The United States Food and Drug Association (FDA) recently changed their blood donation restrictions for MSM (men who have sex with men), reducing the deferral (temporary restriction) period to three months. Men must abstain from having sex with other men for three months before being eligible for blood donation. This was prompted by the sudden reduction in blood supply due to the coronavirus pandemic. Prior to this, for no reason whatsoever, the deferral period had been 12 months. Taking into consideration the advancement in HIV testing, these restrictions are often fueled by homophobia and stereotyping.
In India, the conundrum for the longest time was that to prohibit gay men from donating blood, the society must acknowledge the existence of gay men. When the Supreme Court decriminalized gay sex in India, almost like clockwork, the National Blood Transfusion Council (NBTC) in Maharashtra updated their screening questionnaire. The new questionnaire inquires the potential donor about their sexual history, which includes male to male sexual activity.
The NBTC made a few revisions to their guidelines in 2017, which includes restricting gay and bisexual men, female sex workers and transgender people from donating blood. The data regarding HIV in MSM in India is comparatively insufficient. Statistical data can be easily misguiding, mostly due to the stigma and resultant secrecy attached to both HIV and homosexuality in India.
In an article published in the Hindustan Times, Sujatha Rao (the then director-general of National AIDS Control Organisation) exclaimed at the ridiculousness of several physicians and various hospitals who had admitted to discouraging homosexual people from donating, even if they were healthy. The NBTC guidelines back then did not state anything specific barring anyone of any sexuality from donating blood, nor did the guidelines cite the word ‘homosexual’. Yet hospitals went out of their way to establish restrictions. This was all back in 2009.
Currently, not only do we still have prejudice within the society, but we also have questionnaires and guidelines backing up these prejudices. RTI activist Chetan Kothari in 2017 found that the NACO categorises the LGBT+ community as a ‘high risk’ demographic, and that these ‘high risk’ donors are screened through the questionnaire/counselling that takes place before donating blood.
The AIDS crisis that hit America in the 1980s, a time during which there was no reliable test available for the virus, resulted in a ban on all MSM and women who have had sex with MSM from donating blood. This ban lasted for decades, even after medical technology had made significant advancements.
Multiple countries have specific guidelines to reduce the chances of people exposed to HIV, Hepatitis, or any other disease from donating blood. But these measures are at times influenced by social biases. In certain countries, all high-risk sexual behaviours lead to a temporary ban, regardless of the sex of the partner. Sexual contact with anyone who has used needles for non prescribed drugs may also result in a temporary ban. Sex workers, women who have had sex with MSM, and anyone who has had multiple sex partners, all are likely to face some sort of deferral period. While certain rules are borne due to necessity, some reek of blatant bias. Blood drives find themselves in the middle of a controversy when their MSM policies contradict the non-discriminatory policies of the venues in which they are held. Boycotting blood drives however is hardly the thing to be done- especially considering the constant need for a maintained blood pool. Blood cannot be stored for a long period of time, so it is important that donations keep on coming in continuously.
A significant amount of HIV cases in India can be attributed to unprotected heterosexual intercourse. Overall, however, India’s HIV epidemic is slowing down. The concentrated efforts in certain areas have resulted in safer sex practices, especially amongst sex workers.
So then the question remains: is a blanket ban prohibiting all such high-risk communities from donating necessary? What are the implications associated with banning people of particular sexuality? And how effective is the updated questionnaire?
The ELISA testing method, which looks for antibodies as a response to the virus, is still used in developed countries. There is a window period of uncertainty when using this testing method and that can range from three to six months. It is to make up for this window period that potential donors are screened for ‘high risk’ behaviour. Strangely enough, even a monogamous gay man with a healthy medical history will be considered a high-risk donor in many countries.
The efficiency of the questionnaire introduced also depends completely upon the person filling it up, and keeping in mind the stigmatization in Indian society when it comes to homosexuality one cannot expect the questionnaire to be answered with clarity.
All that the updated questionnaire manages to achieve then is to further vilify the LGBT+ community.
India needs more blood donors, especially now with a pandemic putting the country at a standstill. Blood testing needs to be consistent, and completely prohibiting certain communities from donating is an unnecessary measure. India also needs better policies to ensure the dignity of an LGBT+ person in society, and the blood donation rules are in direct contradiction to that.
The assumption here is that members of the LGBT community are promiscuous, which leads to other nonsensical notions of impurity being attached to same-sex practices. Improper blood testing, the disparity in the supply of blood in different parts of the country and social stigma are the concerns to be dealt with. What we need is proper sex education and awareness.
Too long, didn’t read? Here’s the gist: blood donation screenings should be more concerned with safe sex practices, rather than the sexuality of the donor.