Drawing Conclusions

Snowy weather and busy holiday times spell shortages for blood banks across the region. While agencies like the American Red Cross carefully shift blood supplies throughout the country to make up for regional shortages, government policies prohibit them from tapping into a supply of blood from one willing and able group.

For about 20 years, the US Food and Drug Administration has prohibited men who have had sex with men and their sexual partners, male or female, from donating blood. Their reasoning is that the measure reduces the risk of HIV in the blood supply - and a 7-6 committee vote in 2000 reaffirmed the decision. If you've ever given blood, you've no doubt heard the question: Men are asked if they've had sexual contact with a man, even once, since 1977; women are asked if they've had sexual contact in the past 12 months with a man who has had sex with a man since 1977. The questions smack of discrimination and ignorance, unfairly portraying all gay and bisexual sex as inherently promiscuous and ignoring the reality of promiscuity among some heterosexuals.

"The FDA has no policy that specifically defers blood donors based on sexual orientation," Cathy McDermott, public affairs representative for the FDA, says in an e-mail. "However, a potential donor may be deferred based on a high-risk behavior that could result in the transmission of a blood-borne infectious disease, such as AIDS or hepatitis. In this context, male-to-male sex is considered a high-risk behavior."

The "1977 questions" are part of a two-step process for screening blood donations. Before you can lie down on the cot, you must submit to a pre-donation interview that asks about risk factors for disease. This is particularly important for some diseases that are undetectable in the laboratory, such as latent mad-cow-like illnesses. If you are cleared to donate, technicians later perform a barrage of tests on the collected blood, including one that checks for human antibodies to HIV, which would indicate infection, and one that searches for the genetic material of HIV itself and is accurate as long as exposure to the virus was more than 10 days prior to the blood draw. The two tests together are highly sensitive, meaning that a false negative rarely can slip through.

In spite of these safety measures, thousands of healthy men who have had sex with men are barred from giving blood. Meanwhile, the Red Cross hauls blood from the South to the North and increases its outreach efforts to make up for seasonal shortages. The FDA's rule is a problem, not just because it forces the Red Cross to juggle blood bags, but because the federal government is approving prejudice by asking people whether they've had gay sex or sex with someone who has. Few government policies actively discriminate against homosexuals, and homosexuals are never explicitly barred from serving their communities through volunteer work - but this rule does both. Frustrated by the FDA position, college students across the Northeast have taken to protesting when blood drives come to campus.

"All gay men are assumed to engage in unsafe, risky practices simply because they're gay," says Bennett Klein, director of the AIDS Law Project at Gay & Lesbian Advocates & Defenders, a legal rights organization based in Boston. And this, Klein says, contributes to homophobia by stigmatizing gay men. "It sends a message through government policy that, in terms of risk of HIV transmission, we should be concerned about a person's identity instead of their behavior."

Furthermore, blind adherence to a rule originally meant to make the blood supply safer actually makes it more dangerous. Lost in the fuss over sexually active gay and bisexual men is the growing number of heterosexuals who carry HIV (particularly, the numbers of infected young women and women of color are fast growing). According to Red Cross spokeswoman Michelle Hudgins, the agency and others in the blood industry are looking at screening and testing data and have recommended that the FDA consider re-evaluating its blood-ban criteria.

Here's a suggestion: Before people roll up their sleeves to donate blood, ask them, "How often do you have unprotected sex of any sort?" By changing the question, the FDA would make the national blood supply even safer - and would do away with its sweeping generalizations about gay and bisexual men.

Matthew S. Meisel is a junior at Harvard University, where he studies chemistry, and is an editorial editor for the Harvard Crimson. E-mail comments to magazine@globe.com