Tuesday, May 15, 2012

Transcript - My Speech about MSM Blood Donation

This week we did persuasive speeches in my Public Speaking class. I decided to write my speech about the FDA's lifetime deferral of MSM blood donors. The transcript is below:

I'm an ex blood donor. On my seventeenth birthday, I started donating blood to the American Red Cross. I donated every time I became eligible again until a little over a year ago, when I tried to donate at a blood drive right here at RIT. That day, I didn't leave with a bandage on my arm and a sticker proudly proclaiming that I had donated. I instead left with a letter explaining the terms of my FDA-imposed 12-month deferral from blood donation and an apology from the nurse who had taken my history. According to the Food and Drug Administration's website and the letter that I received, men who have had sexual contact with other men even once (who they refer to as "MSM") receive a lifetime deferral from blood donation due to an increased risk of HIV. In addition, any of their partners are prohibited from donating blood until one year after their contact with that person has stopped. Because of this policy, I haven't been able to donate blood since.Today I'll share with you the concerns being raised about the current FDA policy and also tell you the reasons why this policy should be changed.

The first concern with the FDA's current policy regarding MSM blood donation is that it isn't consistent with their policies regarding other high-risk demographics. According to the American Association of Blood Banks (AABB) and the American Red Cross, the deferral period for a person who has had sexual contact with a person who has contracted HIV or hepatitis is only one year, as opposed to the lifetime deferral currently imposed on MSM. Additionally, the FDA allows other high-risk demographics such as heterosexual people who have had multiple sexual partners to donate blood without any deferral period at all. A one-year deferral for potential MSM donors would be more in line with deferral periods for other high-risk potential donor groups.

Along with their blood donation guidelines, the FDA also has policies regulating the donation of organs or other human tissue for transplant. These policies are quite different from their MSM blood donation policy. MSM individuals aren't prohibited from donating organs or tissue but are considered "high risk" if they've had sexual contact with another man within a 5-year period. However, despite perceived risk, these organs are typically used anyway unless they've actually tested positively from HIV or other diseases. It's unclear why a five-year period is acceptable in this case and not in the case of blood donation.

The FDA has also expressed concerns that they would be unable to adequately test blood for the presence of HIV during that's called the "window period". The "window period" is the time between when the virus is contracted and when tests can actually detect the virus. the AABB and Red Cross argue that the "window period" is now only 9 days with new testing methods as opposed to the former 2-3 months for older tests. A one-year deferral period would be more than enough to ensure that the virus is detected outside the "window period". This would also help resolve concerns about hepatitis, which the FDA claims is also prevalent amongst MSM.

A particularly unusual reason why the FDA claims to have their MSM policy in place is a concern about human error. They are afraid that HIV-infected blood may be accidentally given to a patient instead of being discarded. However, human error is present when dealing with any donated blood in the supply and isn't related to only MSM-donated blood. Additionally, most blood supply distribution is now computerized which lowers the risk of human error significantly.

Another issue with current FDA policy is that it is outdated and based on antiquated testing methods. The policy was enacted in 1983 as a result of the HIV/AIDS epidemic when there were no reliable testing methods available for HIV. But today's testing methods have less than a one-in-a-million chance of coming up with a false negative and the risk of getting HIV from a blood transfusion is virtually zero, according to the FDA themselves. This policy has already been changed in other countries. For example, in September 2011, the National Health Service Blood and Transplant organization in the United Kingdom changed their policy about MSM from a lifetime deferral to a one-year deferral primarily due to these new advances in testing.The NHS claims that according to their modeling, there is only even the potential for a 2% increase of HIV-infected blood to enter the supply but even that 2% is very highly unlikely.

But perhaps the biggest problem with the FDA's MSM policy is the fact that it cuts out a significant number of potential donors who are otherwise eligible despite the constant need for blood and frequent supply shortages. Less than 38% of the general population in the US is eligible to donate blood according to the Red Cross and an even lower percentage donate on a regular basis. Although it's difficult to get an exact number, the CDC estimates that between 4 and 13% of the total US population are considered MSM. The current policy doesn't just eliminate MSM donors, but also potential eligible donors who choose not to donate on principle.

So what can you do to help? There are several things you could do. You could donate blood if you're eligible and take the place of an MSM or their partner who would love to donate but currently cannot. You could also support the Red Cross by volunteering or making a monetary donation. Most importantly, you should raise awareness of this issue by spreading the word. There is absolutely no good reason for the FDA to prohibit MSM from donation, especially when the blood supply is so short to begin with. Just remember, there are over 5 million patients per year that require donated blood and you never know when one of those patients might be you or someone you love.

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