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Open Discussion Discuss Inferior Blood at the General Forum; From 1977 to the present, have you had sexual contact with another male, even once? You'll have to answer that ...

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Old 06-28-2010, 10:15 AM
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From 1977 to the present, have you had sexual contact with another male, even once? You'll have to answer that question, word for word, on a donor form if you want to give blood in this country. The form, authorized by the Food and Drug Administration and reaffirmed 10 days ago by an FDA advisory panel, offers three possible answers: "yes," "no," or "I am female." If you check "yes," you're done. You're forbidden to donate blood.

Why? Because, as the FDA explains, men who have had sex with men—known in the blood world as MSM—"are, as a group, at increased risk for HIV, hepatitis B and certain other infections." To protect blood recipients from this risk, your blood must be excluded.

Maybe you fooled around with a guy 30 years ago and have spent the rest of your life as a celibate priest. Maybe you've been in a faithful same-sex marriage for 40 years. Maybe you've passed an HIV test. It doesn't matter. You can't give blood, because you're in the wrong "group." On the other hand, if you're in the right group—heterosexuals—you can give blood despite dangerous behavior. If you had sex with a prostitute, an IV drug user, and an HIV-positive opposite-sex partner 13 months ago, you're good to go.
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This kind of group-based screening is a long-standing practice in blood regulation. Over the years, we've prohibited donors on the basis of nationality as well as sexuality. There's nothing wrong with such categorical exclusions, according to the FDA, as long as they make the blood supply safer. But if that's true, why not screen donors by race?

The FDA bases its MSM policy on simple math. "Men who have had sex with men since 1977 have an HIV prevalence … 60 times higher than the general population," the agency observes. "Even taking into account that 75% of HIV infected men who have sex with men already know they are HIV positive and would be unlikely to donate blood," that leaves a population of MSM blood-donor applicants whose HIV prevalence is "over 15 fold higher than the general population."

So a 15-fold difference is good enough to warrant group exclusion. How about a nine-fold difference? According to the Centers for Disease Control, HIV prevalence is eight to nine times higher among blacks than among whites, and HIV incidence (the rate of new infections in a given year) is seven times higher. For black women, HIV prevalence is 18 times higher than for white women.

And these numbers understate the likely difference in risk to the blood supply. A recent CDC analysis of MSM in five cities found that while only 18 percent of the HIV-infected white men were unaware of their infections, 67 percent of the infected black men were unaware. If the awareness gap between blacks and whites overall is even half as great as it was among the men in this study—i.e., if blacks are twice as likely as whites to be unaware that they're infected, and therefore more likely to try to donate infected blood—then theoretically, black donors are just as risky as MSM donors.

Under FDA doctrine, even slight differences in average risk are sufficient to warrant group exclusions. The agency says its job is to "maximally protect" blood recipients. "Several scientific models show there would be a small but definite increased risk to people who receive blood transfusions if FDA's MSM policy were changed," it notes. Accordingly, "to err on the side of safety," MSM are excluded. A similar calculation, applied to blacks, would yield a similar result.

Is race a less legitimate basis for exclusion than sexual orientation is? Race is immutable, but plenty of evidence suggests that homosexuality is immutable, too. Technically, the MSM exclusion isn't a gay exclusion: You can be gay as long as you don't have sex with other men. A parallel policy, applied to race, would be that you can be black as long as you don't have sex with other blacks. After all, the No. 1 reason you're more likely to get infected by a gay man than by a straight one is the already high prevalence of HIV among gay men. The same is true of the higher infection risk among blacks.
If it's OK to reject blood from gay men, what about blacks? - By William Saletan - Slate Magazine
I've often wondered this question.

Since they test the blood in the first place, the whole "exclude an entire group" doesn't make sense to me.
But if we embrace that mentality, then shouldn't that mentality be embraced with all groups?
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Old 06-28-2010, 10:31 AM
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Default Re: Inferior Blood

Remember, when you place your faith in the test, you are saying, "I bet my life."

Quite possibly it would be wise to update the policies, but making this a discrimination issue is an infantile style of thinking.

Changing major health policies is hopefully a huge and very exacting procedure, and just maybe, the Adults are busy with other issues just now.

