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Gay blood donors back
Posted: Thu Sep 08, 2011 10:20 pm
by Gob
The lifetime ban on blood donations by homosexual and bisexual men will be lifted in England, Scotland and Wales.
Ministers have agreed to let men who have not had sex with another man in the past 12 months to donate from November.
The restrictions were put in place in the 1980s to prevent the risk of HIV contamination.
However, the latest medical evidence presented to a government panel argued the ban could no longer be justified.
Ministers in the three countries accepted the argument and said they would be relaxing the rules. Northern Ireland is expected to make a decision soon.
The National Blood Service screens all donations for HIV and other infections. However, there is a "window period" after infection during which it is impossible to detect the virus.
In the UK, a lifetime ban was introduced in the early 1980s as a response to the Aids epidemic and the lack of adequate HIV tests.
http://www.bbc.co.uk/news/health-14824310
Re: Gay blood donors back
Posted: Fri Sep 09, 2011 12:11 pm
by Daisy
Whilst this seems to be "good" news it is in fact unworkable.
What they will actually allow is men who have not had sex with another man for 12 months.
Pretty fucking pointless exercise IMO.
Re: Gay blood donors back
Posted: Fri Sep 09, 2011 12:24 pm
by rubato
The reason for the exclusion is that there is a period of time between infection with HIV (and thus having blood which will infect another) and when that infection is detectable.
I don't see any value in changing that. The percentage of homosexual men who are HIV+ is so high that just on a statistical basis it would be a foolish risk to inflict on an unsuspecting person.
yrs,
rubato
Re: Gay blood donors back
Posted: Sat Sep 10, 2011 11:10 am
by loCAtek
That window is about six months; so a year of abstinence, or a year of a known safe partner and you've both been tested negative; is workable.
Yup, people can and do abstain.
Re: Gay blood donors back
Posted: Sat Sep 10, 2011 12:10 pm
by Scooter
rubato wrote:The reason for the exclusion is that there is a period of time between infection with HIV (and thus having blood which will infect another) and when that infection is detectable.
The solution is to screen people based on risk
behaviours rather than excluding people based on risk
groups. If you have had unprotected vaginal or anal intercourse with anyone but a monogamous partner in the past year, you shouldn't be donating blood. If all sex has been protected and/or within the context of a monogamous relationship, then there is no risk and therefore no reason to reject a donor regardless of sexual orientation.
The percentage of homosexual men who are HIV+ is so high that just on a statistical basis it would be a foolish risk to inflict on an unsuspecting person.
Who is at higher risk of infection? A gay man who has been in a monogamous relationship for the past 30 years in which he and his partner have done nothing but give each other hand jobs, or a heterosexual female who has unprotected vaginal and anal sex with ten different men each week? Under this policy, the latter may donate while the former may not.
Re: Gay blood donors back
Posted: Sat Sep 10, 2011 3:04 pm
by Joe Guy
Scooter wrote:The solution is to screen people based on risk behaviours rather than excluding people based on risk groups. If you have had unprotected vaginal or anal intercourse with anyone but a monogamous partner in the past year, you shouldn't be donating blood. If all sex has been protected and/or within the context of a monogamous relationship, then there is no risk and therefore no reason to reject a donor regardless of sexual orientation.
When I donate blood I am required to fill out a questionnaire that asks if I've ever had sex with a prostitute or a man and whether I have or have had certain diseases. It seems to me that they already are screening based on behavior.
The problem I have with that is that people have been known to lie about their sex lives.
No - really.
People have actually lied about it.
Hard to believe, isn't it?
Re: Gay blood donors back
Posted: Sat Sep 10, 2011 5:12 pm
by BoSoxGal
You mean like when a person thinks s/he's in a long-term monogamous relationship and then finds out s/he's been unwittingly exposed to STDs for years by a partner's infidelities?
Re: Gay blood donors back
Posted: Sat Sep 10, 2011 5:36 pm
by Scooter
Joe Guy wrote:When I donate blood I am required to fill out a questionnaire that asks if I've ever had sex with a prostitute or a man and whether I have or have had certain diseases. It seems to me that they already are screening based on behavior.
I said "risk behaviour". Getting a man or a prostitute to give you a hand job doesn't put you at risk of contracting any disease a blood collection agency needs to be worrying about. They may as well be screening based on whether you have ever played Chinese checkers.
There are certain sexual acts that put you at risk of contracting blood borne diseases whether you are a man or a prostitute or Rebecca of Sunnybrook Farm. We know what those are, so that is how donors should be screened.
bigskygal wrote:You mean like when a person thinks s/he's in a long-term monogamous relationship and then finds out s/he's been unwittingly exposed to STDs for years by a partner's infidelities?
That is happening, probably more than anyone cares to believe. I repeat again that the single best predictor of getting infected with HIV is being a married woman, and most of those women live in cultures where they are expected to be virgins before marriage and monogamous thereafter. Unfortunately the same expectations are not placed on their husbands.
