- Opinion
- 15 Mar 05
The Irish Blood Transfusion Service has for some time been making life extremely difficult for homosexual men who wish to donate blood. Whilst the ban has largely gone unnoticed until now, as Ciara Cunnane reports, gay men are no longer prepared to tolerate what they see as a discriminatory system. Photoography by Cathal Dawson.
When Will O’Connell [pictured] was 18 he decided to donate blood for the first time. Like all new donors he was given a detailed questionnaire to fill out, ranging from ‘Have you ever had an STI?’ to ‘Have you taken any medication in the last four weeks?’ One of the last questions he was asked was ‘Have you ever had oral or anal sex with another man (even if condoms were used)?’
Being in denial about his sexuality and far too embarrassed about his one gay experience to admit it to a complete stranger, Will lied. He passed the test and gave his pint. If he had told the stranger across the desk the truth, he would have been turned away.
The Irish Blood Transfusion Service (IBTS) enforces a life long ban on men who have ever had oral or anal sex with men, even if a condom was used, from donating blood. This is in line with the majority of policies of blood transfusion services in the developed world.
This policy was first introduced in the early 1980s when it became apparent that HIV could be spread by blood transfusions, and at a time when gay men represented the largest identifiable source of HIV transmission. The ban on gay men was adopted before a test for HIV infection in blood donors was developed, and was very successful in reducing transmission of HIV from transfusions.
However, what was once a necessary measure has become a major bone of contention. The IBTS’ website acknowledges that “this policy causes considerable offence: it is clearly discriminatory against gay men, and categorises all gay men as being at increased risk of HIV.”
People who have spent a year or more in the UK between 1980 and 1996 are also banned for life, as are those who received blood transfusions outside the Republic at anytime. If you are a woman who has had sex with a man who has had sex with another man, there is a 12 month ban.
There is also a 12 month ban if you have had sex with someone from Africa or South East Asia, where HIV is hugely prevalent. After getting a tattoo or piercing, people must not donate for six months. There are temporary bans on people who have contracted an STI and donators suffering from cold sores or flu are asked to come back after their ailments have cleared up.
However, many gay and bisexual men take offence at the fact that they are considered to be a ‘high-risk’ category along with prostitutes and drug addicts, even if they have not participated in unprotected sex.
Currently, the loudest voices of protest are student LGBT organisations. The UCC LGBT society held a three day petition during the IBTS’ college donation campaign in November. UCC LGBT Auditor, Mike Wauldron said; “A lot of universities and colleges have banned the blood bank coming to their campuses. We felt that was destructive. This way we had our petition and raised awareness while the IBTS got their blood.” Mike said the group gathered 3000 signatures during the petition, which “in a campus of 16,000 people is a lot.” They will be sending their findings to the Equality Authority and have been seeking support from local politicians.
The ban is not well known, even among prominent public figures. Labour’s Health spokesperson, Liz McManus, said she didn’t know enough about the ban to comment either way. Sinn Féin TD Seán Crowe said, “It’s not an area I know much about, but as long as they’re healthy sexual preference shouldn’t be an issue. The argument about gay men being more promiscuous just doesn’t add up.”
Trinity Law lecturer and barrister, Ivana Bacik wasn’t aware of the ban either and was “frankly surprised that they would adopt such a ban purely on the grounds of sexuality. The ban may have the unfortunate effect of contributing to a stigmatisation of gay men in Irish society.”
The Equality Authority’s press officer said, “As it stands, someone could probably take a case against the IBTS. The Equality Authority doesn’t have an official line on the issue because no one has of yet taken a case; it depends on the individual to do so.”
An IBTS source who wished to remain anonymous said, “I think it’s an unfortunate necessity. I don’t personally think that rates of HIV are higher in females; I think that potentially young gay men take fewer precautions than women.”
She also said that the 52 questions one has to fill out before donating are quite heavily based on sexual relations, “whether heterosexual or homosexual. People who sleep around on a regular basis are asked not to give blood. All the restrictions affect some people – if you suffer from cold sores on a regular basis you may find you can never give blood either.”
The IBTS’ website actually cites two reasons for the ban: “While the testing currently used by the IBTS is the most sensitive available, no test can reliably detect infection in the first ten days after someone has become infected. This means that a person who donates blood soon after becoming infected with HIV can transmit the infection even if the test for HIV is negative.”
