In January 1983, the US Centers for Disease Control and Prevention implemented an indefinite deferral of blood donation by men who have sex with men (MSM) due to the higher prevalence of HIV/AIDS in this population and suspicion that this was a blood-borne disease that may be transmitted by transfusion. This restriction is currently still in effect, where men who have ever had sex with other men since 1977 are excluded from donating on the basis that this date precedes the start of the AIDs epidemic.1 The deferral applies to all MSM including those who have had a low number of partners, those who practice safe sex, or even those in long-term monogamous relationships as this group is still considered to be at increased risk of HIV, Hepatitis B, Hepatitis C and other transfusion transmissible infections.2
The FDA continues to support this policy today due to data that supports that although MSM may only represent approximately 2% of the US population, this population continues to be most severely affected by HIV.2 For example in 2010, MSM accounted for at least 61% of all new HIV infections in the U.S., with an estimated 77% of diagnosed HIV infections among males attributed to male-to-male sexual contact.2 Furthermore from 2008 to 2010, the estimated overall incidence of HIV remained the same however the incidence in the MSM population increase 12% while it decreased in other populations.2
Many other countries around the world also have lifetime deferrals of donations from MSM, including France, Germany and Canada. Other countries have adopted shorter deferral periods, such as for MSM who have abstained from homosexual relations for greater or equal to 12 months in Argentina, Australia, Japan, and Hungary, and 5 years in New Zealand.3,4 Implementing a one or multi-year ban as these countries have has been proposed for the U.S. to help aid in recruiting more blood donors, however this is yet to occur due to current aforementioned data the FDA believes is unsupportive of such changes. The FDA maintains that it is the priority of the organization to enhance blood safety and protect blood recipients and therefore until presented with scientific data that supports that a change in policy will not present a significant and preventable risk to blood recipients, the current policy will remain. 2 (for a list of other donor eligibility requirements in the U.S., click here)
Looking at these statistics regarding MSM and HIV, it may seem obvious why permanent deferral is still in effect in the U.S., however a closer look at other populations who are not currently banned or restricted may clue one into why the FDA has received a great amount of questioning and grief regarding the current lifetime ban. For example, in 2009 it was reported that while the Black demographic only accounted for 12% of the total U.S. population, this group accounted for 44% of the people living with HIV in 2008 and an estimated 44% of new HIV cases in 2009.5 In addition,...