Blood, we are frequently reminded in colorful ad campaigns, is in us to give. We are urged to give the gift of life. Although it is in all of us, flows through all our veins, it is apparently not in all of us to give. No matter how desperate the need for blood, no matter how many people could use our blood, some of us are disqualified from giving the gift of life.
I recently donated blood for the 11th time. As always, I felt good about it. I was giving of myself, quite literally, to those in need. Yet every visit to the Canadian Blood Services also leaves me feeling uncomfortable, as if, with the gift of life, I am also complicit with systemic discrimination based on sexual orientation. I feel increasingly uncomfortable with the blood donor screening process, particularly with the bottom half of the second page of the donor questionnaire.
After taking my information, then drawing a little blood from my finger to check the iron content of my blood, I was given the donor questionnaire, the top half of which I was free to fill out on my own. Thereafter, I was called into a small room, which, incidentally, feels like an interrogation room, to have my blood pressure, heart rate, and temperature checked, and also to be asked the series of 'personal' questions on the bottom half of the questionnaire.
Some of the questions are about HIV/AIDS and STIs/STDs, drug use (both medical and narcotic), surgery, and risky sexual practices. I don't have an issue with these. The two questions that concern me, and that concern many people around the world, as you'll see from a small sampling of reactions which I have linked to below, have to do with sexual orientation. Of course, they are careful not to use those words — that would sound like discrimination. It's claimed the questions have nothing to do with sexual orientation. But the message is clear: gay and bisexual men are barred for life from donating blood, and women who have had sex with gay or bisexual men are ineligible for 12 months following that sexual act. Potential male donors are asked whether they have "ever had sex with a man, even one time, since 1977," while female donors are asked whether they have "had sex with a man who had sex, even one time since 1977, with another man" in the past 12 months.
Article comments
1 - Nancy
I don't know the incidence rates, but I would infer that the blood of all those of certain ethnic backgrounds is routinely checked for the sort of problems they carry, as well: Jews for Tay-Sachs, blacks for sickle cell, etc. etc. not to mention everyone for high cholesterol or other problems? If not, why not?
Actually, this technology is SO 19th century. I'm surprised a blood substitute hasn't been invented so that donated blood is no longer necessary. To continue to require people to open their veins is barbaric as well as primitive.
2 - Abram Bergen
Nancy: In answer to your first question about screening blood donors for specific issues prevalent among people of particular ethnic backgrounds, the answer seems to be no--the questionnaires, at least the ones I've looked at, screen donors for countries they have lived in/visited, and/or people they've had sex with who have visited/lived in certain countries, not for ethnicity. That would look too much like racial/ethnic discrimination.
As for your second comment, I wouldn't go as far as calling the use of donated blood unnecessary, or barbaric/primitive. Maybe that was just a little hyperbole on your part. There are, however, some interesting developments in artificial blood, some based on blood components,others entirely synthetic.
For a brief overview (though a bit dated), see: Artificial Blood: What Is It? Will I Use It?
3 - Abram Bergen
See also: - Scientific American, "How do scientists make artificial blood? How effective is it compared with the real thing?"
- New Scientist, "New artificial blood shows promise"
- The University of Sheffield: Media Centre, "Sheffield scientists develop artificial blood"
4 - Anna
You could comment on this study which is in China, but still relevant I'm sure - They determined over 60% of the people in the study with HIV contracted it through IV drug use - interestingly, a higher percentage contracted the disease through blood donation than sexual contact.
5 - Anonymous
I've been donating since I was sixteen years old, I just haven't told them I'm gay. It hurts to say "Yes, I am straight" but hey, if it gets more people blood, then I'm fine with it. Just because I'm gay doesn't mean I have AIDS. It's called a condom, people.
6 - Anon
I have read your viewpoint on this but it is thin on the science. The relevant point is that testing is not perfect (although it is improving). Epidemiological studies have identified populations that are at high risk including men that have sex with men. Blood services try to reduce the risk at point of donation. Any such deferral criteria will inevitably include people that are actually not high risk but they happen to fall within a high risk group. I do agree that the current criteria are not fair and based on the testing technology of the past. They need revision- but nevertheless there is a residual risk, despite the testing, and this needs to be minimised by appropriate deferral periods fair to all.