Blog 4/18/23

Equitas Health Urges FDA To Go Further With Updates to Blood Donor Eligibility Rules

In late January 2023, the Food and Drug Administration (FDA) proposed changes to their guidance on who can give blood. Historically, their rules have discriminated against members of the LGBTQ+ community. As promised, Equitas Health gave feedback to the FDA in a public comment.

We reminded the FDA that their blood donation bans have mainly targeted men who have sex with men (MSM). This includes gay, bisexual, queer, pansexual, and questioning men among others. We also shared that these bans misgender people.  This has had a negative impact on transgender women, trans-feminine people, and other gender expansive people who were assigned male at birth (AMAB).

Groups, like the AIDS Coalition to Unleash Power! (ACT UP!) and others, have argued that the FDA’s blood donation policy is unfair for decades. While the proposed rules are a step in the right direction, we believe there is still more work to do.

Here is what would happen if the FDA’s new rule goes into effect:

• Men who have sex with men (MSM) and women who have sex with MSM will not have to stop having sex for three month before giving blood.
• Donor forms will ask everyone about new or multiple sexual partners in the past three months regardless of their sexual orientation.
• Anyone who reports having a new sexual partner, or more than one sexual partner, and had anal sex in the past three months will have to wait to give blood.
• People taking HIV prevention meds, like pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP) will have to wait three months from their most recent dose.
• People who get PrEP shots will have to two years from their most recent shot.

The FDA should use science to make these rules, not stigma. Equitas Health supports an approach that is more gender-inclusive and based on individual risk.

Here are the ways that the FDA should go further with changes to this policy:

• Issue a non-discriminatory and evidence-based Final Guidance on blood donor rules this year. This will begin to correct the FDA’s history of discrimination against LGBTQ+ blood donors.
• Review their blood donor rules every 3 years to make sure they reflect current science and technology.
• Encourage more research on how PrEP, PEP, and anti-retroviral therapy (ART) affect HIV RNA detection. This will help make sure that science informs rules on giving blood and wait times, not stigma.
• Give clear, concise, and culturally humble information about why people using PrEP/PEP have to wait to give blood. This will help lower stigma against people living with HIV and PrEP/PEP users.
• Continue working with advocacy groups and community health centers that serve the LGBTQ+ community and people living with HIV. This will help make sure that the FDA makes changes to blood donor rules with more cultural humility.

While the FDA expects their proposed changes to boost the national blood supply, we urge them to enact a more culturally humble policy. Given the need for blood during the ongoing COVID-19 pandemic, we advocate for a policy that will:

• Increase the number of people who can give blood, and
• Help make a safe national blood supply more available.

But of course, we must continue to demand a policy that does not stigmatize LGBTQ+ people, PrEP/PEP users, and people living with HIV.

To read the full text of our recommendations to the FDA, please click here.