The problem is that excluding those in long-term monogamous relationships who don't use condoms is going to reduce the size of the donor pool to next to nothing. That's probably ok wrt HIV, for which we can test. The problem will be the next unidentified pathogen that is transmitted both sexually and through blood products and that doesn't cause noticeable signs of disease for 10 to 20 years after infection. When (note that I did not say if) that happens, the current model of screening by risk groups rather than risk behaviours will create a new epidemic among recipients of blood products.
Re: Gay blood donors back
Posted: Sat Sep 10, 2011 6:01 pm
by Joe Guy
Scooter wrote:There are certain sexual acts that put you at risk of contracting blood borne diseases whether you are a man or a prostitute or Rebecca of Sunnybrook Farm. We know what those are, so that is how donors should be screened.
That would be only be effective if we could guarantee that nobody would lie about the kinds of sex acts they have had or wouldn't lie about using needles, etc.
Re: Gay blood donors back
Posted: Sat Sep 10, 2011 6:26 pm
by Scooter
Can you guarantee that now? Then screening people based on risk behaviurs can only be an improvement.
Re: Gay blood donors back
Posted: Sat Sep 10, 2011 6:50 pm
by rubato
Scooter wrote: The solution is to screen people based on risk behaviours rather than excluding people based on risk groups. If you have had unprotected vaginal or anal intercourse with anyone but a monogamous partner in the past year, you shouldn't be donating blood. If all sex has been protected and/or within the context of a monogamous relationship, then there is no risk and therefore no reason to reject a donor regardless of sexual orientation.
One solution is to use risk behaviors. Another solution is to use risk groups*. I see no advantage is switching from the latter to the former and significant disadvantages. And I think you're uselessly splitting hairs by saying that having gay sex is not a 'risk behavior'.
Who is at higher risk of infection? A gay man who has been in a monogamous relationship for the past 30 years in which he and his partner have done nothing but give each other hand jobs, or a heterosexual female who has unprotected vaginal and anal sex with ten different men each week? Under this policy, the latter may donate while the former may not.
You are committing a fallacy of composition. The question in terms of setting public policy is what are the odds that a member of one group is HIV positive or has recently been exposed. Because their are a few members of that group whose risk is lower does not make the use of the category less effective.
I like being able to donate blood and I consider it a blessing to be able to do so but if I traveled to Africa or some other places I would be told I could not do so. And I would accept that without complaining.
If it were shown the people who had worked with blood products in the lab had a significantly greater chance of being HIV+ (or some other pathogen), (which I did back in the early 90s) I would accept the exclusion even if it were also shown that only careless people had actually been infected.
I understand that eliminating certain groups makes it safer for everyone. I think you should as well.
yrs,
rubato
Re: Gay blood donors back
Posted: Sat Sep 10, 2011 6:55 pm
by Scooter
What you are saying is that the current shortcuts in screening in which people who pose no risk to the blood supply are screened out while people who pose significant risk are allowed to donate is perfectly acceptable to you. That's fine. I hope you can live with it when it comes back to bite us all on the ass.
The question in terms of setting public policy is what are the odds that a member of one group is HIV positive or has recently been exposed.
And since the odds that a gay man who has never engaged in unprotected anal or vaginal sex would be HIV+are next to nil, you have made my point for me. How is more difficult to ask that question than the one currently being used? Not all all. How much more effective would it be than the current question? A great deal, because there are a LOT of men who have had sex with men who don't even want to acknowledge it to themselves. Posed as a question about unprotected sex in a gender neutral way, there is more likelihood that the question will be answered honestly and will therefore make a more effective screen.
Because their are a few members of that group whose risk is lower does not make the use of the category less effective.
Has anyone demonstrated that the current screening questionnaire has demonstrated any effectiveness in eliminating infected blood from the supply? Or does the entire credit for that achievement go to the use of antibody testing, and was the screening questionnaire nothing but risk screening theatre?
Re: Gay blood donors back
Posted: Sat Sep 10, 2011 7:08 pm
by Joe Guy
Scooter wrote:Can you guarantee that now? Then screening people based on risk behaviurs can only be an improvement.
I don't see how screening by behavior can be an improvement (for the reason I stated above). The negative to screening by groups is that you'll screen out people who are not a risk along with those who are a risk.
Re: Gay blood donors back
Posted: Sat Sep 10, 2011 7:16 pm
by Scooter
The other negative to screening by groups is that you do not screen out people who actually do pose a substantial risk. Screening by behaviour will perforce be an improvement because it addresses actual causation of infection, rather than engaging in guilt by association. Yes, people will lie. But people lie now, so how does that have any impact one way or another? If anything, as I said to rubato, addressing what actually constitutes risk behaviour in a gender neutral way will be more likely to elicit a truthful response, because you are not requiring someone to identify themselves as having had sex with a man when that is something that a lot of men will be extremely reluctant to admit.
Re: Gay blood donors back
Posted: Sat Sep 10, 2011 7:41 pm
by loCAtek
Scooter wrote:I repeat again that the single best predictor of getting infected with HIV is being a married woman,
The riskiest contact behavior is receptive anal intercourse, which most married women don't engage in. Receptive vaginal intercourse is far less risky.
