In May 2023, the FDA finalized its recommendations to allow blood donations from monogamous gay and bi men, relaxing policy restrictions against them that were widely criticized as discriminatory and that date back to the 1980s AIDS epidemic.
Under the proposed new guidelines, all prospective donors will be asked about their recent sexual history. If monogamous and no new partners in the last three months, all prospective donors, including gay and bi men, would be considered eligible to donate with no deferral period.
The updated guidelines include:
- A revised donor history questionnaire to ask all prospective donors about new or multiple sexual partners in the past three months.
- Prospective donors who report having a new sexual partner, or more than one sexual partner in the past three months, are then asked about a history of anal sex in the past three months.
- All prospective donors who report having a new sexual partner or more than one sexual partner and had anal sex in the past three months would be deferred from donation.
- A prospective donor who does not report having new or multiple sexual partners, or anal sex in the past three months, may be eligible to donate, provided all other eligibility criteria are met.
- Those taking oral medications to prevent HIV infection such as PrEP or PEP would be deferred from donating for three months from their most recent dose. The FDA notes that the use of PrEP and PEP may delay detection of HIV by licensed screening tests for blood donations, potentially resulting in false negative results.
Some of the remaining restrictions are still unnecessary and stigmatizing, including the prohibition against donations by people taking PrEP to prevent HIV. Morrison says, “When we limit and defer people who are being proactive in their sexual health, that stigmatizes them. There’s the potential for misconceptions, is that people on PrEP are promiscuous or have a higher risk of HIV infection—that’s categorically false.”
The FDA guidelines also recommend that people taking PrEP do not go off of it in order to donate blood. The FDA will continue to track data about PrEP and blood donation.
Here are additional points of interest around LGBTQ people, specifically gay and bisexual men, being part of the blood supply in the U.S.:
- GLAAD is among organizations and leaders who have consistently advocated for an end to restrictions on blood donations from gay and bisexual men, and other LGBTQ people. Two years ago, GLAAD released an open letter penned by over 500 medical professionals responding to the U.S. Food & Drug Administration’s (FDA) revised recommendations on gay and bisexual men, and other LGBTQ people, from donating blood by reducing the deferral period from 12 months to 3 months. In the letter, the hundreds of signed medical professionals from across the United States “call on the FDA to reverse its unscientific and discriminatory ban against men who have sex with men (MSM) from donating blood in favor of risk-based screening.” The letter also notes that “the FDA’s recent decision to shorten the prohibition window to 3 months is a step in the right direction, [but] it does not go far enough in reversing the unscientific ban.”
- Leading medical organizations have debunked the ban on LGBTQ blood donations for years. The American Public Health Association has stated that the current ban “is not based in science but appears to be modeled after other countries’ choices and fears.” The American Red Cross has also spoken out, noting that “blood donation eligibility should not be determined by methods that are based upon sexual orientation.” The American Medical Association called on the FDA to update its guidelines to be more in line with science: “We urge the FDA to take future steps to remove the categorical restrictions for blood donations by MSM so they are instead based on a person’s individual risk, consistent with the latest scientific evidence, to ensure blood donation criteria is equitably applied across all people.” A 2014 study by the Williams Institute estimated that if the ban were to be lifted, an additional 360,000 men would likely donate, which could help save the lives of more than a million people. With population growth and a record number of people out as LGBTQ since then, the impact would be even greater today.
- The new proposed guidelines would eliminate rules targeting potential donors based on sexual orientation and gender. Instead, the new guidelines would focus on sexual behaviors by any prospective donor, regardless of gender or sexual orientation, that pose a higher risk of contracting and transmitting HIV.