FDA Proposes Easing Lifetime Ban On Blood Donations By Gay Men | Kaiser Health News


FDA Proposes Easing Lifetime Ban On Blood Donations By Gay Men | Kaiser Health News.

Let’s look at some facts and data, shall we? Then I’ve got questions.

Statement from the FDA.
From Red Cross:

redcross blood safety

redcross blood safety 2

What it means: Blood is tested for antibodies to HIV 1&2 as part of the battery of tests performed to ensure donated blood is safe for use. However it may take several weeks to months after infection for HIV antibodies to present in the serum (if you contracted it last night, it may not be apparent until 3 months from now).

From CDC:
cdc hiv transmission rts

What it means: The population of concern are people who have been exposed to HIV but have not yet developed screen-able antibodies–new infections. So we look at the most recent transmission data from the CDC and note that men having sex with men are 2.5 times as likely to have a new infection as the second largest category, heterosexual contact.

My questions: How is the one year waiting period scientifically justified? One year would allow time for antibodies to appear, of course. But there is risk of undetectable infection in blood of people engaging in heterosexual contact, too. Even it it’s 2.5 times less than MSM is that risk not deserving of the one year abstinence period? And then where would be be in terms of blood supply? What is the risk benefit analysis here? I don’t yet get how this is a decision based in evidence on the part of the FDA. To me, it’s a little don’t-ask-don’t-tell-y. And by that I mean homophobic and embarrassing.

Also, I would like to know that data on the risk of transmission of HIV and the Heps when anitgen/antibody complexes are undetectable in the serum. And the number of people per year who contract HIV or Hep B or C from blood transfusions. Add that lit search to the pile.

Poetry from the AIDS Epidemic, another for World AIDS Day

Excerpt of “Atlantis” by Mark Doty
About his partner with AIDS

Jimi and Tony
can’t keep Dino,
their cocker spaniel;
Tony’s too sick,
the daily walks
more pressure
than pleasure,
one more obligation
that can’t be met.
And though we already
have a dog, Wally
wants to adopt,
wants something small
and golden to sleep
next to him and
lick his face.
He’s paralyzed now
from the waist down,
whatever’s ruining him
moving upward, and
we don’t know
how much longer
he’ll be able to pet
a dog. How many men
want another attachment,
just as they’re
leaving the world?
Wally sits up nights
and says, I’d like   
some lizards, a talking bird,
some fish. A little rat.
So after I drive
to Jimi and Tony’s
in the Village and they
meet me at the door and say,
We can’t go through with it,

we can’t give up our dog,
I drive to the shelter
—just to look—and there
is Beau: bounding and
practically boundless,
one brass concatenation
of tongue and tail,
unmediated energy,
too big, wild,
perfect. He not only
licks Wally’s face
but bathes every
irreplaceable inch
of his head, and though
Wally can no longer
feed himself he can lift
his hand, and bring it
to rest on the rough gilt
flanks when they are,
for a moment, still.
I have never seen a touch
so deliberate.
It isn’t about grasping;
the hand itself seems
almost blurred now,
softened, though
tentative only
because so much will
must be summoned,
such attention brought
to the work—which is all
he is now, this gesture
toward the restless splendor,
the unruly, the golden,
the animal, the new.

Mark Doty, “Atlantis” from Atlantis: Poems. Copyright © 1995 by Mark Doty.
Source: Atlantis (HarperCollins Publishers Inc, 1995)

It’s World AIDS Day. Epi changes in HIV/AIDS.

CDC – Geographic Distribution – Statistics Overview – Statistics Center – HIV/AIDS.

Some highlights:

-> Largest percentage of newly diagnosed infections: The South

-> Largest percentage of people living with AIDS: Dixie

-> Largest percentage of deaths from AIDS: Former Confederate States of America

Racial disparity also observed (new diagnosis highest in African-American population, particularly African-American women).

What does it mean? The epidemiological profile of AIDS has changed quite a bit since the 1990s. HIV/AIDS needs to be on the radar for health care providers (and people having sex) everywhere: in the south, in rural areas, as well as major urban areas, the northeast, and the west coast. Screening should be taking place at every primary care visit and, since it is often used as a primary care, the Emergency Department. Normalizing HIV screening as one of those tests we do for everyone at every point of contact just makes sense. Broken leg? How about a side of HIV screen gratis b/c of Obamacare?

I’ve been HIV tested 3 or 4 times and I promise you it is fun and easy. Do it! Ask your doctor or nurse if they offer the test to everyone. If no, why not?

TBT to an actual American epidemic

For the time being the news cycle won’t let go of Ebola in the US. I’m not interested in that, but thanks to Ebola you no doubt have heard of Dr. Anthony Fauci, the director of the NIAID (National Institute of Allergy and Infectious Disease) at NIH. Dr. Fauci took that post in 1984 and the man has a special place in my heart because of the progress the institute made on his watch thanks to the venerable AIDS activist group, ACT UP.

Really this is just a plug for the best documentary in years and best health-related documentary probably ever, How to Survive a Plague. Watch it and weep. These activists are responsible for the restructuring of the FDA drug approval process to allow fast tracking for AIDS and cancer drugs. They forced their way onto previously closed committees at NIH, creating transparency in the clinical trial process and giving a voice to patients affected by whatever the disease in question. I get teary at the protest scenes outside of the NIH and the FDA and the march at the first AIDS quilt (which I will be forever thankful to my mother for dragging me to though I had no idea what it meant at the time). This documentary stokes the dying embers of my heart. Truth to power. Policies can be changed. Advocacy makes a difference.

Sorry for the preaching but you have to love 80s Dr. Fauci.