Ethical discussion about blood donation.

Nurses General Nursing

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So after reading an article about a man rejected from giving blood becase he seemed gay (http://news.yahoo.com/blogs/lookout/man-says-rejected-blood-bank-seeming-gay-151627659.html), I noticed a friend of mine (who is gay) made a facebook post stating that he was giving blood and alluded to the fact that he lied during the candidate screening phase.

I am just really conflicted about this. I know the supply of blood products can get to critical levels and that the blood gets screened anyway for diseases and that just because you are gay doesn't mean you are hiv+. So a large part of me says that it's an unnecessary and outdated edict put forth by the FDA 30-some years ago. But I also understand the basis of concern and of course I have a problem with people lying. The lying is probably bothering me more than anything else.

Is it time for the FDA to put this rule to rest? Wouldn't it help the already streeched thin blood supply? Or is the overall picture of the risky lifestyle of homosexual men too much of a liability.

CarolMacca66....Uh, I'll cross the monkey BBQ off of my fav places to pig out!! :)

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It is a statistical fact that the rate of HIV infections of homosexual males have been DECREASING while that of heterosexuals have been INCREASING.

There are many other countries besides the USA where the predominance of HIV infections are NOT concentrated in the homosexual population.

Uh huh...and your source is?

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Google AIDS rates in Africa, teenagers, and heterosexuals... there are a lot of sources out there.

Several PSAs on TV. Seen the one about pregnant women? Did they impregnate each other? :)

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Google AIDS rates in Africa, teenagers, and heterosexuals... there are a lot of sources out there.

Several PSAs on TV. Seen the one about pregnant women? Did they impregnate each other? :)

I'm quite familiar with Google, thanks anyway. I want her source.

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Actually globally, there are more women and children infected than men.

Second, they do do antigen testing as well as antibody testing on blood donations. It's a multi-layered process. They do a questionnaire to weed out high risk, then do an antibody test and then pool multiple donations together and run a NAT (nucleic acid test) for HIV, Hep B, Hep C and West Nile viral antigens in combo. If it comes back postive then the batch is retested seperately for each specific viral antigen. Then it's sent to the hospitals. The testing process for blood/plasma donations is pretty thorough.

http://www.americasblood.org/go.cfm?do=Page.View&pid=8

http://hospitals.unitedbloodservices.org/forms/BS_988B.pdf

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Globally the HIV/AIDS rates are higher in women, but according to my microbiology professor, who also works for the DPH, that is inflated mainly in Africa. I know that the CDC still has "men that have sex with men" as one of their risk factors for HIV. I'm not sure if today's research still holds true, but their stance has always been that if you are a man that has sex with other men, we are assuming you have a higher risk.

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Specializes in Critical Care, Progressive Care.
Gay sex is undeniably higher risk than heterosexual sex due to the trauma endured by the orifice which is not meant to stretch as much as a lady parts. And unfotunately, if we decided to get more "PC" about it and deny blood donation by anyone who engages in sex in general, then well we'd all bleed out unless a whole lot of priests and nuns lined up for donation! :jester:

"Gay sex" as you call it, does not carry inherent risk. You are correct in noting that receptive anal intercourse is (much) riskier than receptive lady partsl sex. But sex, in all its splendor, is varied thing. Many, many gay men do not have receptive anal sex and are therefore at no increased risk for HIV infection.

IMO, screening should be for sexual behavior, not orientation, if we even need to screen donors (as opposed to donated blood) at all. As it stands now a celibate gay priest is prohibited from donating. The current practice is not supported by evidence and must be changed in favor of an evidence based approach The current practice does not make our blood supply safer but it fosters the view of gay men as as "other" and as diseased.

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http://www.cdc.gov/hiv/

http://www.avert.org/aids-statistics.htm

Avert.org is a great resource for a demographic breakdown on HIV stat's and includes more context, IMO. I think stigmatizing high risk populations is a problem and breeds ignorance and bigotry.

"Gay sex" as you call it, does not carry inherent risk. You are correct in noting that receptive anal intercourse is (much) riskier than receptive lady partsl sex. But sex, in all its splendor, is varied thing. Many, many gay men do not have receptive anal sex and are therefore at no increased risk for HIV infection.

IMO, screening should be for sexual behavior, not orientation. As it stands now a celibate gay priest is prohibited from donating. The current practice is not supported by evidence and must be changed. It fosters the view of gay men as as "other" and as diseased.

Well said!

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Specializes in Critical Care, Progressive Care.

Thank you.

And thank you for the excellent information about blood screening.

But back to original question- the ethics of the lie on the screening form. I think this depends on why the donor lied. If for example he lied in order to gain compensation, for a plasma donation for example, then his ethics are suspect. If he lied as a protest, then I think it might possibly be acceptable. I would however argue that a more effective protest might be found in not donating and working to change the policy.

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Specializes in Nurse Scientist-Research.
In high school we have a blood drive. They ask us if we are homo. The only homos I went to high school with (who are still very close friends of mine) were virgins when we had the blood drive.

It sounds like the screening process was being done incorrectly. I also believe the original story regarding the donor who was rejected because he was suspected of being homosexual is wrong.

The screening for blood donation addresses behaviors not sexual preferences. The high schoolers written about above would not have been screened out because they were not males having sex with males. If one is a lesbian, one is not refused unless one fails d/t other factors on the questionnaire.

Sexual preference is not addressed anywhere on any form I've seen, risky behaviors or circumstances are. Should other risky behaviors be on the form? Maybe

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Specializes in Nurse Scientist-Research.

I must not be reading the same screening forms as others. The ones I have read address males having sexual contact with other males, not whether one defines oneself as homosexual or not.

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Specializes in Critical Care, Progressive Care.
I must not be reading the same screening forms as others. The ones I have read address males having sexual contact with other males, not whether one defines oneself as homosexual or not.

I hear you- and you are right. My concern is that not all sexuall contact between all males is "high risk." What about a concordant seronegative monogamous male couple that have been together for 20 years? Their HIV risk is nil. They should be allowed to donate. What a about a single straight woman that has sex with multiple partners and has had anal intercourse without a condom? Her risk is relatively elevated, and she is permitted to donate. This is why we need to test donated blood, and not stigmatize potential donors.

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