Tuesday, 13 September 2011

A critique of the coverage following the lifting of the lifetime ban on blood donations from men who have had sex with men

For those of you who don't already know, last week it was announced there would no longer be a lifetime ban on men who have had oral or anal sex with men (MSM) giving blood. Men will now be able to give blood a year after they last had sex with another man.

First of all: I welcome this change. In 2004 I collected signatures to ask the National Blood Service to review their policies as I felt at the time it was unnecessarily discriminatory. Since then however, I have changed my mind somewhat. Being able to give blood shouldn't about the feelings of the donors but about the health of those who receive the blood. MSM make up a significant proportion of those living with HIV, when compared to the proportion of the total population who are MSM. Because of this, I can understand why evidence had to be looked at before lifting the lifetime ban. If the recent study had found that the lifetime ban had remained in place in order to secure the blood supply, I would have supported this as long as the evidence had supported this. I do think that there is room for improvement though. As it stands now, a gay man in a committed relationship will still not be able to give blood, even if both partners have been faithful for the last 12 months. I'd be in favour of a further change which only ban those who have had a new partner in the last 12 months. However, if there isn't any evidence to support this change, then I can accept that it can't be made. Chris Ward, a writer for Lib Dem Voice appears to share my views and writes about them more eloquently here. This doesn't mean I think that all gay men are inherently at risk from being infected with HIV. In fact, I think it's nonsensical that a committed gay couple still can't give blood whereas a man or a woman who sleeps with a different partner of the opposite sex each week will be able to.

The coverage for this change has been mixed. Even the best article about it have been misleading, at least as far as the headline goes:

From Pink News: One-year blood donation deferral for UK gay men
The headline implies the new policy only applies to those men who identify as gay. However, it doesn't. Thanks to this change, men who now identify as straight who experimented in his youth will now be able to give blood. Thankfully though it goes on to rectify this in the very first paragraph:
The Department of Health has announced it will remove the lifetime blood donation ban on any man who has ever had gay sex.
I can forgive the headline because the alternative would have been almost as long winded as my own.

However, unsurprisingly, the coverage from The Mail and the Telegraph hasn't been as good. The problems with The Mail's coverage starts with the laughable headline:
Lifetime blood donor ban for gay men lifted - as long as they haven't had sex for a year
The lifetime blood donor ban for MSM has been lifted and replaced with a one-year deferral. To try and say that a lifetime ban would still be in place if the man has had sex in the past year is simply wrong and logically non-sensical. Not only that, this rule wouldn't stop bisexual men who have had sex with women in the past year. Also, gay men occasionally have sex with women. It's not the norm but it happens. Those men who identify as gay who for some reason have only had sex with a woman or women in the past year would not be banned under the new rules.

The writer just refused to qualify throughout the article that the lifetime ban didn't just impact gay and bisexual men but also men and those who may have experimented in their youth and those who didn't have much choice in the matter. The Mail also seems to break basic rules of writing articles, saying that LGB organisations welcome the changes in the paragraph directly before this one:
Deborah Jack, chief executive of the National AIDS Trust, said: 'The lifetime ban on gay men donating blood has been at the centre of much controversy and debate in recent years, particularly as it became clear that this rule and current science were completely out of sync."
The NAT isn't an LGBT rights' organisation, it never has been. From its 'about us' page:
NAT is the UK's leading charity dedicated to transforming society's response to HIV. We provide fresh thinking, expertise and practical resources. We champion the rights of people living with HIV and campaign for change.
A better quote to follow the previous paragraph would have been from Stonewall's statement, which they have very helpfully provided on their website. They also make a massive clanger:
Most new HIV (human immunodeficiency virus) infections in the UK still result from men having sex with men.
In the latest statistics I can find (from 2010) MSM only made up 39% of those newly diagnosed with HIV. But research, what's that Mail?

I didn't think it'd be possible for anyone to outdo The Mail's bad journalism but somehow on this occasion, the Telegraph rose to the challenge.

Even the headline is an amazing example of scaremongering:
Gay men can give blood after discrimination claims
Coming from The Telegraph one instantly gets the impression the paper thinks this is "a bad thing" which must be stopped. It seems to suggest the reason why the lifetime ban has been lifted because of pesky homosexuals demanding their pint of blood to be sucked from their arteries. This could not be further from the truth if it tried. Yes, some gay men have been campaigning for the blood ban to be re-examined, including Peter Tatchell (more on him later). However, what lead to the change was a study of empirical evidence by The Advisory Committee on the Safety of Blood, Tissues and Organs (SABTO) which concluded there would be no higher risk of people acquiring HIV and other blood borne viruses with a one year deferral when compared to a lifetime ban. They also included this lovely paragraph:
It is not thought that the change will result in large numbers of new donors, however, since most homosexual men are sexually active.
Yeah, those pesky homosexual men, they're all at it, unlike the... er... rest of humanity? Unlike in The Mail's article, bisexual men aren't even mentioned here.

I haven't found some of the response from gay rights' campaigners to be altogether helpful either. For instance Peter Tatchell wrote in the Guardian last Friday to say that the changes should go further:
Most gay and bisexual men do not have HIV and will never have HIV. If they always have safe sex with a condom, have only one partner and test HIV negative, their blood is safe to donate.
I completely agree with him here, but what SABTO needs is data to prove this, not rhetoric. So what I think would be more helpful would be to ask for the next study to examine allowing those in committed relationships to give blood, rather than insisting the change must happen regardless.

In Stonewall's statement, their CEO Ben Summerskill is quoted as saying:
To retain a blanket ban on any man who has had sex with another man in the last year, even if he has only had oral sex, remains disproportionate on the basis of available evidence.
However, if you actually read SABTO's report which was published by the Department of Health it says:
The risk with oral sex is very low but HIV transmission does occur, however, given the lack of data it is difficult to make summary estimates for the transmission risk through oral sex.
So according to the official report, no such data relating to oral sex exists. However, the rest of the statement seems quite sensible:
Stonewall will continue to push for a donation system based on the real risks a potential donor poses. People wanting to donate blood should be asked similar questions - irrespective of their sexual orientation - that accurately assess their level of risk of infection.
I'd welcome this, although the donor questionnaire might get a bit busy. Perhaps another study is required? (I perhaps should have mentioned I'm an analyst at heart ;-))

I never thought I'd say this: congratulations to the coalition for coming to a good decision. You're not there yet, but maybe as more evidence becomes available you'll get there eventually.

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