Ten-year gay blood ban is unjustified

A change of policy to include the HIV virus test alongside the antibody test would be safer, smarter

According to the Sunday Times (£), the government is planning to lift the blanket, lifetime ban on blood donations from men who have had oral or anal sex with men. This ban was introduced at the height of the Aids panic in the 1980s, on the grounds that gay and bisexual men are at greater risk of HIV.

The public health minister Anne Milton is reportedly planning to modify the ban. Men who have had sex with men will be no longer be barred for life, but only for ten years after the last time they had oral or anal sex. This ban will apply even if they always use a condom and even if they test HIV-negative.

A ten-year ban is too long. So is five years or even one year. These are needlessly cautious exclusion periods. Protecting the blood supply is the number-one priority but ensuring blood safety does not require such lengthy time spans during which gay and bisexual men should not donate blood.

The blood service could replace the blanket lifetime ban on blood donations from gay and bisexual men with a much shorter exclusion period. It should focus on excluding donors who have engaged in risky behaviour and those whose HIV status cannot be accurately determined because of the delay between the date of infection and the date when the HIV virus and HIV antibodies manifest and become detectable in an infected person's blood.

HIV antibodies normally take a maximum of one to three months to become identifiable in lab tests. The HIV virus can take two weeks to be detected. The blood service currently tests all donated blood for HIV antibodies but not for the HIV virus. To be safe, perhaps it should do both tests on potentially risky blood donations?

Reducing the exclusion period for blood donations from gay and bisexual men should go hand-in-hand with a "Safe Blood" education campaign, targeted at the gay community, to ensure that no one donates blood if they are at risk of HIV and other blood-borne infections due to unsafe sexual behaviour.

Moreover, the questionnaire that would-be blood donors have to answer should be made more detailed for men who have had sex with men, in order to identify more accurately the degree of risk – if any – that their blood may pose.

There is, in addition, a strong case for excluding only men who have had risky sex without a condom. At the moment the blood service makes no distinction between sex with a condom and sex without one. All oral or anal sex between men – even with a rubber – is grounds for refusing a donor under the current rules. This strikes me as odd. If a condom is used correctly, it is absolute protection against the transmission and contraction of HIV. Those who use condoms every time and without breakages should not be barred from donating blood.

In contrast to the suggested ten-year ban for gay and bisexual blood donors, a six-month exclusion period would be sufficient. This would exclude male donors who have had oral or anal sex with a man without a condom in the previous six months. All men who last had unprotected sex with men more than six months ago would have their blood tested for HIV antibodies, as is the current practice.

Although the six-month exclusion period is more than twice as long as it takes HIV antibodies to appear in the blood of an infected person, this is may be justified, to err on the side of caution and to reassure the public.

The exclusion period could, however, be much shorter than six months, with certain provisos. The blood service could decide to ban only donations from men who have had unsafe, condomless oral or anal sex with a man in the past month. For men who have had unprotected oral or anal sex with a man in the preceding one to six months, the blood service could be extra-safe and do both a HIV antibody test and a HIV virus test on their blood.

Since the HIV virus shows up in blood tests within two weeks of the date of infection, the one-month total exclusion period offers a double-length margin of safety. This would guarantee that the donated blood posed no risk to recipients.

A change of policy along either of the aforementioned lines would not endanger the blood supply. With the specified safeguards, the blood donated would be safe.

The call for change is growing worldwide. The American Red Cross, the American Association of Blood Banks and America's blood centres favour ending the lifetime ban on gay and bisexual men donating blood.

According to Dr Arthur Caplan, former chair of the US government advisory panel on blood donation: "Letting gay men give blood could help bolster the supply. At one time, long ago, the gay-blood ban may have made sense. But it no longer does."

The truth is that most gay and bisexual men do not have HIV and will never have HIV. Both the lifetime and ten-year bans are driven by homophobic, stereotypical assumptions, not by scientific facts and medical evidence. For the vast majority of men who have sex with men, their blood is safe to donate. Far from threatening patients' lives, they can and should help save lives by becoming donors.

Peter Tatchell is a human rights campaigner and the founder of the gay rights group OutRage!

Peter Tatchell is Director of the Peter Tatchell Foundation, which campaigns for human rights the UK and worldwide: www.PeterTatchellFoundation.org His personal biography can be viewed here: www.petertatchell.net/biography.htm

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Leave will leap on the immigration rise, but Brexit would not make much difference

Non-EU migration is still well above the immigration cap, which the government is still far from reaching. 

On announcing the quarterly migration figures today, the Office for National Statistics was clear: neither the change in immigration levels, nor in emigration levels, nor in the net figure is statistically significant. That will not stop them being mined for political significance.

The ONS reports a 20,000 rise in net long-term international migration to 333,000. This is fuelled by a reduction in emigration: immigration itself is actually down very slightly (by 2,000) on the year ending in 2014, but emigration has fallen further – by 22,000.

So here is the (limited) short-term significance of that. The Leave campaign has already decided to pivot to immigration for the final month of the referendum campaign. Arguments about the NHS, about sovereignty, and about the bloated bureaucracy in Brussels have all had some utility with different constituencies. But none has as much purchase, especially amongst persuadable Labour voters in the north, as immigration. So the Leave campaign will keep talking about immigration and borders for a month, and hope that a renewed refugee crisis will for enough people turn a latent fear into a present threat.

These statistics make adopting that theme a little bit easier. While it has long been accepted by everyone except David Cameron and Theresa May that the government’s desired net immigration cap of 100,000 per year is unattainable, watch out for Brexiters using these figures as proof that it is the EU that denies the government the ability to meet it.

But there are plenty of available avenues for the Remain campaign to push back against such arguments. Firstly, they will point out that this is a net figure. Sure, freedom of movement means the British government does not have a say over EU nationals arriving here, but it is not Jean-Claude Juncker’s fault if people who live in the UK decide they quite like it here.

Moreover, the only statistically significant change the ONS identify is a 42 per cent rise in migrants coming to the UK “looking for work” – hardly signalling the benefit tourism of caricature. And though that cohort did not come with jobs, the majority (58 per cent) of the 308,000 migrants who came to Britain to work in 2015 had a definite job to go to.

The Remain campaign may also point out that the 241,000 short-term migrants to the UK in the year ending June 2014 were far outstripped by the 420,000 Brits working abroad. Brexit, and any end to freedom of movement that it entailed, could jeopardise many of those jobs for Brits.

There is another story that the Remain campaign should make use of. Yes, the immigration cap is a joke. But it has not (just) been made into a joke by the EU. Net migration from non-EU countries is at 188,000, a very slight fall from the previous year but still higher than immigration from EU countries. That alone is far above the government’s immigration cap. If the government cannot bring down non-EU migration, then the Leave argument that a post-EU Britain would be a low-immigration panacea is hardly credible. Don’t expect that to stop them making it though. 

Henry Zeffman writes about politics and is the winner of the Anthony Howard Award 2015.