These statistics show that homosexuals are still at the highest risk of contacting HIV. I know, a very bad copy;
the chart can be found here.
Transmission Category
Estimated Number of Diagnoses of HIV Infection, 2009
Adult and Adolescent Males Adult and Adolescent Females Total
Male-to-male sexual contact 23,846 - 23,846
Injection drug use 2,449 1,483 3,932
Male-to-male sexual contact and injection drug use 1,131 - 1,131
Heterosexual contact* 4,399 8,461 12,860
Other** 47 29 76
Already included in the blood donation questionnaire is:
"Have you had sex with a man who has sex with another man since 1977?"
So, if a married woman is aware of her husband's extramarital sexual activity and/or history; then this question already covers contingency. I see that as screening the behavior, not the group.
Re: Gay blood donors back
Posted: Sat Sep 10, 2011 7:50 pm
by Scooter
Thanks. And what do the worldwide numbers look like? You've heard of the world, right? That round thing with over 6 billion people on it who don't live in the U.S.?
Re: Gay blood donors back
Posted: Sat Sep 10, 2011 8:12 pm
by loCAtek
Fair question;
Global HIV and AIDS estimates, end of 2009
The latest statistics of the global HIV and AIDS epidemic were published by UNAIDS in November 2010, and refer to the end of 2009.
Estimate Range
People living with HIV/AIDS in 2009 33.3 million 31.4-35.3 million
Adults living with HIV/AIDS in 2009 30.8 million 29.2-32.6 million
Women living with HIV/AIDS in 2009 15.9 million 14.8-17.2 million
Children living with HIV/AIDS in 2009 2.5 million 1.6-3.4 million
People newly infected with HIV in 2009 2.6 million 2.3-2.8 million
Adults newly infected with HIV in 2009 2.2 million 2.0-2.4 million
AIDS deaths in 2009 1.8 million 1.6-2.1 million
Orphans (0-17) due to AIDS in 2009 16.6 million 14.4-18.8 million
At the end of 2009, women accounted for just over half of all adults living with HIV worldwide.
However, the increase in infection rates among women is largely due to Africa;
Africa
In sub-Saharan Africa, there are an estimated 22.5 million (range: 20.9 million–24.3 million; 2007 figures) people infected by HIV with over 2.8 million new infections in 2006. In this region, there were 2.1 million deaths (figure 11 and 12). Ten million young Africans between the ages of 15 and 24 and 3 million children are infected. In contrast to western countries, young African women are more likely to be infected with HIV than young men. According to UNAIDS, 61% of HIV-infected people in sub-Saharan Africa are female and the gap is increasing. Women are being infected with HIV at an earlier age than men in most countries in sub-Saharan Africa. The differences in infection levels are most pronounced among young people (aged 15 – 24 years) with, on average, 36 young women living with HIV for every 10 young men in sub-Saharan Africa.
Sub-Saharan Africa is the hardest-hit region in the world.In 2009, an estimated 1.8 million people became infected with HIV, totaling in 22.5 million people in sub-Saharan Africa living with HIV. Globally, 68 percent of all people who have HIV live in this region. A
bout 76 percent of all HIV-positive women in the world live in this region. Sixty percent of people living with HIV in sub-Saharan Africa are women and girls. Most women with HIV here have been infected by their husbands or sexual partners. Nearly 12 million children under the age of 18 living in sub-Saharan Africa have lost one or both parents to AIDS. Many grandparents, who have lost all of their adult children to the disease, are left raising their grandchildren, many of whom also are HIV-positive. Fortunately, in most sub-Saharan African countries, HIV rates are stable or showing signs of decline. Prevention efforts appear to be having an impact in some countries. Coinfection with tuberculosis (TB), which is a major cause of illness and death in people with HIV, also is a big problem in this region. People living with HIV are more vulnerable to getting drug-resistant TB. In South Africa, 44 percent of people with TB also have HIV. Addressing both infections is an urgent need.
All it says is they are young (aged 15 – 24 years) without saying how many are married. I'm going to speculate, and say that even if they were healthy that women in that region and situation, don't take into consideration being blood donors often.
Re: Gay blood donors back
Posted: Sat Sep 10, 2011 9:03 pm
by Gob
As a heterosexual man, who has been in a monogamous relationship for 10 years, and has never had sexual relationships with another man, (not knowingly, never while concious,) I am in a risk group excluded from giving blood.
Re: Gay blood donors back
Posted: Sat Sep 10, 2011 9:09 pm
by Scooter
And because you are vegan, your exclusion makes no sense in the circumstances (i.e. risk of vCJD acquired from eating BSE infected animal products in the UK).
Re: Gay blood donors back
Posted: Sat Sep 10, 2011 9:14 pm
by Scooter
Gob wrote:As a heterosexual man, who has been in a monogamous relationship for 10 years, and has never had sexual relationships with another man, (not knowingly, never while concious,)
Don't worry, the video clips posted on the internet clearly show that the guy who took a poke at you while you were passed out was wearing a rubber.