VANCOUVER, Wash. – Over the last six years, blood center employee Dylan Smith was often asked how frequently he gave blood himself. His answer was always the same: As a gay man, he couldn't.
That changed this month.
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Thanks to new federal guidelines finalized in May, gay and bisexual men in monogamous relationships can now donate at many blood centers around the country without abstaining from sex.
Bloodworks Northwest, where Smith works as a donor services supervisor, adopted the change on Dec. 6. He and his partner gave blood for the first time the next day.
“It’s been really emotionally difficult just to explain every single time the reason why,” said Smith, 28. “To be able to finally step up and support the mission that I really have just believed in since I started here just makes my heart feel so happy.”
The new U.S. Food and Drug Administration guidelines are the latest step in a yearslong effort to reverse restrictions that were designed to protect the blood supply from HIV, but which were increasingly criticized as discriminatory following scientific advances that allowed better detection of the virus.
In 2015, the FDA dropped the lifetime ban on donations from men who have sex with men and replaced it with a one-year abstinence requirement. The agency shortened the abstinence period to three months in 2020 after donations plummeted during the COVID-19 pandemic.
The American Red Cross, which accounts for about 40% of blood and blood component donations in the U.S., began implementing the new guidance in August.
About half of the 16 independent blood bank organizations that are members of the Alliance for Community Transfusion Services have rolled out the new guidelines, with more expected next year, the organization said.
“It is going to take time,” said Benjamin Prijatel, president of Shepeard Community Blood Center in Augusta, Georgia. “Blood centers and health professionals are going to have to put forth the effort to engage and educate this community in order to overcome years of distrust. That’s the only way this rule change will translate into additional donations.”
The change puts the emphasis on sexual activity rather than on sexual orientation. All potential donors are screened with a new questionnaire evaluating their HIV risk based on sexual behavior, partners and other factors that can contribute to the spread of blood-borne infections, such as intravenous drug use or recent tattoos or piercings.
Potential donors who report having anal sex with new partners in the last three months are barred from giving until a later date, and anyone who has ever tested positive for HIV will continue to be ineligible. Those taking pills to prevent HIV through sexual contact are still barred until three months after their last dose; the medications, known as PrEP, can delay the detection of the virus, the FDA said.
Donated blood is then tested for HIV, hepatitis C, syphilis and other infectious diseases.
Bloodworks Northwest, which supplies blood to more than 90 hospitals in the region, isn’t keeping track of how many newly eligible donors are coming in, said Dr. Kirsten Alcorn, the nonprofit’s co-chief medical officer. But workers have heard plenty of stories from people excited to give.
“It feels very meaningful to many of them to now be able to contribute to somebody’s survival,” Alcorn said.
Bloodworks executive Aaron Posey, whose own life was saved by a transfusion when he fell down a set of stairs and broken glass sliced an artery, welcomed the new guidance. He said hospitals and patients need access to a new pool of donors.
“Having always witnessed a shortage in the blood supply, it has at times been very frustrating,” said Posey, who first donated blood during the pandemic when the abstinence period was cut to three months.
Smith learned of the restrictions on gay men giving blood when he was screened while trying to donate his freshman year of college in 2013. The rules blindsided him, he said. It was a long time to wait before he could finally donate with his partner and other friends.
“Just being able to see them donating next to me, smiling next to me ... meant so much,” Smith said.