LETTER TO EDITOR
|Year : 2022 | Volume
| Issue : 1 | Page : 100-102
Endorsing a permanent lifting of the ban on men who have sex with men and transgender from donating their whole blood
Manish Raturi1, Kunal Das2, Yashaswi Dhiman1
1 Department of Immunohematology and Blood Transfusion, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
2 Department of Pediatrics, Division of Pediatric Oncology and Bone Marrow Transplantation, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
|Date of Submission||12-Nov-2020|
|Date of Decision||28-Feb-2022|
|Date of Acceptance||03-Mar-2022|
|Date of Web Publication||07-Jun-2022|
Dr. Manish Raturi
Department of Immunohematology and Blood Transfusion, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Jolly Grant, Dehradun - 248 016, Uttarakhand
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Raturi M, Das K, Dhiman Y. Endorsing a permanent lifting of the ban on men who have sex with men and transgender from donating their whole blood. Indian J Sex Transm Dis 2022;43:100-2
|How to cite this URL:|
Raturi M, Das K, Dhiman Y. Endorsing a permanent lifting of the ban on men who have sex with men and transgender from donating their whole blood. Indian J Sex Transm Dis [serial online] 2022 [cited 2023 Mar 23];43:100-2. Available from: https://ijstd.org/text.asp?2022/43/1/100/346605
Given the blood shortage worldwide, in the present COVID-19 pandemic, a controversial policy of restrictive ban of 12 months of sexual abstinence before their whole blood donation (WBD) on men who have sex with men (MSM) has been relaxed to a period of 3 months by the US Food and Drug Administration on April 2, 2020. Altogether, it has drawn attention and summoned calls for a permanent lifting of the ban. In the words of Katharine Bar, an assistant professor of medicine and an expert in HIV and general communicable disease care, the restriction was justified back in the 1980s, when blood banks had limited resources for transfusion transmissible infections (TTIs) testing. However, in the current era, when testing methods are more sensitive, the rationale behind banning an entire group of sexually active people without evidentially proven to be HIV positive is questionable. Many people have regarded even this 3-month ban as homophobic and an outdated process.
While the primary ethical requirement to receive safe blood stays with all the recipients by the principles of beneficence and nonmaleficence, this ban ostensibly questions the autonomy of an MSM to, rightfully, have a relationship with their sexual partner/s. This blanket policy deters WBD even from the MSM or LGBTQ (Lesbian, gay, bisexual, transgender and queer) who are at low risks, such as those who practice monogamous relationships and always wear condoms. The difference within the existing rules for sexually active MSM versus heterosexuals may raise some very critical issues such as:
- This ban may encourage deceit to honestly report their identity and high-risk behaviors (HRBs) right before giving blood
- It may reduce good numbers of donors during difficult times such as a global pandemic or blood shortage.
Literature suggests that the individual risk is dependent on a specific HRB or sexual network, instead of anyone's sexual orientation. For example, an MSM in a monogamous relationship would usually be at a lower risk of acquiring HIV than a promiscuous heterosexual person. However, the former gets banned from making a WBD given his sexual orientation depicting the harshness of the guidelines. The very thought of banning them hurts the blood transfusion centers at large. Recently, the Indian blood donation guidelines [IBDG] updated a robust, elaborate list of exclusion and inclusion criteria for blood donors to prevent TTIs; however, a noticeable imbalance of deferral against the demand was noted, including a permanent deferral on the transgender and MSM community [Table 1]. Besides, our blood community has faced challenges during this pandemic due to a dramatic reduction in bloodstock given social distancing and cancellation of voluntary blood donation drives. In fact, with the changing social structure, LGBTQ is treated at par with the rest. To conclude, we do propose adapting a more liberal allowance for the LGBTQ community if they wish to come forward and help with their WBD. An empirical revision in the IBDG without compromising blood safety is perhaps the need of this hour.
|Table 1: Proposed modification in the specific high-risk behavior/s in the present blood donor selection criteria|
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Conflicts of interest
There are no conflicts of interest.
| References|| |
Raturi M, Kusum A. The active role of a blood center in outpacing the transfusion transmission of COVID-19. Transfus Clin Biol 2020;27:96-7.
Kesby M, Sothern M. Blood, sex and trust: The limits of population-based risk management paradigm. Health Place 2014;26:21–30.
Raturi M, Kusum A. The blood supply management amid the COVID-19 outbreak. Transfus Clin Biol. 2020;27:147-151.