Why am I permitted ....

...to donate blood.

For a number of reasons. I haven't lived for six months in England or France since 1980 ( vCJD risk ). I haven't given money or drugs for sex ( HIV risk ). I haven't had sex with someone I don't know the sexual history of - ie: hookers ( HIV risk ). I have not used a needle to inject drugs ( HIV risk ). I have never been to Chad or a number of other African nations ( HIV risk ). I have never had a job or a hobby where I handled or cared for monkeys ( God only knows what risk )

Oh yeah, and I haven't had sex with a man, even once, since 1977.

I know these things permit me to donate because I have donated for 30 plus years. That puts me in a group and a sub-group - the group is comprised of about half of the adult population of Canada that is not excluded from donating blood. The sub-group is the three percent of eligible people that do donate.

The issue that has had some attention recently is the exclusion from donating of "men who've had sex with men, even once or protected, since 1977".

The charge is that this is discriminatory to gays. And it is.

CBC backgrounder on the safety of the Canadian blood supply.

The 'gays giving blood' issue is not new. This is an article ( pdf ) from the Canadian Medical Association Journal from back in 1997.

I am not looking to be politically correct and cry discrimination at the drop of a hat. I think a safe blood supply is an essential thing and good science coupled with minimizing risks is the way to ensure it.

HIV antibodies can be "detected from around three months after infection." All donated blood in Canada is screened for HIV, regardless of who donates it or what the donor may or may not say in the screening process. So the screening process only needs to catch people that have engaged in risky behavior in the past, to be safe, year.

The screening question currently excludes anyone who has had 'man on man' sex. If it were changed to exclude only those that had had that activity in the past year it would be a step in the right direction. Even that change would still exclude gays that were in a monogamous relationship. The question about knowing your partner's sexual history would cover that. The questions can be worded so there is no discrimination against people, only exclusion of donors engaged in risky activities during a limited recent time frame.

Saying things like "People do not have a right to donate blood." is a red herring. They have a right to not be unfairly excluded from an activity that people can choose to do.

Canadian Blood Services said it's reliant on student donations. "We are very dependent on being able to do blood donor clinics in universities," said Dr. Margaret Fearon, executive director of medical microbiology at the blood agency.
She said students are mistaken to see the policy as a gay rights issue.
"People who receive blood have a right to safe blood. People do not have a right to donate blood. It's a privilege, really."

I must mention that there is an 'out' in the blood donor program. If a person is being pressured to give blood or is unwilling, for whatever reason, to disclose that he or she may be in a risk group they can anonymously indicate that their blood shouldn't be used. You have to, in private, place one of two indistinguishable, bar-coded stickers on your paperwork. One indicates to use the blood, the other to not use the blood. If one uses this out no one is the wiser and the blood supply is safe.

So lets say the screening is changed, loosened if you will. Gay men could now donate if they meet the one relevant criteria - no sex, in the last year, with anyone that you don't know the sexual history of. Does this introduce more risk into the blood supply ? Perhaps marginally. How ? The donor can lie. 'Course anyone can lie at any time. So that's not that relevant to the gay blood donor situation. I would think there is as much risk in the pool from hetro guys that are fooling around or visiting hookers and not disclosing their activities in the screening booth. I can only hope that they are picking the correct sticker so that the blood supply stays safe.

The other risk that conceivably can be increased has to do with the problem of 'false-negative' test results. False-negative is a problem with any test. It means that a sample may have the virus but return a test result that says it does not contain the virus. That risk is very small in current HIV tests. As in the other risk I mentioned I am sure there are hetro blood samples that slip through on the false-negative problem.

Wiki

false-negative rates of 0.003% in the general population

British Medical Journal

The commercial kit had a sensitivity of 99.2%

HIV InSite - UCSF Center for HIV Information. Copyright 2008, Regents of the University of California.

False negatives do happen but are rare. The most common test used for HIV screening is the ELISA test. It has what is called a sensitivity of anywhere from 99.5% to 99.9% depending on the test used. This means that, in a sample of 1,000 specimens with HIV, HIV will be missed in 5 cases (99.5% sensitivity) or 1 case (99.9% sensitivity).

False-negatives are so rare as not to be a factor and the inaccuracy applies to both hetro and gay blood. Not a factor that can support discrimination.

The wording of the questions is a holdover from the time when testing for the HIV virus was not available and / or not as accurate. The discrimination will continue because the general public is not sufficiently knowledgeable about the risk of HIV transmission, other aspects of blood donation screening procedures and testing accuracy.

There is almost no downside to ending the discrimination. Curiously there is almost no upside either, outside of doing the right thing - that being ending the discrimination. The pool of eligible donors will not increase much. The pool is not tapped that much at the present time - as I noted only 3 % of eligible donors donate. There is a constant demand for blood that is being meet but not exceeded. Donors need to be recruited early so they become lifelong donors. I would hazard a guess that most people who have not given blood before they are thirty don't ever give blood. Recruiting older donors might be a good tactic for Canadian Blood Services.

Roll up your sleeve, eh ! It's in you to give.

I have to apologize for not including how this issue affects the lesbian community. I did not research that aspect.

I'll give a nod to Saskboy where I first saw mention of the issue.

Thanks for reading. I am off to sign up for a womens only Aquacise class. Maybe I will see a discrimination hat dropping there ;-)