Five Quarts_ A Personal and Natural History of Blood - Bill Hayes [98]
Of course, quizzing people about their sexual histories isn’t foolproof. Having worked in AIDS education, I know that people don’t necessarily tell the truth about their sexual past or may genuinely not realize if they’ve put themselves at risk. And with practices such as unprotected oral sex, there isn’t consensus about what is safe. Ultimately, experts agree, the best test is blood testing itself. That being said, the ELISA, an effective test, does come with a problem: the “window period.” According to the FDA, “up to two months” may elapse between the time of infection and the body’s production of the antibodies the ELISA detects. If the ELISA were the only HIV test performed today, I could understand the FDA’s erring on the side of extreme caution. But the fact is, three separate HIV tests are now performed on all blood donations—the ELISA, plus HIV antigen and nucleic acid tests, the latter two effectively detecting the virus itself immediately after infection. If done correctly, these tests are accurate.
Louder voices than mine have taken up the cause. Like many people, gay and straight alike, California State Assembly member Mark Leno finds the ongoing ban “blatantly discriminatory,” and he has fought to change it for more than four years. Assemblyman Leno told me that back in January 2000, when he was a member of the San Francisco Board of Supervisors, he gathered six men like himself—gay and HIV negative—alerted the media, and headed to the local branch of Blood Centers of the Pacific, the same facility I visited. On camera, standing on the blood bank’s steps along with its administrator, Leno called for a change in the policy.
What do you call a protest without a confrontation? Un-newsworthy? Well, no, for this story held a twist: “Even the administrator herself agreed that it was a foolish policy,” Leno recalled. “She was frustrated, too. The ban shrinks the available donor pool when instead we need to expand it.” In the time since, the problem has only worsened. According to the American Red Cross and America’s Blood Centers, which together represent virtually all U.S. blood banks (including Blood Centers of the Pacific), many facilities across the country routinely have less than a day’s supply on hand and can’t meet hospital demand. While the need for blood steadily increases each year, due in large part to the rise in heart and cancer surgeries, organ transplants, and other complex procedures requiring large transfusions, blood donations are on a steady decline. About 95 percent of qualified blood donors do not give, according to a recent statistic.
To bolster his argument, Leno and his staff did a rough analysis showing that if just one in twelve HIV-negative gay men in the United States donated regularly, their annual contribution would represent one-third of the blood needed every year by the nation’s hospitals. Joining forces with the Blood Centers of the Pacific and numerous medical experts, Leno helped lobby for a change in the FDA’s policy on gay donors, with the aim of shrinking the over-twenty-year abstinence period down to five years or, better yet, down to one. But the Red Cross fought hard against it. And when it came up for vote in September 2000, the FDA’s advisory panel voted seven to six to uphold the ban indefinitely. The years 2001, 2002, and 2003 passed without official debate on the issue. Over time the abstinence requirement, anchored in 1977, grows more punitive.