Smart HIV detection could increase number of blood donors
In the United States, a new determination by the Food and Drug Administration (FDA) states that gay and bisexual men are no longer prohibited from donating blood. For decades, they could not be donors due to the belief that there was a risk of contamination of the blood bank with the HIV virus. The FDA says the new policy reflects the latest scientific evidence.
“For HIV specifically, this prohibition for gay and bisexual men, which dates back to the 1980s, came into effect from the moment it was understood in that epidemic, which was at its beginning, that cases were concentrated in the male population. gays and bisexuals. So, the first thing they did, since they didn’t even know it was a virus, that it was a bacteria, they prohibited blood donation by gay and bisexual men, trying to protect those people who were going to receive these bags”, explains Ricardo Vasconcelos, infectologist , researcher and coordinator of the Mosaic study on HIV vaccine at the Hospital das Clínicas of the Faculty of Medicine of USP.
Blood donation and HIV in Brazil
Vasconcelos argues that there are more effective ways than the ban, which can guarantee more donors for blood banks: “The possibility that still exists of transmission is only from a person who has just become infected with HIV and donated blood in the period in which the tests still cannot identify that the virus exists there. But that period is as short as a week, ten days. So, much more efficient than separating those bags that should not be tested, it is understanding what vulnerability that person has in their life and whether or not in those previous seven or ten days there was a risk of the person becoming infected”.
In Brazil, during the 1980s, the prohibition linked to homosexual relationships also happened, but today, the scenario is different: “The paths of these advances here in Brazil are different. We went through the courts, in 2020 there was a judgment by the STF that considered the restriction on blood donation based solely on an individual’s sexual orientation to be unconstitutional. After that, this STF decision forced Anvisa to review its criteria for blood bank donors and we, in June 2022, have an update, which is much more similar to that of the United States of now”, says Vasconcelos .
The professor also mentions that, in Brazil, there are several criteria to define the viability of blood donation: “[There is a temporary disability for] the person who started a new sexual relationship or who had multiple sexual partnerships in recent months and we have a temporary disqualification of 12 months for donation of any person who has had sexual intercourse with more than one person simultaneously. You see that these are much more refined criteria, much more refined and do not cut off a part of society simply because it has relations with a person of the same sex”.
emergency change
During the covid-19 pandemic, the need for more donors for blood banks increased and so the restrictions on blood donation by gay and bisexual men were reduced: “[The total restriction] in 2015, there in the United States , underwent a change and a gay man was allowed to donate blood if he had spent 12 months without having any sexual intercourse, and then later, in 2020, during the covid pandemic, during the period when blood bank stocks were fine low, they wanted to put more donors allowed to donate, and then they shortened it from 12 months to three months”.
This happened because it was understood that behaviors and factors that do not allow blood donation can be observed in people of any sexuality: “We have arrived now, in 2023, at this moment in which a gay person, just because he is gay, he is not prohibited [ to donate blood]. But, depending on the type of exposure and sexual behavior she has, it doesn’t matter if she is gay, straight or whatever, she may or may not donate blood”, argues Vasconcelos.
“Even more modern than risky behavior is the vulnerability approach, which understands that everyone in the world has some vulnerability to HIV and that this vulnerability can be greater or lesser, depending on multiple factors, which go far beyond just the person’s sexual behavior. For example, if I am a gay man and I live in a country that criminalizes homosexuality, I have an increased vulnerability to HIV, because I will have less access to health, quality care, testing and HIV treatment, because I have than to hide my homosexuality”, he adds.