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Bad blood 

Just after the events of 9/11, a woman waiting on me in a department store saw the telltale signs of blood having been drawn from my arm and thanked me for giving blood in response to the call for rank-and-file citizens to serve others with the "gift of life." But, I had not given blood that day. Indeed, despite the fact that I have a particularly desirable blood type, I've never given blood. For my entire adult life, the blood of all gay men has been rejected — initially by the Red Cross and then, starting in 1985, by a policy of the Food and Drug Administration — for the fear of HIV contamination of the blood supply. This is despite the fact that all blood is now strenuously tested for a variety of infectious diseases before entering the blood supply. Over time, as other signs of anti-gay discrimination have faded in American society, the lifetime ban on gay men donating blood remains a glaring reminder of historical antipathy.

Last month, however, the first steps towards overturning the policy were taken when members of the federal Department of Health and Human Service's advisory committee on blood safety heard testimony from medical professionals that it's time to end the lifetime ban on gay men's blood donation. This follows the announcement last year that the American Medical Association (AMA) favors a shift in the policy "to ensure blood donation bans ... are applied to donors according to their individual level of risk and are not based on sexual orientation alone."

At the grassroots level, boycotts of blood drives are growing on college campuses — key venues for the Red Cross to collect large amounts of blood and recruit new generations of donors each year — in response to the persistent ban. Activists and health professionals alike are right: It's time for the archaic policy — reaffirmed regularly across the last three decades by the FDA — to go. It's a change that's right in terms of both public health and social equality.

In the early days of the AIDS crisis, when so little was known about the origins and transmission of HIV and when the health crisis was centered in the gay male community, limiting gay males' blood donation made public health sense. Many longtime donors stopped giving blood because out of fear they would come in contact with a contaminated needle. Even more problematic, those most dependent upon the nation's blood supply, such as hemophiliacs, were susceptible to the introduction of HIV into the system. One famous early victim of the tainted blood supply was Arthur Ashe, the tennis champion who became infected from a transfusion during heart surgery. So, a short-term ban on men who'd had sex with other men made sense to respond to this still-mysterious crisis.

However, fairly quickly, ways of ascertaining HIV status were developed, we became more knowledgeable about the how the virus was (and was not) spread, and it became clear that HIV/AIDS was not a crisis facing just the gay male community. Despite these changes, the lifetime ban on gay men stayed in place even as a strict regimen for testing all blood was established and it became clear that other groups in American society also had elevated rates of HIV transmission.

What now makes more sense, as last year's AMA statement emphasized, is to respond to the risky activity of individuals rather than on barring donations for life by an entire group of Americans. No matter one's sexual orientation, those who engage in risky behavior should be barred from donating blood for a period. (At present, those who are straight but have had sex with an HIV-positive opposite-sex partner or with a prostitute or who have used IV drugs are eligible to give blood as long as they wait a year.) Gay men who are monogamous or engage in safe activity should be encouraged to donate to enlarge the pool of donors and to remove one of the last vestiges of a once prevalent view that gay individuals are "sick" and an inherent risk to the broader community.

Particularly during times of crisis such as a natural disaster or an event like 9/11, giving blood provides an important practical role in making it possible for more to survive. But, it also plays a crucial symbolic role in reasserting the vibrancy of a community when it feels under assault. One group of Americans has been overtly excluded from this expression of community for too long. It's time to welcome them into the fold.

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