But why does the lack of reliable testing affect homosexual males donating and not heterosexuals? According to Dr. Ellen McSweeney, donor consultant with the IBTS, “Of course the window period applies to both heterosexuals and homosexuals, but we do not take donations from heterosexual donors who have had risky behaviour until 12 months thereafter. If the risky behaviour continues they are permanently excluded from donating blood.”
The IBTS thus conclude that this lack of reliable testing means that “all persons who are identifiably at increased risk of HIV are excluded.” But they admit earlier in the statement that “in recent years heterosexual females have overtaken IV drug users and homosexual men as the largest group of new HIV cases in Ireland.”
They clarify this in parenthesis: “most of the heterosexual females who developed HIV infection in recent years would have been rejected blood donors on the basis of residency in sub-Saharan Africa or other identifiable risk.”
Dr. Sweeney also said, “We know that people living in Ireland who have become HIV positive through heterosexual intercourse have generally had a definite risk factor, for example they have had sex with an intravenous drug user or with a person from Sub-Saharan Africa.”
The second reason given causes the most offence. The IBTS say that HIV was first seen among gay men and “this indicates that men who have sex with men may constitute a route in the future through which a new disease … could find its way into the community before it is detectable”.
Dr. McSweeney denied that the IBTS were trying to suggest that gay sex creates blood diseases, but “we have to bear in mind that new infections may emerge in the future that are transmissible by blood transfusions.” However, this still doesn’t explain why the IBTS thinks the emergence of future diseases would be spread by the gay community, and not the straight.
Will O’Connell proposes that gay men should present themselves as donors at IBTS clinics because, “in being refused, we would at least be less invisible as a group and would be demonstrating that we are not amongst the feckless-can’t-be-arsed to which the IBTS continually advertise.”
Will registered to donate and after his refusal he wrote to the IBTS questioning their policy. Dr. Ellen McSweeney thus provided a further explanation as to why gay men are banned, one which is very hard to get from the IBTS. She said that transfusion services in the UK and Ireland collect three million donations every year of which an average of 20 are confirmed positive for HIV, and that between a third and half of these donations come from men who eventually confirm that they are gay or bisexual, though they had not declared this at the time of their donation.
However, O’Connell says such men are first and foremost liars. “In order to have evaded detection he would have had to have lied not just about having sex with another man, but also in other questions, such as having unprotected sex. If you open up to a gay community who tells you the truth about their sexual history then you can judge it on the same merits as heterosexuals.
“Secondly, records of HIV positive samples from men who have sex with men represent a percentage of the total sample of between 0.00025% and 0.000167%. To use such an infinitesimal ratio with which to draw generalisations is not just bad logic, but a manipulation of statistics.”
According to the British Medical Journal, “The most common mode of transmission of AIDS throughout the world is by sexual intercourse. Whether this is anal or vaginal is unimportant. Even though infections amongst men who have sex with men still arise, an increasing proportion of new infections in the USA are occurring amongst injecting drug users sharing equipment. There is also an increase amongst heterosexuals in both the USA and the UK.”
A summary of the latest figures (2003) of the National Disease Surveillance Centre in Ireland shows that in 2003 there were 399 new cases of HIV. Of these, 221 were heterosexually acquired, of which 181 (81.9%) were born in sub-Saharan Africa and 30 (13.6%) were born in Ireland.
In America in 2002 an FDA (Food and Drug Administration) vote to overturn the lifetime ban on gay men lost out by one vote: 7-6. At a meeting of the FDA Blood Products Advisory Committee in September 2000 the American Association of Blood Banks and America’s Blood Centres who together collect more than half the blood in America, asked for the lifetime ban to be lifted.
The US has recently modified its ban on gay men, to men who have had sex with another male at any time since 1977. The IBTS’ website says, “It is possible that Europeans would consider such a move in the future, however the practical consequences are likely to be minimal.”
Padraic Whyte thinks the ban on gay men donating blood is part of a wider stigma attached to homosexuality. “The Taoiseach has said that there’s nothing ‘immoral, illegal, or improper’ about homosexual relations. Yet there is hypocrisy in government policies. The prohibition on giving blood and the prevention of gay marriage still affects people’s perceptions of the gay community.”
Will O’Connell says, “The IBTS are taking the role of least resistance, it’s easier to trample on the minority. There is a lot of prejudice and ignorance around gay issues and I think if the IBTS took away the ban there would be a lot of right wing people saying this is a disgrace. It can be used as a political vehicle as well.”