To place the same restrictions on monogamous gay couples as those placed on straight men who have unprotected sex with multiple partners, or intravenous drug users, is simply inexcusable policy. Orlando blood-donation clinics could assess the actual risk posed by gay donors based on the status, identity, and number of partners they have. While MSM do still make up the majority of new and current HIV infections, the label itself says nothing about individual status, and blood donation centers have had the tools to actually assess that status for decades. Unprotected penetrative anal sex is the most common way of acquiring HIV, but its risks hinge on factors that make sex risky for everyone: sex with multiple partners, non-awareness of HIV status, and lack of protection. It is a restriction simply not based in science. That same deferral is now keeping members of Orlando’s LGBT community and other potential donors across the country from supporting victims of the Pulse massacre in one of the most basic ways that Americans have always responded to violent tragedies. The deferral is based on sex at birth, a unique handicap for transgender people that illustrates its ridiculousness.
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Despite that technology, the lifetime ban somehow persisted until 2015, at which point it was replaced by a one-year deferral. Since 2002, the FDA has approved blood testing that can identify the HIV virus within just a few weeks of exposure. Now, even that one-year ban is questionable. Based on the science then, and doctors’ limited knowledge of risk, banning men who had sex with men within the last year was maybe a defensible policy. The only issue was that HIV antibodies could remain latent for several months. The Western Blot improved this process in 1987, and since then medicine has had the ability to correctly identify HIV-infected blood at close to a 100-percent success rate. In 1985, however, the FDA approved a new test, known as ELISA, that could detect antibodies produced against HIV. The original 1983 ban was an emergency protocol for an beleaguered public-health field that had no reliable way to test blood for HIV. These bans progressed not with scientific understanding of HIV, but against it.
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Despite a 2015 move by the FDA to change the deferral for MSM from a lifetime ban to a year without sexual contact with another man, at least 20 other countries have followed the United States’ lead and implemented lifetime bans. In 1992, the FDA finally recommended the lifetime ban for MSM that became the American and global standard for over 20 years. In 1986, the guidelines became de facto mandatory exclusions of men who had sex with men in the previous 10 years. After the mode of transmission was fully understood by the medical community, the FDA’s 1983 guidelines asked men who had sex with multiple male partners to refrain from donation. The MSM population was the epicenter of the HIV panic of the mid-80s. The original blood-donation rules for men who have sex with men, or MSM––a designation designed to encapsulate sexual activity instead of orientation––were actually less restrictive than current rules. * Even after the most deadly act against gays, lesbians, bisexual, and transgender people in American history, the built-in homophobia of American public health keeps the country from mounting the most effective possible response. Specifically, men who have had sex with men in the past year are still barred from donating blood because of a rule from the Food and Drug Administration. Many potential donors, however, found themselves blocked at blood centers. One of the ways people in Orlando tried to help victims was through blood donations.
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The Democrats’ Midterm Identity Crisis Ronald Brownstein