College Tribune | October 28th 2008
Features
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Giving blood: The lifetime blanket on gay men Tadgh Moriarty spoke to Rob Doyle (USI LGBT rights officer), Dr Ellen McSweeney (Consultant Haematologist, St James Hospital) and Dr William Blakely (Medical Director of the IBTS) to find out why exactly the practice of banning transfusions from men who have sex with men is still in place. In the early nineteen eighties, AIDS (caused by HIV) began to crop its head among those who had received blood transfusions on the East coast of the USA. At this time there was no test for the virus, however there was a strong association between the virus and homosexual men. It was decided at the time, as a precautionary measure, to ban gay men from donating blood. The ban worked. The number of infected transfusion recipients fell dramatically and so other countries, including Ireland, followed suit. The year is now 2008, and times have changed. There are a number of accurate tests available for testing blood for infectious diseases such as HIV, Cytomegalovirus (CMV) and Hepatitis B. So why then is the lifetime ban on men who have sex with men still in place? The current policy of the Irish Blood Transfusion Service (IBTS) is not to accept any blood donations from men who have sex with men. This includes both oral and anal sex, regardless of safer sex (using a condom and lubricant) being practiced, despite the significant decreased risk of virus transmission when such precautions are taken. This is a blanket lifetime ban, meaning any man who has had sex with another man, even once, is prohibited from donating blood for life. Dr William Blakely, the medical director for the IBTS, attempted to explain the idea behind the policy. According to him, the ban was instigated due to the outbreak of AIDS in the United States back in the nine-
teen eighties. The homosexual popu- donate the blood.” Homosexual men lation were seen as a high risk group still remain a high risk group and it and therefore ‘appropriate action is the guiding principle of the IBTS was taken at the time.’ to “discriminate against any class of When quizzed on the current rigid people who have a higher incidence testing of all blood products by the of infectious disease.” transfusion board, Dr Blakely exExamples of other groups who are plained that there is a window period deemed high risk are; “workers in or ‘lag-time’ between when infection the sex industry or intravenous drug with the virus occurs, and when the users” and heterosexuals who have virus will show up on “the most ad- had sex with people from Sub-Sahavanced, state of the art test.” Despite ran Africa. “While the relationship the fact that the infection does not show up at testing, these blood products are still seen as infectious. For HIV this lag period is ten days, for Hepatitis C it is three weeks, and for Hepatitis B, forty days must elapse between infection and detection. Dr Ellen McSweeney stated that “donations during this period pose the greatest threat to the security of our Dr. Ellen McSweeney, blood supply.” St. James’ Hospital Dr Blakely admits that the current practice does indeed “put all gay men into a general class,” it does is ongoing the deferral is permanent. not discriminate between those who If the relationship finishes then we partake in high risk sexual activities ask that they do not donate for 1 and those in “stable faithful relation- year thereafter.” Blakely concludes ships.” However, “it is not practical by remarking that it is indeed “sad within the conditions of a blood do- a statutory body has such a policy nor clinic to enquire deeply into the that many view as offensive.” They intimate details of each individual’s “don’t want to be in this situation,” lifestyle.” We therefore have to re- but “current best practice” maintains gard “all gay and bisexual men, and that homosexuals have an increased men who have sex with men, as a incidence of HIV, and as long as this single population.” The IBTS has “a is the case, donations from “men duty of care to its patients, not a duty who have sex with men” (MSM) will of care to its donors.” Their primary be declined. concern is the health, safety and wellDr McSweeney admitted that the being of their transfusion patients, number of new HIV infections among not “the people who come in to heterosexuals in Ireland was indeed higher than those in gay men, however she maintained that “the relative risk is higher in MSM” because “most men are not gay.” The IBTS is also concerned about other infections which can be transmitted by blood transfusions such as hepatitis B and syphilis. “Sadly, there has been an increased n u mb e r
in MSM in recent years.” She continues by stating the IBTS always follow up on the donors of HIV positive donations, and the information gathered has revealed that “between a third and a half of these donations come from men who confirm that they are gay or bisexual but did not declare this at the time of their donation.” Dr McSweeney concluded by stating “the justification for our policy is to protect patients from receiving an infection through blood donated by gay or bisexual men,” i.e. an infection which is in the window period and therefore not detectable by testing. Although there is also a risk from blood donated by heterosexuals, an analysis of the reasons why HIV positive blood donations are still being given “clearly indicates that the risk from heterosexuals is much less than that from gay or bisexual men.” As more and more campaigns are launched in countries worldwide, many state transfusion boards are being forced to review their current policy. In Australia, for example, they have recently decided to implement a policy whereby a homosexual man would be allowed to donate blood a year after his last sexual encounter with another man. However Rob Doyle, LGBT rights officer for the USI, comments that this is not enough. It is impracticable to expect a gay man in a stable relationship to abstain from sex with his partner for a year in order to be allowed “the privilege” of donating blood in order to “save lives.”
The justification for our policy is to protect patients from receiving an infection through blood donated by gay or bisexual men
The USI LGBT Officer, in collaboration with the MSM blood ban campaign, is seeking an independent review body to be set up by the Minister for Health to investigate the current practice and propose alternative or updated polices and guidelines which would be “both less biased against the gay population, and beneficial for society in general.” In Doyle’s opinion, “donating blood is one of the few ways in which people can truly give back to society.” According to the transfusions board’s own statistics, one in four people will require a transfusion at some point during their life. This means that 3,000 blood donations are required on a weekly basis but only 3% of the population donate blood. There is an obvious need for more donors to come onboard and donate blood regularly. A sizeable proportion of the community are, however banned for life from doing so, despite the fact that many are willing and yearning to do so. The fact remains that gay men are being excluded simply because of their sexual preference. and not even our very own Minister for Health, democratically elected by the population, appears prepared or interested in changing what has been described as the “openly biased, prejudiced, and offensive policy.”