Pressure is mounting on the Department of Health and the National Blood Service to end the blanket lifetime ban on gay and bisexual men donating blood. This sweeping prohibition was originally introduced in the early 1980s in response to the advent of the HIV pandemic. Well-intended at the time, it is now increasingly seen as a panic, knee-jerk over-reaction.
The ban states that no blood donation is acceptable from any man who has ever had oral or anal sex with another man – even just once, even with a condom.
Among those prohibited from donating blood are: gay couples in lifelong monogamous relationships, celibate gay and bisexual men, heterosexual men who experimented at school and males who last had gay sex in the 1960s – more than a decade before HIV was first diagnosed. Even if men from these groups take blood tests that show them to not have HIV, they are banned for life from donating blood. This policy is madness.
In response to protests and criticisms. the government's Advisory Committee on the Safety of Blood, Tissues and Organs is undertaking a review to determine whether the comprehensive ban should remain.
The demand for change has been building in the run-up to World Aids Day. The National Aids Trust has called for a reconsideration of the policy, on the grounds that it is medically and scientifically questionable.
Other critics have been more forthright. The National Union of Students has concluded that the automatic lifelong ban is flawed and is actively lobbying to get it lifted. The lesbian, gay, bisexual and transgender (LGBT) human rights group OutRage! has campaigned against the ban for 17 years. It condemns the prohibition as being based on "stereotyped, irrational, unscientific and homophobic assumptions".
Impetus for change has also come from the decision of the Anthony Nolan Trust to lift its automatic ban on all donations from gay and bisexual men. It takes the view that each individual donor should be assessed on their personal risk factors.
Several other countries have ditched their lifetime exclusion, including New Zealand, Spain, Italy, Japan and Australia. They now allow some gay and bisexual men to donate blood, in certain circumstances.
Since Spain and Italy ended their total gay ban, the number of HIV infections from contaminated blood donations has fallen dramatically. They eased the restrictions and, at the same time, improved the screening process and educated gay donors about the new policy.
Ironically, the government is defending the ban at a time when the National Blood Service is appealing for extra donors, ahead of the winter flu season. Some of the potential shortfall in the blood supply could be met if the ban was lifted.
The priority must be to protect the blood supply from infection with HIV. But this can be achieved without the universal exclusion of all gay and bisexual men. The blood service should replace it with more narrow restrictions focused on risky gay and bisexual donors. This change of policy could go hand in hand with a "safe blood" education campaign targeted at the LGBT community, to ensure that no one donates blood if they are at risk of HIV and other blood-borne infections.
The only men who should be definitely excluded as donors are those who have had oral or anal sex with a man without a condom in the previous six months and those who have a history of unsafe sex. Most other gay and bisexual men should be accepted as donors, providing their blood tests HIV-negative.
If the blood service wanted to be ultra cautious, it could exclude all male donors who have had oral or anal sex with a man in the last month, and do both a HIV antibody test and a HIV antigen test on all other men who have had oral or anal sex with a man in the preceding six months. This would guarantee that the donated blood posed no risk to its recipients. This change of policy would not endanger the blood supply. With these provisos, the blood donated would be safe.
This is not just my opinion. The call for change is growing worldwide. The American Red Cross, the American Association of Blood Banks and America's Blood Centres favour changing the lifetime ban on gay and bisexual men donating blood.
According to Dr Arthur Caplan, former chair of the US government advisory panel on blood donation: "Letting gay men give blood could help bolster the supply. At one time, long ago, the gay-blood ban may have made sense. But it no longer does."
Evidence given in 2008 to a Tasmanian tribunal on the blood ban suggested that if gay and bisexual men who practised safe sex were allowed to donate, one HIV-positive blood donation would be likely to slip through the clinical screening process once every 5,769 years. That's once between now and the year 7778.
The truth is that most gay and bisexual men do not have HIV and will never have HIV. Our blood is safe to donate. Far from threatening patients' lives, we can help save them.
