New blood donor rules for gay men may help Michigan hospitals amid shortage

• The FDA has loosened restrictions imposed on gay and bisexual men donating blood
• The new policy uses individual assessment questions for all prospective donors, regardless of sexual orientation
• Michigan health officials hope the change will help hospitals after the pandemic stunted donations

Michigan hospitals are hopeful that new rules making it easier for gay and bisexual men to donate blood will help alleviate a pandemic-induced plasma shortage.

Robertson Davenport, director of transfusion medicine at Michigan Medicine’s Department of Pathology, says the eased restrictions are an important step toward safety, supply and equity.

“The goal is always to have a safe blood supply to take care of our patients,” says Dr. Kristina Davis, medical director of blood donation and transfusion medicine at Corewell Health, a Grand Rapids and Southfield-based hospital system.

“The new guidance from the FDA that came out this month aims to do just that. It uses evidence-based recommendations to maintain a high standard of safety while increasing the number of potential donors to help make sure there is enough blood to help our patients.”

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Announced by the U.S. Food and Drug Administration May 11, the new policy employs a set of questions to assess risk donor eligibility for all individuals, lifting the three-month deferral period for men who have sex with men. Under that former policy, that meant all gay men had to abstain from sex for three months before giving blood.

Some restrictions remain in place, but they are based on risk, rather than a broad category ban. Would-be donors with a new sexual partner or more than one partner in the past three months that involve anal sex must wait for three months. Also asked to wait to donate blood are those who take medications to treat or prevent HIV, such as pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). The drugs are effective, but new infections may not be immediately detected, according to the FDA.

The American Red Cross, which supplies 40 percent of the nation’s blood supply, declared its first ever “national blood crisis” in early 2022, citing a 10 percent drop in donations since the pandemic’s onset. The Versiti Blood Center of Michigan, one of the state’s two major blood suppliers, issued an emergency call for donors in January of this year in the face of critically low supply in the state.

The FDA first issued restrictions on blood donations from gay and bisexual men, a group disproportionately impacted by the ongoing HIV/AIDS epidemic, in the 1980s. A man who had sexual contact with another man at any point after 1977 was barred completely from donating plasma. At the time, no reliable way of testing blood for HIV existed. 

The policy was revised in 2015 to allow gay and bisexual men to donate blood only after abstaining from sex for 12 months. The deferral period, which was reduced again to 3 months in 2020, was enacted to account for the window of time between HIV exposure and detection. 

Though the previous policy made sense as a preventative measure at the time it was instituted, the ban being upheld even as screening for HIV in blood developed has long drawn criticism from gay rights activists and health professionals alike. 

“Things have changed a great deal: we have far better testing, we have a far better understanding of the epidemiology and we have better scientific data,” Davenport said.

Beyond the advancement of blood testing, opponents of the old policy have argued the ban perpetuates negative stereotypes about LGBTQ+ individuals by not imposing the same blanket restrictions on other individuals participating in high-risk activity. Even as restrictions were eased, many gay and bisexual men still encountered difficulties as blood centers struggled to quickly implement the changes.

Erin Knott, executive director for LGBTQ+ advocacy group Equality Michigan, praised the change. “Equality Michigan applauds the FDA's decision to follow science and issue new recommendations for all Americans, regardless of sexual orientation, who selflessly donate blood to help save lives,” Knott said in a statement to Bridge. “We urge the FDA to continue to place science over fear and homophobia and treat all blood donors with fairness and dignity.”

In a Mar. 31 letter, Michigan Attorney General Dana Nessel joined 21 other attorneys general in urging the FDA to implement the change, calling the former policy outdated and discriminatory.

More than 13 million pints from nearly 7 million donors are collected in the U.S. annually. A 2014 study at the University of California Los Angeles estimated that lifting the ban for MSM (men who have sex with men) donors would increase the annual nationwide blood supply by up to 600,000 pints of blood per year.