Liquid Gold at the End of the Rainbow: What the COVID-19 Pandemic Has Done for MSM Blood Donations
At the height of the first wave, the plasma from recovered COVID-19 patients was in high demand. A treatment known as plasma-derived therapy was introduced from the antibodies present in the plasma of those who had recently recovered from COVID. This plasma could be donated and used as a treatment for someone actively battling the virus (1). Due in part to its color and value, this plasma became colloquially known as “liquid gold,” but what happens when this gold is found at the end of a rainbow?
For men who have sex with men (MSM), donating their potentially lifesaving plasma isn’t as simple as walking into a donation center. As of April 2, 2020, the Food and Drug Administration’s policy on blood donations requires a deferral period of 3 months “for a man who has had sex with another man during the past 3 months” (2). To clarify, this means that any MSM who wish to donate their blood, including those who are in long-term, monogamous relationships, must remain celibate for 3 months prior to donation. This is an update from their previous lifetime and 12-month bans.
Relative to its history, this policy revision may seem like the final frontier in tackling the antiquated blood bans on the LGBTQ+ community. In September of 1985, the FDA implemented a lifetime ban on blood donations from “male donors who have had sex with another male, even one time, since 1977” (2). This was in response to the AIDS epidemic sweeping the country, which was particularly prevalent in the MSM community. For the next 30 years, gay men were entirely prohibited from donating blood. It wasn’t until 2015 that this lifetime ban was reduced to a 12-month deferral period for MSM. This meant that after the June 2016 terror attack at Pulse night club in Orlando, gay men were turned away from their local blood donation centers (3). While blood banks were calling for urgent donations, these men were told that they would have to remain celibate for 12 months before they could help anyone, let alone those in their community who needed blood immediately. Despite pressure from medical professionals and lawmakers, this policy remained in effect until April of 2020.
Even now, as we face a national blood shortage with 32% of community blood centers having only enough blood for 1 day or less (4), the 3-month deferral period remains in effect. Organizations are working day and night to convince Americans to donate blood, but there is an entire demographic group willing and able to donate blood who are forbidden from doing so. Not only is this ban harming patients in dire need of blood and plasma donations, but it is continuing to stigmatize the LGBTQ+ community. When we focus on who someone is having sex with rather than the safety surrounding those sexual experiences, we perpetuate the sense of otherness that is all too familiar to the queer community.
In terms of using the plasma of recovered COVID-19 patients as a treatment for active cases, a 3-month ban still prevents hospitals from collecting this plasma at a time when antibodies are at their highest. It is now known that levels of antibodies decrease exponentially in the months following recovery (5), meaning that, by the time MSM have fulfilled their 3-month deferral period, their plasma is not nearly as useful as it once was.
As we move forward in this battle for equal access to blood donation, there are many questions, and answers fall few and far between. With tests designed to detect HIV within 11 days of exposure, some wonder if the FDA should reduce its deferral period accordingly (6). Others wonder why there needs to be a ban at all if donated blood is already being tested after collection (7). The cynics among us have noted the need of a global pandemic to force the hand of the FDA into reducing the ban to 3 months and wonder what global crisis we are waiting on now.
Despite the abundance of questions and lack of certain answers, one thing is abundantly clear: We have come too far and learned too much to conceal homophobia under the name of science.
Edited by: Jennifer Xu
Graphic Designed by: Acelo Worku