- The US Food and Drug Administration (FDA) restrictions on plasma donation prevent some men who have sex with other men (MSM) from donating.
- These donation restrictions stem from HIV concerns during the early 1980s and are steeped in unfair prejudice.
- The FDA plans to lift some of these restrictions, but there are still rules preventing some healthy MSM from donating.
Donating plasma — or the liquid portion of blood that remains when red blood cells, white blood cells and platelets are removed — can save the lives of patients who have suffered trauma, burns and other medical emergencies.
Plasma donations are also essential for those who suffer from conditions such as immunodeficiencies, hemophilia, and lung disease, says Dr. Mark Schuster, founding dean and chief executive officer at the Kaiser Permanente Bernard J. Tyson School of Medicine.
Despite the need for plasma donors, the Food and Drug Administration (FDA) has restricted MSM donations since 1983 due to concerns about HIV transmission. The Food and Drug Administration eased this restriction in 2015 and again in 2020 for some men.
Now, the Food and Drug Administration (FDA) may lift the restrictions in favor of the individual screening approach, according to news reports. This approach would allow men who haven’t had any new partners in three months – but have had sex with an existing male partner – to donate.
“The proposed change to allow men who have sex with men in monogamous relationships to donate blood is definitely a step in the right direction,” says Alex Sheldon, interim executive director at GLMA: Health Professionals Advancing LGBTQ + Equality.
Who can donate plasma?
The Food and Drug Administration sets qualifications for who can donate, and healthcare organizations track those qualifications, Schuster says.
Schuster, who is gay, shared his frustration at not being able to donate blood when his son needed a transfusion.
In general, plasma donors should:
- You must be 18 years old
- Weighs at least 110 pounds
- Negative HIV and hepatitis test
- You have not had new tattoos or piercings within the past 4 months
Blood is made up of solids (red and white blood cells and platelets) and liquid (plasma). To donate plasma, blood is collected from the donor’s arm. It is sent through a machine that separates the liquid and collects the plasma. Red blood cells, white blood cells, and platelets are returned to the donor. Schuster says the process takes about 90 minutes.
Plasma has different types like whole blood. People with blood type AB – or general donors – are especially required to donate plasma, as plasma can be given to anyone. However, all blood types can donate plasma.
Since only about 5% of the population has AB blood, allowing more donors can increase the pool of AB blood donors.
Why is preventing MSM from donating plasma a problem?
After donation, the plasma undergoes rigorous testing for infectious diseases, including hepatitis and HIV. Although HIV disproportionately affects men who have sex with men, anyone can contract the virus. These screening tests have improved since the Food and Drug Administration first banned donations from MSM.
“Although testing capabilities have greatly improved, the FDA has been slow to change its policy,” Schuster says. “The current restrictions seem to have not kept pace with the technological advances that have allowed us to test for HIV more effectively.”
In addition to better screening, medical professionals now understand more about how HIV is transmitted.
“Policies that focus on the sexual orientation or gender identity of potential donors now ignore the ever-evolving medical evidence about HIV,” says Sheldon.
When people have undetectable levels of HIV in their blood, they cannot pass the infection on to sexual partners even if they test positive for the disease. However, people with undetectable levels could, in theory, pass HIV through a plasma donation, Schuster says. Plasma donation is different because such large amounts are donated from person to person. The FDA continues to ban donations from anyone who tests positive for HIV.
The US Food and Drug Administration (FDA) is currently looking for alternatives to the MSM donation ban with the ADVANCE study. The data from the study is promising, showing that the likelihood of transmission of HIV or other infections from donors who have sex with men is extremely low. This could contribute to the policy change the FDA is considering.
“The FDA believes that the data from the ADVANCE study, along with the broader blood donation data, will likely support a change in MSM policy,” says Jessica Merrill, director of biomedical communications for the American Red Cross. with men.”
An informed takeaway
The Food and Drug Administration for the first time banned donations from MSM in response to the HIV/AIDS crisis. Although the policy has been relaxed, it has not kept pace with technological innovations in plasma screening, and increased understanding of HIV transmission.
“It was overly restricted,” Schuster says.
The news that more MSM may soon be able to donate is encouraging for medical professionals in the LGBTQ+ community. However, Sheldon said, the history of politics that encouraged stigmatization, erasure, and exclusionary practices will linger.
“Perhaps the FDA should make a concerted effort to repair the damaged relationship with the LGBTQ+ community resulting from decades of maintaining a discriminatory policy,” they say.