HT ran a story today on how Sir Ganga Ram Hospital in Delhi has banned homosexuals from donating blood: http://www.hindustantimes.com/StoryPage/StoryPage.aspx?sectionName=HomePage&id=11b758bb-541e-462c-81a5-d2e1b459b1bf&Headline=Blood+banks+outlaw+gay+donors+despite+shortages The story is drawing attention both within the community and the media and it looks like it may be taken further, but some caution is needed because the issue is a bit more complicated than it seems. I've spoken to Ramki in Chennai whose background in Public Health and the US gives him some knowledge about this, and here's some relevant information and possible response: - The hospital's blood ban quite probably follows the norms for blood donation laid down by the US's Food and Drug Administration, which lays down the public health guidelines in such cases. This guideline has been in place since the start of the AIDS plague in the Seventies, and has never been lifted, although there has been opposition to it, both outside and within the FDA. The FDA votes to sustain the ban have become increasingly narrow and its possible it might change at some point. - The FDA does have some logic on it's side. Donated blood is always tested for HIV, but only with an antibody test which shows presence of the virus around three months after infrection. So there is a possibility of infected blood that is within the window period passing the test. Given the lifelong consequences of AIDS, from a public health point of view this does suggest that the authorities should be cautious over here, and one way of doing so would be to ban high risk groups for HIV/AIDS which does include homosexuals. - The point where the FDA ban does become discriminatory though is that this rigour is applied more strongly to homosexuals than to heterosexuals, who could well be within the window period as well. A more stringent policy would involved very detailed tests on people's sexual history regardless of their sexual orientation. (Ideally, I guess, there should be molecular tests for the virus rather than antibody tests on all blood donated, but this would probably have major cost and time implications). - Our guess is that the Delhi hospital has applied this American policy directly, perhaps in reaction to the 377 judgment (the HT report doesn't make it clear if this was in place before). But whenever it was done its a policy that doesn't make too much sense because: (a) in India, unlike the US, the vast majority of HIV affected people are heterosexual (b) the stigma attached to homosexuality means that people are unlikely to be honest about their sexual preference, so its a pointless question. (c) its not a requirement by the Indian medical authorities, which probably have a realistic view of the matter, so the Delhi hospital does seem to be overstepping the limits in a homophobic way. - This is just a suggestion, but a possible recommendation for hospitals who want to be ultra cautious is that they should ask detailed questions about a subject's sexual history with relation to multiple partners, periodicity and protected or unprotected sex, but should make it clear at the start that there is no moralistic judgment involved here and that the fact of the partners being male or female will make no difference to the decision about whether to accept the blood.
