The Food and Drug Administration (FDA) released new rules on Thursday discarding policies adopted out of HIV panic that specifically targeted men who have sex with men (MSM). Eligibility for blood donation will now be universally determined by “individual, risk-based questions” administered to all donors during intake, regardless of sexual orientation or gender.
Although the new policy will apply the same criteria to all potential donors rather than singling out MSM, restrictions remain in place for many people who are sexually active and those who are taking pre-exposure prophylaxis, or PrEP. The guidelines still require blood centers to defer potential donors for three months if they fit certain risk profiles for transmitting HIV, including people who’ve had anal sex with new or multiple sexual partners within the past three months, since anal sex carries the highest risk of HIV transmission, according to the CDC.
In the policy’s biggest shift, those engaging in anal sex with just one partner will no longer be deferred. The new changes have been in the works since at least January.
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“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, signals the beginning of the end of a dark and discriminatory past rooted in fear and homophobia,” Sarah Kate Ellis, CEO of GLAAD, said in a statement Thursday.
But Ellis also criticized the FDA for holding onto their three-month deferral policy for anyone on PrEP, which the FDA says “may delay detection of HIV” during the blood screening process.
“Placing potential blood donors taking PrEP in a separate line from every other donor adds unnecessary stigma,” Ellis argued in her statement, urging the FDA to “prioritize science over stigma and treat all donors and all blood equally.”
The FDA’s policies restricting MSM from donating blood were first established in 1983, during the height of the HIV/AIDS crisis in the U.S. Because the virus was still treated as a “gay disease” — a deadly misconception which the Reagan administration’s apathy did nothing to dispel — the FDA issued a lifetime ban on blood donations from gay and bisexual people, specifically targeting any man who had had sex with another man from 1977 to the present.
Following years of protests urging reform, the FDA relaxed their regulations in 2015 by allowing MSM to donate blood after a one-year deferral period — essentially mandating a year of celibacy for those who wished to donate. The COVID-19 pandemic forced the issue again in 2020, when the FDA shortened the deferral period to three months. But those incremental steps did little to prevent the U.S. from falling into its first-ever blood crisis, which the Red Cross declared last year.
Despite lingering problems with the updated policies, blood donation groups applauded the FDA’s new direction on Thursday, hoping it will help meet the intense medical demand for plasma.
“This shift toward individual donor assessments prioritizes the safety of America’s blood supply while treating all donors with the fairness and respect they deserve,” said Kate Fry, CEO of the nonprofit America’s Blood Centers, in a press release. “We will continue working with our member blood centers to welcome impacted donors as quickly as possible.”
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