Why the hell can’t you donate blood in America if you’ve had sex with another man?

a number of people are dead as a result of HIV getting into the blood supply. A certain number of haemophiliacs for example.

People have heard of this precautionary principle, yes?

21 thoughts on “Because….”

  1. It’ s what we might call the hamburger principle. If you get a blood transfusion you’re likely to have blood from 100 to 1,000 people in you.

    Testing is nowadays good. But it’s not infallible.

  2. OK, so we’re fans of economics here – let’s do a cost-benefit analysis. What is the cost of using blood from men who have had sex with men compared to the cost of *not* using it? How many QALYs are lost from insufficient blood supplies? How many would be lost from false negative HIV testing of donated blood?

  3. Brits can’t donate in Germany because of mad cows either.

    Incidentally I many years ago worked on the licensing for one of the widely used donation screening techniques. You do still want to keep the amount of infected blood in the supply chain low, because individual donations are not all individually tested unless they’re part of a pool that comes up positive. And this is now more about cost and availability than the risk of infection transmission. I think there is a theoretical one transmission per year worldwide from screened blood.

    The more positive pools the more individual donations need testing, the more that costs, and the older the blood gets before it can be used. That can be critical for certain blood products.

  4. I’m well off their list anyway.

    “Hello sir, have you considered giving blood?”
    “Why yes, yes I have! In fact I’d love to! After working the last 3 years in Nigeria I learned that I ought to contribute to the wellbeing of mank…”
    “Yes! Wonderful place!”
    “Oh. Sir, we might have a problem…”

  5. And Australia. Fortunately (I really hate needles) I have several different bans to fall back on if anyone ever tries to legalise me donating blood.

  6. Similarly Matthew L (I’m a Matthew too- great name). I used to donate blood in the UK and in Oz. Then when the JCD scare came up, I was banned.

    At my last donation, I told the nurse I was about to be banned. She laughed, stuck the needle in my arm and took the pint.

    On the “not giving a fuck” scale, she took a 9.5.

  7. With apologies to Donald Rumsfeld:

    There are knowable unknowns, such as “is this blood tainted with HIV?”; but there are also unknowable unknowns: “Is this blood tainted with a mystery blood infection which we won’t discover for another twenty years?”

    Any cost/benefit analysis has to take into account the risk of unknown diseases which only become apparent decades later, just like HIV was.

  8. Andrew M


    You what?
    OK, so tell us how you “account” for unknown unknowns then.
    (And don’t say: Get Richie to do it?)

  9. Better still, tell me what the risk factors will be for the unknown unknowns.

    Any way, I am also off the list. Neither Iraq nor Afghanistan are approved locations for donors to spend their “holidays”.

  10. BiF, S2,
    With difficulty. But given the priors (HIV, CJD, etc.) it’s entirely possible to derive a reasonable estimate of the unknowns. It’s similar to the German tank problem.

  11. Matthew L,
    No, I’m simply pointing out that it’s entirely rational to exclude from the pool of donors people who frequently expose themselves to blood-borne illnesses, known or unknown.

  12. Andrew M: That would be the entire sexually active population then? Or are you ok with gay men in monogamous relationships donating blood?

  13. So Much for Subtlety

    Surreptitious Evil – “Better still, tell me what the risk factors will be for the unknown unknowns.”

    Well what have been the past problems with the blood supply? HIV killed a lot of people. Hepatitis made a lot of them sick. And then killed some of them. Mad Cow Disease? Not so much but it is possible.

    Heterosexual sex of the non-anal variety has evolved over the course of the past 100,000 years or so to be pretty tough when it comes to spreading disease. Anal sex, not so much. Gay people are more likely to have HIV and Hepatitis.

    So the simple precautionary principle is what they do – no Gays. Especially if they like hamburgers.

  14. @ Tim Newman
    I got taken off the list because they kept saying I was verging on anaemic. The first time I was turned down I’d done 40 press-ups the previous evening because I wasn’t feeling tired enough at bedtime and I needed to get to sleep: I just stared at the weedy young doctor; the last time I was turned down was a few weeks after I had won a county AAA over-17* championship (far from the most competive of such but still).
    The precautionary principle is sound but the practice verges on the idiotic.
    *I would have thought that winning even an over-50 race would have implied that I wasn’t anaemic.

  15. So Much for Subtlety

    Matthew L – “More straight people than gay people have anal sex.”

    Only because, to a first order approximation, there are no Gay people.

    But that is not the issue. As long as a couple have sex within a relationship, more or less, it probably doesn’t matter. What causes HIV to be a problem is indiscriminate sex with heroically large numbers of people – either anally or with a co-infection. If some married couple in Basildon have anal sex once in a while, it makes next to no difference. If a Gay man goes to a bath house, smokes from crystal meth and has sex with a couple of dozen random men over 36 hours, it does.

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