As years go by, it is easy for the human psyche to accept certain situations as "normal", even if they’re not.
Take, for instance, the current stance of the Canadian Blood Services (CBS) banning blood donations by any male who has had sex with another male after 1977.
When the policy was first initiated, AIDS was cutting a deep and devastating swath through the gay population and there was mounting evidence it was moving into the general population as well. AIDS hysteria was rampant, with even health care workers refusing to touch someone with AIDS, or even enter a hospital room containing someone with AIDS. It was a dark, dreadful, paranoid time. Nobody was even sure how AIDS was being spread and common beliefs at the time maintained it was possibly airborne, or that one could be infected by exposure to perspiration, saliva, tears...and there were many tears....
Subsequent research, of course, eventually showed the virus believed to cause AIDS (and we are still in the "believed to cause" stage, even after over 30 years) was specific to two body fluids; semen and blood. And even at that, in order to be infected, or even at risk for infection, one has to be directly exposed to semen or blood and have it enter one’s own bloodstream. This is the whole premise behind "safer sex"....minimizing the exposure of possibly infected semen gaining access to one’s bloodstream through minute tissue tears of the anus or mouth or vagina, a normal occurrence during sex and, normally, not much of an issue at all.
When it comes to blood transfusion, meaning the direct introduction of someone else’s blood into one’s own blood stream, the concern is obvious. In those early days of the disease, those who relied on transfusions such as haemophiliacs or those who had experienced some sort of trauma and required a transfusion during surgery, were at considerable risk of contracting HIV. Prior to the development of various drugs and therapies that interfered with the rapid mutation of HIV into full-blown AIDS, the normal course of the disease, from diagnosis of HIV to death, was often a matter of months rather than years. Now, of course, those who are HIV-positive can, and do, live for years and never develop full-blown AIDS; HIV is now "just" a manageable and chronic disease, not the death sentence it once was.
But back then, that was the climate when the Red Cross, the agency then responsible for the dissemination of blood and blood product into the general population, created the policy of banning donation by men who had had sex with men. It followed some highly publicized occurrences of recipients becoming infected with tainted blood/blood product. The Red Cross eventually got out of that area of the business and the Canadian Blood Services was created, yet the policy against accepting blood donation from any male who had had sex with another male after 1977 remained in effect.
Various gay organizations and AIDS service organizations, including Egale Canada and CAS, have fought against the blanket ban for years, arguing it unfairly discriminates against gay and bisexual men and, in fact, stigmatizes us as "AIDS carriers". The facts do not support a blanket ban. It is not having sex with another male which puts one at risk for contracting HIV, and passing that infection on, but the type of sex one has had. If one’s "sexual style" only involves mutual masturbation and perhaps some oral, which the Canadian AIDS Society (CAS) has identified as ‘low risk’ for HIV infection, that is quite different than someone who is the recipient partner of bareback anal sex where semen is ejaculated inside the anus, classified as ‘high risk’ by CAS.
The ban does not take this into consideration at all. It also maintains that if one has had sex even just one time with another male since 1977, that is reason enough to disallow the individual to donate blood. It does not take into consideration the actual health status of the donor. One can be truly HIV-negative and never engaged in risky sexual or drug use behaviour (i.e. sharing needles) but if you are open about your sexual history with men, the Canadian Blood Services will not permit you to donate blood.
This, of course, creates a Catch-22 situation. One can be perfectly healthy, a prime candidate for donating, but if you are gay, bi, or have had sex with another male since 1977, you are rejected. However, if you do not reveal your orientation or that you "experimented" one time back in 1980 or whatever - in effect, lie - you are accepted. And this has happened, unfortunately. Probably more times than anyone knows about. Alternatively, a heterosexual male who has engaged in high risk sexual behaviour with women is not affected by the ban. This is classic heterosexism at best, certainly a double standard, and could be described as homophobic at worse.
However, CBS now is re-considering the policy. The federal blood donor agency now says it is "acting out of goodwill" when it says it is considering reducing the time that gay and bisexual men, and other men who have sex with men, must wait after having sex before donating blood.
The agency plans to request a relaxing of the rules from Health Canada as it no longer believes a lifetime prohibition is justified, and is funding a $500,000 grant to research a new policy focusing on specific high-risk activities rather than sexual orientation, something those lobbying against the current policy have advocated for years.
This new development is welcome, and long overdue, and there seems to be a new generation with a more enlightened view in the CBS hierarchy. Lorna Tessier, Director of Public Relations for the blood agency, has been quoted as saying the agency will not wait for the results of the research before approaching Health Canada on reducing the deferral period.
"There’s got to be something we can do in the meantime," she said. Whether or not CBS can go ahead and alter the long-standing policy without government approval remains to be seen.
Things seemed to have been spearheaded by a September 2010 Ontario Superior Court decision which, while it upheld the current ban, did add there was "insufficient evidence" to support a lifetime ban.
"We’ve always agreed with that [view]," Tessier said, "So maybe it’s time for us to say...what change can we bring about now?" She adds that there is plenty of relevant information from other countries which allow gay and bisexual men and other men who have had sex with men to donate blood, that to support such inclusion would not compromise the safety and integrity of the national blood supply.
The downside of this, however, is past history. The CBS did consider shortening the deferral period but still called for that period to be lengthy.
The move towards changing a lifetime ban to a deferral period of 5-10 years was rejected by patient recipient groups, who apparently wished to err on the side of caution, but was also rejected by gay organizations since requiring gay and bisexual men to be celibate for 5 -10 years was unrealistic, unfair, and in their view still amounted to a lifetime ban.
With new technologies in the detection of HIV and other dangerous organisms, as well as in the treatment of blood products that effectively destroy any infectious agent including HIV, such bans and deferrals are questionable. Unlike 20 or 30 years ago, we are now able to render the blood supply completely safe. All that is needed is the political will, and funds, to do so. The technology does not come cheap, admittedly, and from a strictly cost-saving perspective I suppose the current policy is somewhat effective, although of course it does not account for those who lie about their history or health status. Utilizing the available technology, on the other hand, would not only open up access to more blood product but would effectively deal with any product that "leaked through" due to the deceit, or lack of awareness, of donors.
We periodically hear, especially in times of disaster, that the Canadian blood supply is depleted or in danger of becoming so. CBS incessantly campaigns for more blood donors to come forward ("It’s in you to give") and is effectively ignoring or denying a significant area of contribution by this ban, and even with its proposed deferral period. The gay community, generally speaking, is a community used to giving, to assisting those in need of assistance. When called upon, we step up. We always have. If the criteria changed from a focus on sexual history and sexual orientation to a focus of behaviour, this would add a fair amount of product to the supply. Plus, utilizing current technologies to ensure the safety of that supply just seems to make sense. Such an approach is used in just about any other industry and could be used, safely and ethically, here.
Clearly, it is not feasible to solely rely on the good intentions of donors. It just isn’t realistic to place the onus on donors to self-monitor or opt out of donating blood. We will always have situations where donors who should opt out of donating, for whatever reason, do not, thereby introducing pathogens or other infectious agents into the existing supply. That is just reality. However, if current technology permits us to screen tainted product and either dispose of it or render it harmless, that is a better way to go than bans - especially bans against a whole population.