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Hey Mad, good to see you around again.

As far as I know the first step to preventing the spread of STDs through blood transfusion is donor screening (hence those questionnaires before you give blood). Though the blood itself is screened that process is not 100% accurate (the screenings are much more accurate now than they were in the 80s). But I think the primary reason for donor screening is to address the period between when a donor can become infected and when that infection is evident in the donor's blood. That time period, again as far as I know, is considered to be six months to be on the safe side. So there is a purpose to the practice of screening donors, I just wonder if its being served by screening all MSM donors.

River: While I do not have any statistics on this issue, I would suspect there are more heterosexuals than homosexuals that have HIV/AIDS.

I don't think this is likely so, just because there is such a higher number of heteros than homos (mind you this is all a guess). If you're talking percentage of homosexual population with HIV/AIDS compared to the percentage of heterosexual I think the CDC just confirmed otherwise, as far as that can be confirmed. Also, according to the CDC gay men are still increasingly more likely to contract HIV/AIDS:

Quote:

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For example, the number of new HIV/AIDS cases among MSM in 2005 was 13% more than the number of cases in 2001. It is unclear whether this increase is due to more testing, which results in more diagnoses, or to an increase in the number of HIV infections. Whatever the reasons, in 2005, MSM still accounted for about 53% of all new HIV/AIDS cases and 72% of cases in male adults and adolescents.

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River, according to the CDC, that is certainly not the case. I'm linking the most recent CDC report I could find. I understand that this outlines only actually reported cases of 33 U.S. states through 2005, but I think it is the most accurate information available to us. If you know of any better information please pass it on.

Look at Table 1 on page 10 of this report. Just in 2005 there were 18,722 new HIV/AIDS infections among MSM contact. There were 4333 new infections among male heterosexual contact. Even when you add in the increase in hetero injection drug use at 3506, the 7839 is still well below half the number of MSM contact at 18,722. And if you include MSM with combined MSM/injection drug use you have 20,058 compared to the 7839 heterosexual contact with combined heterosexual/injection drug use. And these differences are either similar or increased throughout the epidemic. The cumulative numbers of estimated cases from the beginning of the epidemic until 2005 shown in Table 3, page 12 are just depressing. MSM contact 454,106; males infected by heterosexual contact 66,081; females infected by heterosexual contact 102,936. Cumulatively there are well over twice as many infections from MSM than combined male/female hetero contact.

The homosexual community has been aggressive and influential in awareness and they have certainly slowed the progression among their own communities when compared with the 80s. However, I think it's quite clear that MSM has a much higher risk for transference than hetero sex (especially for the men in hetero sex.), and gay men continue to be at high risk for contracting HIV/AIDS. I don't think there is any question of this. But are the FDA restrictions for blood donation justified?

Abs: The FDA is categorizing homosexuals as anyone who has EVER had sex with a person of their gender.

As LanDroid noted, there is no restriction on homosexuals. To clarify further, the restriction that is often confused as a generic homosexual restriction is actually for all men who have sex with men or "MSM."

Chris: There may be more heterosexuals than homosexuals with AIDS

I think it's pretty clear that men are more prevalently exposed to HIV/AIDS through homosexual rather than heterosexual contact. According to the CDC report I linked above, of the 421,873 estimated persons living with HIV/AIDS at the end of 2005, 77% were male and 59% of those men were exposed through male-to-male sexual contact, while only 11% had been exposed through heterosexual contact. Even if the estimates aren't entirely accurate, the discrepancy is too great to even think it's possible that men are more likely to be exposed to HIV/AIDS through heterosexual rather than homosexual sex. Just consider the physical logistics of men in homo/hetero sex. Males during heterosexual contact are not receivers of fluids. Even if they don't use condoms with an infected heterosexual partner, it's still possible they will not to be infected from the exposure, especially if there is no tearing or bleeding during the act.

The question for me isn't whether or not unprotected homosexual contact is more likely to lead to infection than unprotected heterosexual contact--I think that answer is obvious. I'm more curious to know whether or not people agree with the FDA restrictions.

LanDroid: 1) As irishrosem already pointed out, blood donation centers already accept a certain amount of risk as you can have HIV, but test negative for 6 months.

But I'm not sure how that informs a general ban on MSM. That just explains why there is a questionnaire. I think it was Mad who asked isn't the blood tested, why are people refused at all. And so I answered that because of an approximately six month period where infection can go undetected that certain groups are refused because they lead lives with increased exposure risks. But that doesn't necessarily justify the blanket refusal of all men who have ever had sex with another man.

