good first steps in the right direction,” said Jose Abrigo, HIV project director for Lambda Legal who was born and raised in Los Angeles. “It removes the categorical restriction on men who have sex with men on donating blood and goes to a risk-based assessment.
“But it is not just queer men engaging in risky behavior. It should be applied to everyone so it could be fair,” he said on Feb. 20.
Guzman added, “This (rule change) doesn’t address the main concern. You can have multiple partners regardless of your sexuality. I know many straight people who are friends of mine that engage in promiscuous activity and donate blood anytime they want.”
One rule the gay activists want changed is the blanket ban on anyone taking pills to prevent HIV through sexual contact, at least until three months after their last dose. The FDA noted that the medication, known as PrEP, can delay the detection of the virus in screening tests.
Gottlieb said he understood the prohibition for those on PrEP, because an individual may not always take the pill daily as prescribed, leaving him vulnerable to HIV exposure. Others say the unwritten criticism is that men on PrEP have many sexual partners.
Again, it is Guzman’s experience that is not the case. “I know many individuals who are part of queer community who abstain from sex but are on PrEP and now they are excluded (from giving blood),” he said.
Abrigo said banning gay men who are using an FDA-approved prescription to prevent contracting HIV sends the wrong message. “We should not penalize folks for engaging in safe sex practices,” he said.
Since the COVID pandemic began three years ago, the nation’s blood supply has dropped considerably. The FDA and gay activist groups say the easing of restrictions could bring in more blood donors and increase the nation’s blood supply.
Gottlieb, who treated LGBTQ patients before the AIDS outbreak, said many were regular blood donors. “Gay men as a group were generous blood donors. These were patients who regularly gave blood in the pre-AIDS era,” he said. “They represent a significant percentage of the potential male blood donor pool.”
Abrigo sees a benefit to all if the changes are implemented.
“There is a blood shortage in the United States. The more we can expand it, or make the factors more inclusive without undermining the risk to the blood supply, the more beneficial to all,” he said.
FDA regulators will take public comments on the proposal until the end of March before beginning to finalize the guidelines.
The Associated Press contributed to this article.