More Gay and Bisexual Men Will Be Able to Donate Blood Under Updated FDA Guidelines

The Food and Drug Administration (FDA) recently announced new guidance for blood donation, which will allow more gay and bisexual men to donate blood. Under the updated recommendations, the U.S. will adopt an individual risk assessment model for blood donation, meaning that men who have sex with men (MSM) will not be subject to extra requirements or ineligibility if they are not considered to be high-risk donors. This move comes as a response to groups that have long advocated for an end to discriminatory sexual-orientation and gender-specific requirements for blood donation.

The original blood donation ban for gay and bisexual men came in response to an issue in the 1980s, during which blood recipients were infected with HIV. However, not all MSM have HIV, and many criticized the total ban on blood donation based on sexual orientation. The new guidelines are meant to make the criteria fairer, still protect the blood supply, and not exclude people unnecessarily.

A person’s sexual activity or other behaviors could still disqualify them from giving blood. For instance, having a new sexual partner or multiple sexual partners in the last three months and having anal sex in the past three months would make someone “deferred,” or ineligible to donate blood for the time being.

The new language in the questions is gender-neutral, and allows gay or bisexual men who are in monogamous relationships or aren’t having anal sex to donate blood. These updated guidelines bring the U.S. in line with other countries such as the U.K. and Canada and will likely increase the amount of donated blood, experts say.

“They’ve changed the policy in a way that protects the safety and security of the blood supply, but allows more people to donate blood, which will increase the volume, the quantity of units of blood available,” Sean Cahill, PhD, director of health policy research at the Fenway Institute, told Health.

“That trial just completed recently, and I think it’s in response to that new data that the FDA has taken this move,” Cahill said.

In addition, over the years people have come to trust screening technology more, Caplan said. Routine testing after blood is donated would likely pick up any bloodborne pathogens before it’s given to patients.

And though the FDA’s decision is still an evidence-based one, it’s also true that pressure from more frequent blood shortages could have provided an extra incentive for the organization to finally make these changes.

“We’re getting short on blood supply,” Caplan said. “It’s not insignificant that you’d rather have blood and take some small additional risks than have no blood.”

As of last week, blood banks were able to start amending their questions to put the guidelines into effect, the FDA said. The agency will work closely with these groups to “ensure timely implementation of the new recommendations,” Peter Marks, MD, PhD, director of the FDA’s Center for Biologics Evaluation and Research, said in a press release.

But logistically speaking, it may be a while before blood donors notice a difference.

For organizations such as Vitalant, a nonprofit blood donation organization, it will take some time to make these changes, Nick Gehrig, senior director of communications for Vitalant, told Health.

“Vitalant is preparing for the extensive process of updating donation materials and computer systems, and training about 1,500 staff members,” the company’s press release said. “We will complete the transition as quickly as possible while ensuring compliance with the final guidance.”

Once the questionnaires are fully updated, people should obviously still expect to have to answer personal questions about their medical and sexual history. But people can expect “a more sophisticated line of questioning that really pinpoints risk behavior,” Caplan said.

The ruling gets rid of the pointed stigma against MSM, but it’s not yet clear how these changes will affect the U.S. blood supply.

There will be a fair number of people who still won’t be able to give blood—or, they may have to wait—because of their sexual behavior or drug use. For example, the CDC estimates that about 300,000 people have been prescribed PrEP, which also makes them ineligible for blood donation.

On top of that, currently just 3% of people who are eligible donate blood, so it’s hard to know how many many gay and bisexual men will be interested in donating.

But it could have a large impact, Cahill said. A 2014 report found that if a ban on MSM blood donations were to be lifted, the U.S. could see an additional 345,000 to 615,000 pints of blood donated annually.

People who were possibly boycotting blood donation or had a negative opinion of it may also be more inclined to give blood now that the rules have changed, Cahill added.

And besides the benefit of more inclusive and accurate guidelines, the FDA’s announcement is also a good reminder to everyone to donate blood, Caplan added.

“The need for blood continues to grow and we are teetering on the edge of not having enough,” Caplan said. “It’s kind of like water or oil—you can’t run a health system without blood and blood products. So it’s very crucial that we not wind up with an inadequate supply.”