MSM is one of the highest risk activities you can do for bloodborne diseases. If this is discriminatory, life is discriminatory. Life is not fair, and there is nothing any artificially constructed social system will ever do to force mother nature's hands to make life fair. I fully support the rights of people to love and be in relationships with whoever they wish, but that doesn't mean you have the right to contaminate the blood supply due to the inherently high risk of your day-to-day life.
I have never been able to donate blood because of my travels due to their locations and frequencies. I am not going to give up travel to donate blood. MSM is a much higher risk activity than travel, and yet I am also excluded due to my lifestyle risk. It's not fair, but it is reasonable.
With travel, I understand that there is a higher risk of lots of diseases, and testing against all possible infectious diseases is not feasible. Drug use is also obviously disqualifying. But why would you care about someone's sexual behavior? The blood must be tested for common drugs and common blood borne diseases regardless, and it's perfectly possible to engage in sexually risky behaviors and not have any venereal disease (unlike with drug use, where it implicitly means you will have levels of those drugs in your blood), just like it's possible to be very careful with your sexual behavior and still get a disease.
Note: for tattoos, I have no idea if the problem is also related to venereal diseases, or if there is any problem from contamination with the tattoo ink itself, and I don't care enough about this subject to look it up.
> But why would you care about someone's sexual behavior? The blood must be tested for common drugs and common blood borne diseases regardless, and it's perfectly possible to engage in sexually risky behaviors and not have any venereal disease
Men who have sex with men are something like 50-100x more likely than the general population to acquire HIV. HIV tests do not have a 0% false positive. They will not catch all very recent infections. The rationale for excluding them until recently is that it’s defense in depth and it doesn’t hurt the blood supply much because they only make up about 2-3% of the population.
The current rule is that MSM don’t face a blanket ban, but if you’ve had anal sex in the last 3 months you have to wait because anal sex is inherently more likely to transmit HIV and the tests may not catch a very new infection. Other diseases like Hepatitis have a similar issue.
The answer to all of that is mainly hepatitis C, that can have a window detection of 6 months, even more.
And yes, you can be very careful and get a disease. But they are playing statistics here: over 60% of injected drug users have Hep-C, that means a lot of prostitutes. They won't and shouldn't trust anyone who say "hey, I had unsafe sex against all advice, but was very careful with the tattoo in a dark cellar and the heroin party, pinky promise".
Unfortunately tests are not 100% accurate and there's a window between when the pathogen is present and when it's detectible. Add in that many viruses aren't directly detectable, the tests look for antibodies to the virus.
This is why they usually ask if you've had a new sexual partner in the past 3 or 4 months. This is the window period for detecting some STDs and other diseases.
For tattoos, if the artist isn't using a brand new set of needles for you, you risk bloodborne disease transmission, with hepatitis B being a particular danger.
All of these things can mostly be tested. When I donated regularly in the UK after being in the southern US, they screen me for west nile virus but still take my blood and use it.
Granted it’s shorter, but there are longer wait periods depending on the country. It’s defense in depth because false negatives happen and some viruses take time to show up on tests.
"If you spent over 4 weeks in primitive or rural accommodation you have to wait for 4 months after your return before giving blood. However, if you were travelling and staying in places which are modern and clean, such as typical tourist areas, please wait 4 weeks from your return due to Tropical Virus risk which includes Chik V, Dengue or Zika risk providing you do not have symptoms of these."
“ If you visited the rural areas of the states - Chiapas, Chihuahua, Durango, Sinaloa districts, Quintana Roo, you need to wait for 4 months after your return to the UK before giving blood. ”
The US rules also aren’t 4 years (not sure why someone told the OP that). It’s 3 years after undergoing malaria treatment. And 3 months after visiting a malaria prone area.
The bigger worry isn't really false negatives, modern PCR based testing is incredibly good. There is always risk but it's frankly extremely low. The bigger issue is that blood is pooled before testing to make that powerful testing economical. If you increase the rate at which you get (also possibly false) positives you risk having to throw out whole batches of pooled donations.
Tests cost money. They have blood enough to allow them to discriminate. If they were lacking, they will be less picky: in a catastrophic event they call for blood donors and they rely on tests, risking a detection window.
But under normal conditions, letting only the best candidates donate is the most efficient way.
Generally, because they're discriminatory. It's like how racial profiling in law enforcement can be a heuristic that can work. Though, in the case of blood donations, it seems that tests aren't accurate enough to be able to rely solely on them. Also, being discriminated against on being able to donate blood is not as big of a deal. Though in some places with public health systems, stuff like getting a surgery may somewhat depend on you and family/friends donating a certain amount of blood.
We do test the blood, but they also do coarse grained screenings like this to avoid some level of waste on intake. It's like having client and server side validation.
Well, it's the having of an infectious blood borne thing that disqualifies you.
m-m sex is still disqualifying even if all parties are completely clean and safe. it's discriminatory.
0.4% of the US population has HIV.
12-15% of gay men in the US have HIV.
The rules exist for a very real reason.
All anal sex in the US requires a 3 month waiting period (as does any kind of sex with a new partner) not just male to male.
Anal sex is inherently much more likely to transit HIV and HIV tests have a higher false negative rate for new infections.
MSM is one of the highest risk activities you can do for bloodborne diseases. If this is discriminatory, life is discriminatory. Life is not fair, and there is nothing any artificially constructed social system will ever do to force mother nature's hands to make life fair. I fully support the rights of people to love and be in relationships with whoever they wish, but that doesn't mean you have the right to contaminate the blood supply due to the inherently high risk of your day-to-day life.
