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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The rise of the green mayor – Sadiq Khan and the politics of clean energy

At an event at Tate Modern, Sadiq Khan pledged to clean up London's act.

On Thursday night, deep in the bowls of Tate Modern’s turbine hall, London Mayor Sadiq Khan renewed his promise to make the capital a world leader in clean energy and air. Yet his focus was as much on people as power plants – in particular, the need for local authorities to lead where central governments will not.

Khan was there to introduce the screening of a new documentary, From the Ashes, about the demise of the American coal industry. As he noted, Britain continues to battle against the legacy of fossil fuels: “In London today we burn very little coal but we are facing new air pollution challenges brought about for different reasons." 

At a time when the world's leaders are struggling to keep international agreements on climate change afloat, what can mayors do? Khan has pledged to buy only hybrid and zero-emissions buses from next year, and is working towards London becoming a zero carbon city.

Khan has, of course, also gained heroic status for being a bête noire of climate-change-denier-in-chief Donald Trump. On the US president's withdrawal from the Paris Agreement, Khan quipped: “If only he had withdrawn from Twitter.” He had more favourable things to say about the former mayor of New York and climate change activist Michael Bloomberg, who Khan said hailed from “the second greatest city in the world.”

Yet behind his humour was a serious point. Local authorities are having to pick up where both countries' central governments are leaving a void – in improving our air and supporting renewable technology and jobs. Most concerning of all, perhaps, is the way that interest groups representing business are slashing away at the regulations which protect public health, and claiming it as a virtue.

In the UK, documents leaked to Greenpeace’s energy desk show that a government-backed initiative considered proposals for reducing EU rules on fire-safety on the very day of the Grenfell Tower fire. The director of this Red Tape Initiative, Nick Tyrone, told the Guardian that these proposals were rejected. Yet government attempts to water down other EU regulations, such as the energy efficiency directive, still stand.

In America, this blame-game is even more highly charged. Republicans have sworn to replace what they describe as Obama’s “war on coal” with a war on regulation. “I am taking historic steps to lift the restrictions on American energy, to reverse government intrusion, and to cancel job-killing regulations,” Trump announced in March. While he has vowed “to promote clean air and clear water,” he has almost simultaneously signed an order to unravel the Clean Water Rule.

This rhetoric is hurting the very people it claims to protect: miners. From the Ashes shows the many ways that the industry harms wider public health, from water contamination, to air pollution. It also makes a strong case that the American coal industry is in terminal decline, regardless of possibile interventions from government or carbon capture.

Charities like Bloomberg can only do so much to pick up the pieces. The foundation, which helped fund the film, now not only helps support job training programs in coal communities after the Trump administration pulled their funding, but in recent weeks it also promised $15m to UN efforts to tackle climate change – again to help cover Trump's withdrawal from Paris Agreement. “I'm a bit worried about how many cards we're going to have to keep adding to the end of the film”, joked Antha Williams, a Bloomberg representative at the screening, with gallows humour.

Hope also lies with local governments and mayors. The publication of the mayor’s own environment strategy is coming “soon”. Speaking in panel discussion after the film, his deputy mayor for environment and energy, Shirley Rodrigues, described the move to a cleaner future as "an inevitable transition".

Confronting the troubled legacies of our fossil fuel past will not be easy. "We have our own experiences here of our coal mining communities being devastated by the closure of their mines," said Khan. But clean air begins with clean politics; maintaining old ways at the price of health is not one any government must pay. 

'From The Ashes' will premiere on National Geograhpic in the United Kingdom at 9pm on Tuesday, June 27th.

India Bourke is an environment writer and editorial assistant at the New Statesman.

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