How new FDA rule allowing gay, bisexual men to give blood is making donation more inclusive

Written by ABC AUDIO on December 31, 2023

(NEW YORK) — For at least a decade, Chris Van Bibber had been prevented from donating blood.

The 35-year-old from Salt Lake City, Utah — who is openly gay — was restricted due to rules set in place by the U.S. Food and Drug Administration (FDA) that did not allow sexually active gay men from donating.

However, this past May, the FDA dropped all restrictions specific to gay and bisexual men donating blood, moving to a new blood donation risk assessment tool that is the same for every donor regardless of how they identify, which rolled out in August.

This meant that Van Bibber was able to make history as he donated blood at the American Red Cross Blood Donation Center in his home city.

“To sit back in that chair and to go through the questionnaire beforehand, and it was just — I felt so much excitement and so much relief that we were finally here,” Van Bibber told ABC News. “I just felt like I was finally able to do my part and it’s a small thing to do that can make such a big difference.”

The new policy is one that public health experts and gay rights activists said had been a long time coming.

Ban on gay and bisexual men donating

In the early days of the HIV/AIDS epidemic, blood donations were not able to screen for HIV, which led to some cases of HIV via transfusion. This led to the FDA instituting a lifetime ban on gay and bisexual men from donating blood as well as women who have sex with men who have sex with men.

“That was really based not on an individual person’s risk, but more so on belonging to a particular group and some of that, at the initial onset, you could say was based on what we were seeing with regard to the impact of HIV on specific communities, namely, gay and bisexual men,” Ayako Miyashita Ochoa, an adjunct professor at the UCLA Luskin School of Public Affairs, told ABC News.

“We quickly got to a place where we were able to test all blood donations universally for HIV. That policy became outdated…and yet we did not see a change in the policies related to this permanent ban or permanent deferral,” she continued.

In 2015, the blanket ban was repealed but the FDA placed restrictions that men who have sex with men could donate if they were abstinent from sex for at least one year. In 2020, this was shortened to a period of 90 days of abstinence.

Scientists and advocates argued that not having policies that backed science was discriminating.

“I think it’s safe to say that the policy was so incredibly blunt,” Miyashita Ochoa said. “And it was so group-based, identity-based specifically, that it was a tool for furthering stigma and discrimination.”

‘It felt very invasive’

For Van Bibber, the desire to donate blood is partly due to family history. His mother, Sheri, suffered a life-threatening medical complication when he was born and needed a blood donation to save her life.

Van Bibber said he grew up understanding the significance of blood donation, especially because his blood type is O-negative and can be used in transfusions for any blood type.

Sheri works for the Red Cross organizing blood drives so his family would donate regularly. However, he said he felt like an outsider compared to the rest of his family who was able to donate while he wasn’t.

“It felt very limiting and very invasive of my personal life that I wouldn’t be able to donate or give back in the way that I wanted to,” Van Bibber said. “Donating blood and knowing the importance of that has been a part of our family for since I’ve been alive and so to not be able to participate, not be able to do my right in giving back, it was certainly discerning.”

Blood donation rule change

This year, the FDA announced it would no longer be issuing blanket bans due to sexual orientation and instead screen potential donors on their risk of contracting and transmitting HIV, with the policy going into effect in August.

At the time, the federal health agency said it would use “gender-inclusive, individual risk-based questions” without compromising “the safety or availability of the blood supply.”

Questionnaires ask all donors about new or multiple sexual partners in the past three months. Those who have had a new sexual partner or multiple partners in the past three months and a history of anal sex during that time period will be deferred. Those taking medications to treat or prevent HIV infection will also be deferred. The new blood donation risk assessment is the same for every donor regardless of how they identify.

It follows several other Western countries that have recently dropped bans or eased restrictions including the United Kingdom, France, Greece and the Netherlands.

Van Bibber said when he first heard the FDA was considering making the policy change, he was initially wary, but he was excited when it was made official.

“I was a little leery just because I wanted to know, how are they going to make that change and is it truly going to be inclusive and how are they going to involve everybody?” he said. “And as it finally rolled out, and I read the requirements before I went to go donate, I sat there, and I’m like, ‘This is how we do it. This is absolutely the first step to take, and science is going to keep working with us and it’s only going to go up from here.'”

Experts said this new policy focuses on individual risk, taking into account that many donors are monogamous, test HIV negative and practice safe sex.

“I think that the individual risk-based assessment now gives us a chance to step away from sort of blanket decisions around the risks related to donation,” Miyashita Ochoa said. “I think that we are moving to a place where our policies are reflecting better the science and certainly our expectations as a society to not discriminate.”

Experts are also hopeful that more donors will help address the blood supply. On Sept. 11 of this year, the American Red Cross declared a national blood shortage, stating the blood supply level had dropped nearly 25% since early August.

While blood donations have increased since then, it can take weeks for levels to rebound, the Red Cross said.

More work to be done

Van Bibber said the response from the LGBTQ community has been positive with people coming forward to donate who didn’t realize they were now eligible or sharing their own first-time donation experience.

However, he and others say there is more work to be done. One way to make blood donation even more inclusive would be to expand eligibility to those on a medication called PrEP (pre-exposure prophylaxis, which is a daily pill containing two medications that prevent HIV-negative patients from being infected, they said.

“While we definitely don’t want any donors to stop taking their medication because it’s important for HIV prevention and treatment, but more data is needed to understand how these medications impact testing and eligibility,” Dr. Baia Lasky, a divisional chief medical officer with the American Red Cross, told ABC News.

Miyashita Ochoa said she hopes the risk assessment convinces more people not only to reduce stigma but encourage more people to donate.

“These questionnaires are intended to keep our blood supply safe and so while you may feel some discomfort being asked about your sexual health risks, we have to maintain the safety of our blood supply,” she said.

“So please support this effort to move towards this individual risk-based assessment and understand that beyond just addressing stigma and discrimination, this is about education. And this is about an opportunity to participate in a more just in a more right scientific assessment of risk. We can all do our part,” she added.

ABC News’ Sony Salzman contributed to this report.