Don't let old fears drain the U.S. blood supply

Arthur Caplan, Ph.D. • E-mail

If you are in a car crash or have a C-section and need a blood transfusion, will the hospital be able to supply the blood you need? Maybe not. If you are a hemophiliac, have certain genetic diseases or are a child with an immune disease and use treatments made from blood to survive, can you get the life-saving products you need? Don't count on it.

Yet, despite the fact that there is a simple change in public policy that could help solve these problems, old fears about AIDS are standing in the way.

At different times during the year, blood banks and hospitals find themselves unable to meet the demand for blood. And the shortage is growing worse. Demand for blood continues to skyrocket as more Americans undergo bypass operations, organ transplants, C-sections, hip and joint replacements and other treatments that require the use of blood. And as more and more people live with immune disorders or diseases that hamper their ability to make blood, the demand escalates.

We also need blood for other reasons. Sadly, the reality of terrorism and violence has become all too real in American life. This means that the chance of not having enough blood on hand in a particular city on any given day is a risk that each one of us faces.

A simple solution
So what is one simple way to get more blood? Let gay men donate it.

A primary source of blood donation that is currently not being used are men who have had sexual relations with other men. After the AIDS epidemic exploded in 1985, the Food and Drug Administration banned blood donations from any man who had sex with another man even once since 1977.

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At one time, that policy made sense. But it no longer does. Testing for HIV and other infectious diseases has improved enormously since 1985. We don’t worry about heterosexuals who engage in risky behavior and might acquire HIV because we know the strict testing of today will screen out their blood if it is infected with the virus. Yet the FDA has not changed its policy about gay men despite the fact that there are people who will die in the United States or have to postpone elective surgery because of periodic shortages of rare blood types and blood products.

Current technology, which screens for the presence of viral DNA, can detect the presence of HIV at the very earliest stages of infection with uncanny accuracy. Admittedly there is a "window period" during which someone can be infected with HIV and not test positive even with the best of tests.  But this window can be measured in terms of days not years and certainly not the decades that are currently reflected in the FDA policy.

The policy of forever excluding people who had male-to-male sex at some point during the past 30 years should have been changed a long time ago. The accuracy of the latest technology for screening blood means that there is no reason to exclude anyone as a donor in any risk group for more than a month.

The question now is whether the FDA and Congress will act or simply let old prejudices, biases and fears stand in the way of supplying the nation with more badly needed blood.

The AIDS epidemic has been with us for 25 years. The policy currently governing blood donation in the United States has been with us for 22 years. Given our ability to guarantee an exceedingly safe blood supply, it is time to revisit the policy and accept blood from all Americans willing to donate. Fear and prejudice should not be allowed to kill people.

Arthur Caplan, Ph.D., is director of the Center for Bioethics at the University of Pennsylvania.

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