ORLANDO, Fla. — In the days after the 2016 Pulse gay nightclub shooting ―the second-deadliest mass shooting in U.S. history — gay and bisexual men were turned away from donating blood unless they had been celibate for a year.
“Our community really wanted to give back in that way. They wanted to be able to donate blood for those who needed it, who were injured that night, and weren’t allowed to. I think that really weighed heavily on (them),” said Brandon Wolf, press secretary for Equality Florida and a Pulse survivor.
Currently, men who have sex with men must be celibate for three months to donate blood. For years, LGBTQ advocates, blood banks and medical associations have argued this waiting period is unnecessary and discriminatory. The data supported their position, too: 29% of people diagnosed with HIV in 2020 were not men who had sex with men. On Friday, the Food and Drug Administration proposed an update.
Rather than universally barring men who recently had sex with men, donors of all genders and sexualities would be barred from donating if they said they had engaged in anal sex with new or multiple partners over the last three months. Gay men in monogamous relationships would no longer have to abstain from sex in order to donate.
This draft recommendation would keep time limits in place for people taking medication to prevent HIV — due to a potential for false negatives, the agency says — and for intravenous drug users. The agency would continue to ban donations from people who have ever tested positive or been treated for HIV, and blood would still be screened for HIV and other diseases, as has been the case since 1985.
“Maintaining a safe and adequate supply of blood and blood products in the U.S. is paramount for the FDA, and this proposal for an individual risk assessment, regardless of gender or sexual orientation, will enable us to continue using the best science to do so,” said FDA Commissioner Dr. Robert M. Califf in a news release.
This shift in policy happened in part because of efforts by Orlando’s LGBTQ community, propelled by the Pulse tragedy.
“I’m really proud of Orlando’s role in all this,” Wolf said. “It feels good that the darkest day in Orlando’s history, in my eyes, has helped to fuel some positive change.”
Gay and bisexual Orlando residents spoke out about being denied the chance to donate blood after Pulse. This reignited the debate, spurring a letter from members of Congress urging the FDA to ground its recommendations in science and motivating a bill proposed in 2020 by former U.S. Rep. Val Demings and U.S. Rep. Mike Quigley that called for updating eligibility criteria.
After the COVID-19 pandemic exacerbated chronic blood shortages, growing pressure pushed the FDA to begin a pilot study in 2021, dubbed ADVANCE (Assessing Donor Variability And New Concepts in Eligibility). The study found eligibility based on risk factors rather than sexuality didn’t significantly result in more HIV-positive blood donations.
Orlando was one of eight communities to participate in the 1,600-person study.
“The fact that so many gay and bi men here in the Orlando area volunteered to participate in this historic study, I think, is a really great thing,” said former Florida Rep. Carlos Guillermo Smith. “Our own community here in Orlando deserves credit for helping to improve this policy.”
Wolf was one of many locals who participated and recruited others to do the same. He had never donated blood before the study but said he plans to donate if the FDA’s proposed guidelines go into effect.
The FDA’s proposal can make a huge difference and address a desperate need, said Susan Forbes, spokesperson for OneBlood, a blood donation center that partnered with Vitalant and the American Red Cross to lead this study.
“There is never a day in our community when blood donations are not needed,” Forbes said. “All the participants who enrolled in that study should feel very proud.”
Only 3% of people who are eligible to donate choose to do so, according to the American Red Cross.
Despite this proposed step forward, there’s still more work to do, said Guillermo Smith. He hopes in the future people taking medication to prevent HIV will be allowed to donate blood as well.
Joel Figueroa, another study participant and president of Impulse Group Orlando — a local branch of a global nonprofit formed in 2009 — agreed.
“I wish I could sound super excited and super happy, but ... we’re taking one step,” Figueroa said. “There’s just so much greater issues around policy that was created in the early 1990s that are completely antiquated. But ... no matter what, it is still progress, and I’m looking forward to more change.”
The current three-month recommendation is a relic of a time when HIV screening was not as accurate as it is today, say critics of the current law, including the American Medical Association. Before 2015, men who had ever had sex with a man were not allowed to donate blood.
Supporters of the waiting-period rule point out that HIV tests, while highly accurate, cannot identify whether someone has contracted HIV until at minimum 10 days after exposure, according to the Centers for Disease Control and Prevention.
Equality Florida is lobbying for the repeal of other laws from the height of the AIDS crisis, too, such as a Florida law that makes it a felony punishable by up to 30 years in prison for someone not to disclose their HIV diagnosis to a partner.
The law made sense years ago when the HIV-positive person would have been putting their partner at serious risk. But today, treatments can make it impossible to transmit HIV from partner to partner during sex, according to the CDC.
“After more than 40 years of HIV research and significant biomedical advancements to treat and prevent HIV transmission, many state laws are now outdated and do not reflect our current understanding of HIV. In many cases, this same standard is not applied to other treatable diseases. Further, these laws have been shown to increase stigma, exacerbate disparities, and may discourage HIV testing,” the CDC states.