LanDroid: I doubt the public trust level with that option would be very high, obviously a critical concern.

Actually, here I think you hit on probably one of the leading reasons, though rarely expressed by official agencies, why MSM are wholly refused. Public fear/outcry probably plays a huge role in this decision.

LanDroid: 3) Although most in the gay community do practice safe sex, we also hear of increases in high risk behavior partly because HIV/AIDS has become so much more manageable.

I've never heard of this. And I think heterosexuals are just as likely to practice unsafe sex, they're just less likely to become infected because there is generally less blood involved in vaginal than in anal sex.

LanDroid: 4) There are other reasons to be banned permanently due to risk of HIV/AIDS, including certain hetero behaviors or even where you have lived.

And yet, outside of drug users and medical conditions, the only heterosexual group refused are those who have engaged in sex for money--prostitutes. I'm not really sure refusing these specific groups really addresses at-risk donors.

Or you can make the case that denying the population the FDA has chosen as being too exposed to donate blood is actually a violation of their civil rights under equal protection. I think the argument is that restricting MSM blood donations is only a perceived precaution rather than being an actual precaution. The federal government is not in the business of making people feel secure in their prejudices and, in fact, there is a constitutional amendment that denies the federal government from participating in such practices. But don't bother wishing me luck-I have no case because I have not been adversely affected by the FDA's regulations. (Outside of witnessing, yet again, another insult directed at those I care about.) All I can do, for now, is work at debunking scare tactics and nonsensical arguments, such as: "Although most in the gay community do practice safe sex, we also hear of increases in high risk behavior partly because HIV/AIDS has become so much more manageable."

LanDroid: Donating blood is a civil right???

Equal protection is a civil right, and equal opportunity is a social right. If I have the opportunity to do something then gay men should have the same opportunity, unless there is real justification to preclude them. Real justification does not extend to suppositions and conjecturing.

LanDroid: I'm not engaging in insults, scare tactics, or nonsensical arguments, just mentioning what I've read, such as the following.

I didn't say you were engaging in insults (that's for our friends at the FDA); I said you were engaging in scare tactics and nonsensical arguments. And, really, I think you are. If you weren't then you would genuinely represent what you've read rather than pulling quotes out of context-a context that makes your argument impotent.

You stated, "Although most in the gay community do practice safe sex, we also hear of increases in high risk behavior partly because HIV/AIDS has become so much more manageable." You used this statement as justification #3 on why a "permanent ban on homosexual behavior [is] just." (Note here I think you meant a permanent ban to donate blood for those who have engaged in homosexual behavior-not a ban on homosexual behavior itself. Which isn't really the definition of the actual deferral the FDA uses, but I think I know what you are getting at.) And yet the article, in whole, is about unsafe sex practices among both homosexual and heterosexual groups. The part of the article you chose to leave out states that: "Equally alarming data were presented today by McGowan and colleagues from Bronx-Lebanon Hospital in New York City on a very different population from these earlier reports." This "very different population" with "40% of the patients" engaging in "unprotected sexual encounters despite knowledge of their HIV status" consists of "few homosexual men." Kind of blows your reasoning for why gay men are precluded from donating blood out of the water, doesn't it? It seems to me this article supports the position that heterosexuals and homosexuals alike are engaging in unsafe sex practices-so, again, why the restriction on gay men?

Actually, I found the title of the article you referenced particularly amusing: "Increasing High Risk Behavior: It's Not Just Gay Men." Really wasn't that my position? Didn't I state "I think heterosexuals are just as likely to practice unsafe sex," when you stated that homosexuals are likely to practice unsafe sex because "HIV/AIDS has become so much more manageable" and therefore are justified in being singled out among the sexually active community in general?

Regardless, the idea that either the heterosexual or homosexual community have increased instances of unsafe sex because of medication that treats HIV/AIDS is purely speculation. I think an equally sound argument can be made for a decrease in awareness efforts and an increase in abstinence-only education in schools and children/teen activity groups. Again, this is merely speculation. Neither argument should be used as the basis for policy implementation.

To end, I can't help but wonder if those who support the FDA restrictions for blood donations actually feel that those restrictions are warranted or really just want to know in the event they ever need a blood transfusion that blood will not be coming from a gay man. (See what baseless speculation does to a real conversation?)