Perhaps the men in question should politely go about their legitimate business and wait in patience, much as people with real problems, like for instance, fatal diseases do?
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Old 06-28-2010, 10:36 AM
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Default Re: Inferior Blood

Isn't blood that is donated tested before it is given to another person for disease? I would expect that it is, if it isn't then we have a problem.

Another thing I thought was funny was the third answer, "I am female." seems to me that a female is just as likely to carry HIV is she had sexual contact with a male. Just because she is female doesn't make her immune. If they are going to exclude people it seems to me that anyone who has had sex prior to 1977 should be excluded!
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Old 06-28-2010, 10:49 AM
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Default Re: Inferior Blood

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Originally Posted by foundit66 View Post
If it's OK to reject blood from gay men, what about blacks? - By William Saletan - Slate Magazine
I've often wondered this question.

Since they test the blood in the first place, the whole "exclude an entire group" doesn't make sense to me.
But if we embrace that mentality, then shouldn't that mentality be embraced with all groups?
I find it a bit absurd that they should even get into this, considering the behavior of all people, male, female, other, hetero or gay. The exposure to blood born pathogens know no gender or sexual orientation.

I am hetero. But I have a non-fatal blood born virus that makes it illegal for me to donate, or even with knowledgable consent, provide blood to a family member who is dying.

So why exclude any particular group? Even the supposed "super-clean" can pick up a virus that can contaminate your blood... whenever possible, donate your own blood specifically for your use. In case of accident, it's the hospital's testing that can insure the blood is clean.

The discriminatory (inflamitory?) statement is just as absurd as it could be.
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Old 06-28-2010, 10:54 AM
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Default Re: Inferior Blood

I've had several operation over the past few years and the hospital always required me to donate three pints before they would operate, just in case. Only once did they have to give me my own blood only because the Dr. knicked an artery and I lost a bit more blood than normal. And, I remember when they gave it to me they said I might itch for a while......Man was that an understatement!
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Old 06-28-2010, 07:29 PM
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Default Re: Inferior Blood

I dont think "group" protection should outweigh the remotest
chance that a person could be infected by a blood or blood
product.

And how many times have we seen reliable tests found to be
less than reliable at all.
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Old 06-29-2010, 01:37 AM
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Default Re: Inferior Blood

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Originally Posted by Cat slave View Post
I dont think "group" protection should outweigh the remotest
chance that a person could be infected by a blood or blood
product.

And how many times have we seen reliable tests found to be
less than reliable at all.
I think we all agree on the premise of your argument, but the science indicates that no group is safe. Instead of putting a hard and fast rule that gays cannot donate, or any other "high risk" group for that matter, we should base our selection process on individual evaluation. There are plenty of homosexuals out there who are less like to give me something in a blood transfusion than a heterosexual who is free to donate.

sleeping with a man since 1975 or whatever it is increases EVERYONES risk, so women should not be able to donate unless of course they are lesbians. In fact, if we are going to make a hard and fast rule only lesbians (who have not slept with men) and virgins qualify to donate. If that's the logic you want to follow.
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Old 06-29-2010, 07:12 AM
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Default Re: Inferior Blood

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Originally Posted by dabateman View Post
I think we all agree on the premise of your argument, but the science indicates that no group is safe. Instead of putting a hard and fast rule that gays cannot donate, or any other "high risk" group for that matter, we should base our selection process on individual evaluation. There are plenty of homosexuals out there who are less like to give me something in a blood transfusion than a heterosexual who is free to donate.

sleeping with a man since 1975 or whatever it is increases EVERYONES risk, so women should not be able to donate unless of course they are lesbians. In fact, if we are going to make a hard and fast rule only lesbians (who have not slept with men) and virgins qualify to donate. If that's the logic you want to follow.
Well, actually you would have to move up the pyramid, because that lesbian may have slept with a lesbian who slept with a lesbian who slept with a lesbian who slept with a man.

And nowadays, since the definition of virgin has changed according to some people (only penile penetration of the maidenhead apparently counts now), you can't even guarentee that a "virgin" may not have contracted a blood virus. And sex is NOT the only way to get it, either.

So, that leaves us with... no one.
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