Fact Sheet

Effects of Lifting Blood Donation Bans on Men who Have Sex with Men

Update
September 2014

The Food and Drug Administration prohibits the donation of blood by any man who has had sex with another man. Using population-based data sources, this fact sheet predicts the impact of lifting the ban on the nation’s blood supply.

AUTHORS
  • Ayako Miyashita
    Director, Los Angeles HIV Law and Policy Project
  • Gary Gates
    Research Director, Former
Fact Sheet

The Food and Drug Administration (FDA) prohibits the donation of blood by any man who has had sex with another man (MSM) since 1977.1 This research brief uses population-based data sources to update estimates of the size of the MSM population and estimates of blood donation patterns in the U.S. to predict the impact of lifting the ban on the nation’s blood supply.2 Our analyses suggest that lifting the ban could increase the total annual blood supply by 2%-4%, adding from 345,400 to 615,300 pints of blood each year.

Introduction

The FDA’s blood ban on men who have sex with men prohibits such men from ever donating blood. In recent years, both the United Kingdom and Canada have made changes to their laws shifting from an indefinite deferral of MSM to a twelvemonth and five-year deferral, respectively.3 In Mexico, new regulations have established criteria for blood donation based on risk factors for transmission of blood-borne diseases.4

Despite these changes in deferral policies internationally and public pressure domestically to end the current ban on MSM blood donation, the U.S. Department of Health and Human Services has continued to maintain its position.5 The Advisory Committee on Blood and Tissue Safety and Availability (“ACBTSA”) has decided not to recommend any changes to the deferral policy, citing a need to first “establish and fund an ongoing, integrated, coordinated, and nationally representative U.S. transfusion transmissible infections monitoring system.”6 The American Red Cross, American Association of Blood Banks, and America’s Blood Centers have since issued a joint statement calling for modification of the lifetime deferral and further consideration of a twelvemonth deferral for MSM.7

This research brief predicts the impact of lifting the ban on the nation’s blood supply under three scenarios: the lifting of the ban entirely, the granting of a twelve-month deferral to MSM, and the granting of a five-year deferral to MSM.

Data and Methodology

We combine three waves of the biennial General Social Survey (GSS) conducted in 2008, 2010, and 2012, a nationally representative sample of adults in the U.S., to estimate the MSM population of adults (age 18 and older).8 Table 1 reports an estimate of the adult MSM population in the U.S.-based on the percentage of adult men reporting a male sex partner since age 18 and U.S. Census Bureau estimates of the population of adult men.9 These MSM constitute the group we consider to be currently excluded from donating blood.10

In the U.S., 8.5% of men (10 million) say that they have had at least one male sexual partner since age 18. GSS data show that 4.1% of men (4.8 million) have had a male sex partner in the last five years, and 3.8% of men (4.5 million men) reported having a male sex partner in the last twelve months.

The Centers for Disease Control and Prevention estimates that 781,300 MSM are living with HIV.11 We exclude them from estimates of possible new donors,12 as they would be excluded through the pre-donation donor questionnaire or during routine blood screening used to test every donation.

An estimated 45.4% of men (54 million) in the U.S. are eligible to donate blood.13 Approximately 8.7% of eligible men actually donate blood.14 Annually, there are approximately 15.7 million donations of blood per year made by 9.2 million donors, yielding approximately 1.7 donations per donor.15

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Findings

Using the assumptions described above, we estimate the number of MSM who would be newly eligible to donate blood, would likely donate, and the number of donations resulting under three scenarios. Results are shown in Table 2.

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If the current MSM ban were completely lifted, we estimate that an additional 360,600 men would likely donate 615,300 additional pints of blood each year. If MSM who have not had sexual contact with another man in the past twelve months were permitted to donate, we estimate that 185,800 additional men are likely to donate 317,000 additional pints of blood each year. If MSM who have not had sexual contact with another man in the past five years were permitted to donate, we estimate that 172,000 additional men would make an additional 293,400 blood donations.

Conclusion

Our analyses suggest that lifting the ban could increase the total annual blood supply by 2%-4%.17 The American Red Cross suggests that each blood donation has the potential to be used in life-saving procedures on three individuals. Our estimates suggest that lifting the blood donation ban among MSM could be used to help save the lives of more than a million people.

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Effects of Lifting Blood Donation Bans on Men who Have Sex with Men

Vaccines, Blood & Biologics. “Blood Donations from Men Who Have Sex with Other Men Questions and Answers.” U.S Food and Drug Administration Web site. http://www.fda.gov/biologicsbloodvaccines/bloodbloodproducts/questionsaboutblood/ucm108186.htm#policy. Accessed September 15, 2014.

See Effects of Lifting Blood Donation Bans on Men Who Have Sex with Men. The Williams Institute. June 2010. http://williamsinstitute.law.ucla.edu/wp-content/uploads/Gates-Goldberg-MSM-Blood-Ban-Jun-2010.pdf. Accessed September 15, 2014.