I have never been able to donate blood because of my travels due to their locations and frequencies. I am not going to give up travel to donate blood. MSM is a much higher risk activity than travel, and yet I am also excluded due to my lifestyle risk. It's not fair, but it is reasonable.
With travel, I understand that there is a higher risk of lots of diseases, and testing against all possible infectious diseases is not feasible. Drug use is also obviously disqualifying. But why would you care about someone's sexual behavior? The blood must be tested for common drugs and common blood borne diseases regardless, and it's perfectly possible to engage in sexually risky behaviors and not have any venereal disease (unlike with drug use, where it implicitly means you will have levels of those drugs in your blood), just like it's possible to be very careful with your sexual behavior and still get a disease.
Note: for tattoos, I have no idea if the problem is also related to venereal diseases, or if there is any problem from contamination with the tattoo ink itself, and I don't care enough about this subject to look it up.
> But why would you care about someone's sexual behavior? The blood must be tested for common drugs and common blood borne diseases regardless, and it's perfectly possible to engage in sexually risky behaviors and not have any venereal disease
Men who have sex with men are something like 50-100x more likely than the general population to acquire HIV. HIV tests do not have a 0% false positive. They will not catch all very recent infections. The rationale for excluding them until recently is that it’s defense in depth and it doesn’t hurt the blood supply much because they only make up about 2-3% of the population.
The current rule is that MSM don’t face a blanket ban, but if you’ve had anal sex in the last 3 months you have to wait because anal sex is inherently more likely to transmit HIV and the tests may not catch a very new infection. Other diseases like Hepatitis have a similar issue.
The answer to all of that is mainly hepatitis C, that can have a window detection of 6 months, even more.
And yes, you can be very careful and get a disease. But they are playing statistics here: over 60% of injected drug users have Hep-C, that means a lot of prostitutes. They won't and shouldn't trust anyone who say "hey, I had unsafe sex against all advice, but was very careful with the tattoo in a dark cellar and the heroin party, pinky promise".
Unfortunately tests are not 100% accurate and there's a window between when the pathogen is present and when it's detectible. Add in that many viruses aren't directly detectable, the tests look for antibodies to the virus.
This is why they usually ask if you've had a new sexual partner in the past 3 or 4 months. This is the window period for detecting some STDs and other diseases.
For tattoos, if the artist isn't using a brand new set of needles for you, you risk bloodborne disease transmission, with hepatitis B being a particular danger.
All of these things can mostly be tested. When I donated regularly in the UK after being in the southern US, they screen me for west nile virus but still take my blood and use it.
The UK also has a wait time for many countries including Mexico.
https://my.blood.co.uk/eligibility/travel/article?id=47&titl...
Granted it’s shorter, but there are longer wait periods depending on the country. It’s defense in depth because false negatives happen and some viruses take time to show up on tests.
"If you spent over 4 weeks in primitive or rural accommodation you have to wait for 4 months after your return before giving blood. However, if you were travelling and staying in places which are modern and clean, such as typical tourist areas, please wait 4 weeks from your return due to Tropical Virus risk which includes Chik V, Dengue or Zika risk providing you do not have symptoms of these."
Not quite the four years.
The first paragraph is
“ If you visited the rural areas of the states - Chiapas, Chihuahua, Durango, Sinaloa districts, Quintana Roo, you need to wait for 4 months after your return to the UK before giving blood. ”
The US rules also aren’t 4 years (not sure why someone told the OP that). It’s 3 years after undergoing malaria treatment. And 3 months after visiting a malaria prone area.
https://www.redcrossblood.org/faq.html#eligibility-travel
Blood is tested for disease, but the false negative rate for each test is its own risk.
If you got blood from an addict living on the street engaging in prostitution and tested it, would you trust that blood?
I wouldn't.
The bigger worry isn't really false negatives, modern PCR based testing is incredibly good. There is always risk but it's frankly extremely low. The bigger issue is that blood is pooled before testing to make that powerful testing economical. If you increase the rate at which you get (also possibly false) positives you risk having to throw out whole batches of pooled donations.
The false negative rate for HIV testing in newly infected people is actually pretty high, like 50% within the first few months high.
People have more unprotected, regrettable sex during travel and vacations, so maybe they're on to something?
Sounds like something you should test rather that just rely on heuristics
Tests cost money. They have blood enough to allow them to discriminate. If they were lacking, they will be less picky: in a catastrophic event they call for blood donors and they rely on tests, risking a detection window.
But under normal conditions, letting only the best candidates donate is the most efficient way.
Heuristics work, why would you not rely on heuristics?
Generally, because they're discriminatory. It's like how racial profiling in law enforcement can be a heuristic that can work. Though, in the case of blood donations, it seems that tests aren't accurate enough to be able to rely solely on them. Also, being discriminated against on being able to donate blood is not as big of a deal. Though in some places with public health systems, stuff like getting a surgery may somewhat depend on you and family/friends donating a certain amount of blood.
Sounds like something you should evaluate with a cost/benefit analysis, including the false negative and false positive rates.
I don't get the sense we have any standards for actually vetting the blood that's donated, which is deeply concerning
We do test the blood, but they also do coarse grained screenings like this to avoid some level of waste on intake.
We do test the blood, but they also do coarse grained screenings like this to avoid some level of waste on intake. It's like having client and server side validation.
We do, they are just not cheap enough to do on individual donations so you have to throw away a big batch every time they catch something.