Blood Donation, Deferral, and Discrimination: FDA Donor Deferral Policy for Men Who Have Sex With Men

Abstract

U.S. Food and Drug Administration (FDA) policy prohibits blood donation from men who have had sex with men (MSM) even one time since 1977. Growing moral criticism claims that this policy is discriminatory, a claim rejected by the FDA. An overview of U.S. blood donation, recent donor deferral policy, and the conventional ethical debate introduce the need for a different approach to analyzing discrimination claims. I draw on an institutional understanding of injustice to discern and describe five features of the MSM policy and its FDA context that contribute to its discriminatory effect. I note significant similarities in the 1980s policy of deferring Haitians, suggesting an historical pattern of discrimination in FDA deferral policy. Finally, I point to changes needed to move toward a nondiscriminatory deferral policy.

The beliefs and willingness of men who have sex with men to comply with a one‐year blood donation deferral policy: a cross‐sectional study

“…However, given recent advances in HIV screening, some believe the current blood donation deferral for MSM is based in discrimination and not science. 5 Since its inception, the FDA has periodically reviewed its blood deferral policies for MSM, and most recently in mid-2016, the FDA announced that it was considering further modifying the deferral period. 5,6 Currently, it is unknown what impact, if any, the new 1-year deferral may have on the national blood supply and the MSM community.…”

“…5 Since its inception, the FDA has periodically reviewed its blood deferral policies for MSM, and most recently in mid-2016, the FDA announced that it was considering further modifying the deferral period. 5,6 Currently, it is unknown what impact, if any, the new 1-year deferral may have on the national blood supply and the MSM community. Given that the FDA is considering further changing the deferral policy, it is important to first understand how the existing 12-month policy is perceived by the MSM community.…”

Blood, sex and trust: The limits of the population-based risk management paradigm

“…Furthermore, much of the epidemiological literature surrounding blood safety appears to assume a problematic division between blood donors and recipients (Galarneau 2010) -presenting the image of the blood donor as motivated by a fragile altruism that would not withstand more ontologically relevant questions about sexual risk taking. In contrast, we call for the piloting of a more practice-based pre-donation questionnaire that can identify the high-risk donors in all population groups, that can function as a more effective selfdeferment tool and that will present 'donors-as-potential-recipients' with information that is consistent with programmes promoting sexual health.…”

Could FDA Approval of Pre-exposure Prophylaxis Make a Difference? A Qualitative Study of PrEP Acceptability and FDA Perceptions Among Men Who Have Sex with Men

“…The views of MSM regarding the importance of FDA approval may also be shaped by the FDA’s continued policy decision to bar MSM from donating blood. Some have criticized this policy as discriminatory toward MSM (14-16), and we wondered whether MSM who agree with this criticism may have more negative views of the FDA and the importance of drug approval.…”