By Jesse Marx
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But the FDA's blood-donor policies don't distinguish between unprotected and protected MSM sex, or, for that matter, between intercourse, oral sex, and kissing. Nor does the rule that disqualified Brian Gacek as a donor take into account whether a potential donor has tested negative for the virus. "I've had two HIV tests, and both of them were negative," says Gacek. "I can't imagine what more they need from me."
What blood banks and the FDA need, Ehlinger and Danila agree, is a virtual guarantee of the blood pool's purity. Since the U.S. blood-banking industry was born in the 1940s, the federal government has set up strict regulations meant to achieve just that. At the time, syphilis was a full-blown epidemic; within a decade the FDA began requiring that all donated blood be screened for the disease. In 1971 scientists developed a test to detect hepatitis B, and the FDA listed carriers as the first permanently banned donors. Within 12 years, that list grew to include carriers of all strains of hepatitis, as well as other viruses and infections known to be fatal. In 1983 blood banks began "passively screening" donors by informing them about individuals who, by agency standards, ought to voluntarily excuse themselves--a sort of pre-emptive screening directed mainly at sexually transmitted diseases. "If they fell into any of the high-risk categories," explains Joe Siess, a spokesman for the Minneapolis chapter of the Red Cross, "they were supposed to self-exclude."
The advent of the AIDS epidemic changed all that. In July 1982 three hemophiliacs were reported to have been infected by tainted blood products. In response, the Centers for Disease Control and the National Institutes of Health stepped up research on HIV transmission and testing. According to the CDC, in the early 1980s more than half of the nation's 16,000 hemophiliacs were infected with the virus through contaminated blood products, resulting in more than 2,500 deaths and a $600 million class-action lawsuit against four major pharmaceutical companies accused of distributing impure blood and plasma. In that suit, which was settled out of court this past May, the FDA was harshly criticized for failing to issue warnings about HIV as a potentially deadly contaminant.
Both Danila and Ehlinger contend that the most effective safeguard against contamination is cutting-edge technology used to test and screen for the virus: While early HIV testing had a "window period" of up to six months, during which the virus escaped detection, today HIV can be detected as early as 18 days after exposure--either by testing donors or donated blood. These technological advances, says Ehlinger, should bring the FDA's exclusion of gay male donors into question. "The FDA isn't applying scientific knowledge consistently," he argues. "And because of this, their policy is discriminatory."
Two years after forming, the university's student task force mailed off a series of proposed policy changes to the FDA. Among the suggestions in the December 2, 1997 letter was that the MSM exclusion be modified to read, "Any individual who has had anal intercourse even one time within the last 12 calendar months."
The FDA has so far failed to respond. But by coincidence, just days after receiving the group's letter the agency held a public hearing to consider changes to the MSM exclusion. According to minutes of the FDA's Blood Products Advisory Committee meeting, the majority of its panel agreed that the MSM prohibition is "discriminatory." Still, committee members temporarily shelved the issue pending "further study."
Even if the FDA finds those risks to be negligible, Danila and other health professionals predict the agency is unlikely to put itself out on a limb. "It's about the public's perception of the safety of the blood pool," Danila reasons, "and whether giving blood is a right or a privilege." In the FDA's view, he says, donating blood is still a privilege--one the federal agency is in no hurry to extend to men who've had sex with men.
In the month since he was turned away at Centennial High's blood drive, Brian Gacek has been making the rounds with his petition denouncing the blanket rule that excludes gay and bisexual men as donors. He has just put the finishing touches on his own Web site, complete with a copy of the document. And though he fears it may wind up gathering dust on a bureaucrat's desk or getting lost in cyberspace, he intends to keep collecting signatures. "It's better than keeping silent," Gacek says. "And if they don't change the rules, then I at least educated a couple hundred people."