Equity in health opens up with new FDA restrictions on blood donations
June 1, 2023
As of May 11, blood donation restrictions have been loosened to make them more equitable and available to the LGBTQ+ community nationwide. Almost a month later, here is the status of what this change means in health care:
This most recent change in the Food and Drug Administration’s policy creates a standard set of questions asked regardless of one’s sexual orientation, activity or gender. This change follows scientific evidence showing that individual risk assessments can be made while still protecting the blood supply, according to the FDA website.
“The recent easing of blood donation restrictions that exclude parts of the LGBTQ+ community is a long overdue step in the right direction that is based on science and evidence-based medicine,” Shanilka de Soyza, medical doctor at Student Health Services at Oregon State University, said.
According to FDA press officer Carly Kempler, before the new recommendations were finalized the FDA received comments from; blood product recipients, blood collectors and transfusion medicine professionals, federal, state and local governments, LGBTQ+ advocacy groups, health care organizations, professional societies and those in academia.
The American Red Cross – which handles nearly 40% of the United States’ blood supply – has not yet announced its guidance or specific policies following the FDA’s restriction change, leaving the exact effect of this change on donations unclear at this point.
However, OSU Blood Drive Association Co-President and fourth-year biohealth science pre-med student Kendra Yasui predicts that an announcement from the ARC will be made in the near future and that this will cause more people to donate than before.
At this time, the ARC’s website states that “the Red Cross is committed to implementing the FDA’s new final guidance as quickly as possible. The Red Cross is currently working on changes to our regulated processes that will allow those who were previously ineligible to give in the future, in alignment with the new donor criteria.”
“We’re really really excited about it. I think that it is a way that we can make this process more equitable, to say the least, or at least more inclusive of other folks,” Yasui said.
The ban, which first took shape as a lifetime ban in 1983 in response to the prevalence of the AIDS epidemic, has since evolved over the years leading up to this point. In 2015, the ban was limited to 12 months since sexual contact with men who have sex with men, and in 2020, it was further reduced to three months since the last activity.
“At this point, we know there is a blood test for it; there’s better knowledge about the fact that this does not only apply to gay men, they are not the only folks who get HIV, and so we had kind of a step-wise pullback on that requirement,” Yasui said.
Even with this new opening of restrictions, potential donors who have had a new partner, more than one partner, or had anal sex in the past three months would be deferred from donation, according to the FDA website. This restriction is due to the window of detection for positive HIV presence in the blood via nucleic acid testing.
The FDA also prevents those actively taking preventative or treatment medications for HIV from donating, but notes that individuals will be deferred, not banned, as the antiviral drugs may delay the detection of HIV using the current detection technology. Although HIV is not transmitted through sex in those with undetectable levels, transfusion transmission remains a possibility.
“(The restriction change) promotes equity while maintaining the safety of the blood supply and should help to address the ongoing blood shortage in the US,” de Soyza said.