NHS Blood and Transplant. “Deferral of Blood Donation from Men who have Sex with Men from Blood Donation FAQs.” National Health Service Web site. http://www.nhsbt.nhs.uk/news-and-media/news-archive/news_2011_11_01_faqs.asp. Accessed September 15, 2014;. Changes to blood donor guidelines. Canadian Blood Services Web site. http://www.blood.ca/CentreApps/Internet/UW_V502_MainEngine.nsf/page/MSM?OpenDocument. Accessed September 15, 2014.

Noticias. “Celebra Conapred entrada en vigor de norma de donación de sangre, libre de discriminación.” Consejo Nacional para Prevenir Discriminación (CONAPRED) Web site. http://www.conapred.org.mx/index.php?contenido=noticias&id=3334&id_opcion=108&op=214. Accessed September 15, 2014.

Cohen, I Glenn, JD, et. al. Reconsideration of the Lifetime Ban on Blood Donation by Men Who Have Sex with Men. JAMA. July 23/30, 2014; Volume 312, Number 4, Pages 337-38.

Forty-fourth Meeting of the Advisory Committee on Blood & Tissue Safety & Availability (ACBTSA), December 4-5, 2013. Department of Health and Human Services Web site. http://www.hhs.gov/ash/bloodsafety/advisorycommittee/recommendations/dec2013-recommendations.pdf. Accessed September 15, 2014.

Joint Statement Regarding National Gay Blood Drive. June 27, 2014. American Red Cross Web site. http://www.redcross.org/news/press-release/Statement-Regarding-National-Gay-Blood-Drive. Accessed September 15, 2014.

Data from General Social Surveys conducted between 2008 and 2012 were combined to yield estimates of the number of men who report same-sex partners since age 18. This is based on the following question—“Again, thinking about the time since your 18th birthday, (including the past 12 months) how many male partners have you ever had sex with?” Any man indicating one or more male partners was counted as an MSM. Five-year and twelve-month estimates are based on the following question—“Have your sex partners in the last 12 months (five years) been exclusively male, both male and female, or exclusively female?” Male respondents who indicated “exclusively male” or “both male and female” were considered MSM in this report. Analyses were conducted using the Survey Document and Analysis (SDA) website http://sda.berkeley.edu/sdaweb/analysis/?dataset=gss12. Accessed September 15, 2014.

Table PEPAGESEX – Annual Estimates of the Resident Population for Selected Age Groups by Sex for the United States, States, Counties, and Puerto Rico Commonwealth and Municipios: April 1, 2010 to July 1, 2013. US Census Bureau Web site. http://factfinder2.census.gov/faces/tableservices/jsf/page s/productview.xhtml?src=bkmk. Accessed September 15, 2014.

Current FDA policy excludes any man who reports having a male sex partner since 1977 from donating blood. We must assume that all men who report at least one male sex partner since age 18 are currently ineligible to donate since we cannot separately identify men whose male sex partnerships occurred before 1977. As a result, our estimates of newly eligible donors may include some men who are already eligible. This upward bias is likely quite small as we are possibly misclassifying only men who are aged 55 or older who had a sex partner before 1977 but not since.

Monitoring Selected HIV Prevention and Care Objectives by Using HIV Surveillance Data—United States and 6 U.S. Dependent Areas—2010. HIV Surveillance Report, Volume 17, Number 3, Page 22. Center for Disease Control and Prevention Web site. http://www.cdc.gov/hiv/pdf/statistics_2010_HIV_Survei llance_Report_vol_17_no_3.pdf#page=22. Accessed September 15, 2014.

We do not have data that allows us to estimate the number of HIV-positive MSM who have had sex with a man in the last twelve months or five years. As such, we take a conservative approach and assume that all HIV-positive MSM have had recent same-sex sexual activity and subtract the total number of HIV-positive MSM from each of the three groups (had sex with a man since age 18, had sex with a man in the last year, and had sex with a man in the last five years).

James, AB, Hillyer, CD, Shaz, BH. 2012. Demographic differences in estimated blood donor eligibility prevalence in the United States. Transfusion 52(6):1050-1061, Table 4.

The American Red Cross estimates 9.3 million donors per year of which 50% are men. The portion of eligible men who donate is calculated by dividing the number of male donors by the number of men that are eligible to donate in the US.

Blood Facts and Statistics. American Red Cross Web site. http://www.redcrossblood.org/learn-about-blood/blood-facts-and-statistics. Accessed September 15, 2014.

Figures are rounded off to the nearest hundred.

The percentage increase in annual blood supply is based on the assumption that there are 15.7 million blood donations per year (see Blood Facts and Statistics. American Red Cross Web site. http://www.redcrossblood.org/learn-about-blood/blood-facts-and-statistics. Accessed September 15, 2014) and considers the percentage increase for the scenarios provided in Table 2