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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Goodbye, Sam Allardyce: a grim portrait of national service

In being brought down by a newspaper sting, the former England manager joins a hall of infamy. 

It took the best part of 17 years for Glenn Hoddle’s reputation to recover from losing the England job.

Between leaving his job as manager in February 1999 and re-surfacing as a television pundit on ITV during the 2014 World Cup, Hoddle was English football’s great pariah. Thanks to his belief in faith healer Eileen Drewery and a string of unconventional and unacceptable views on reincarnation, he found himself in exile following in a newspaper interview during qualification for England’s Euro 2000 campaign.

But just as Hoddle is now cautiously being welcomed back to the bosom of English football, current incumbent Sam Allardyce has felt the axe fall. After less than two months in charge of the national side and with only a single game under his belt, the former Bolton Wanderers manager was caught up in a sting operation by the Daily Telegraph — allegedly offering guidance on how to circumvent his employer’s rules on third-party player ownership.

The rewards for guiding an English team to major international success promise to be spectacular. As a result, the price for any failure — either moral or performance-related — is extreme.

Hoddle’s successor – the endearing Kevin Keegan – resigned tearfully in a toilet at Wembley after a tumultuous 18-month spell in charge. His replacement, the laconic Sven-Göran Eriksson, provided moments of on-field excitement paired with incredible incidents of personal indiscretion. His tangle with "fake sheikh" Mazher Mahmood in the run up to the 2006 World Cup – an incident with haunting parallels to Allardyce’s current predicament – led to a mutual separation that summer.

Steve McClaren was hapless, if also incredibly unfortunate, and was dispatched from the top job in little over a year. Fabio Capello – who inspired so much optimism throughout his first two years in charge – proved himself incapable of lifting the hex on English major tournament fortunes.

The Italian’s star was falling from the moment he put his name to the oddly timed Capello Index in 2010, although his sustained backing of then captain John Terry over a string of personal misdemeanours would prove to be the misjudgement that ultimately forced his exit. As Allardyce has found out, the FA has become increasingly hard on lapses in moral judgement.

English football is suffused with a strange mix of entitlement and crushing self-doubt. After a decade that has given us a Wimbledon champion, several Ashes triumphs, two Tour de France winners and eye-watering Olympic success, a breakthrough in this area has never felt further away.

In replacing Capello, Roy Hodgson — the man mocked by Allardyce during his hours supping pints with Telegraph reporters — had hoped to put a rubber stamp on a highly respectable coaching career with a spell managing his own country. But this summer’s farcical defeat to Iceland at Euro 2016 put his previous career in a much harsher light.    

Allardyce was a mix of the best and worst of each of his predecessors. He was as gaffe-prone as Steve McClaren, yet as committed to football science and innovation as Hodgson or Capello. He also carried the affability of Keegan and the bulldog spirit of Terry Venables — the last man to make great strides for England at a major tournament.  

And as a result, his fall is the most heartbreaking of the lot. The unfairly decried charlatan of modern football is the same man who built a deeply underrated dynasty at Bolton before keeping Blackburn, West Ham and Sunderland afloat in the most competitive league in Europe.

And it was this hard apprenticeship that convinced the FA to defy the trendy naysayers and appoint him.

“I think we make mistakes when we are down here and our spirit has to come back and learn,” Hoddle mused at the beginning of his ill-fated 1999 interview. As the FA and Allardyce consider their exit strategy from this latest sorry mess, it’s difficult to be sure what either party will have learned.

The FA, desperately short of options could theoretically turn again to a reborn Hoddle. Allardyce, on the other hand, faces his own long exile. 

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