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Lift the Ban:

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by

Joanna Alicea

on 24 April 2014

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Transcript of Lift the Ban:

Lifting of Blood Donation
Twelve Month Deferral
Five Year Deferral
# Eligible to Donate
2,603,004
845,714
# Likely to Donate
130,150
53,269
42,286
# of Pints Donated
219,200
89,716
71,218
1,065,375
Lift the Ban:
let the blood flow
By Joanna Alicea, Joseph Allaire, Julia Alves RN, Matthew Blanchette, Katie Hammond, Elizabeth Medbury, KaSondra Orlando, & Ashley Simonds
Professor Blanchette
>1
MILL
ARE LIVING WITH HIV IN THE U.S.
1
IN
LIVING WITH HIV
6
ARE OF THEIR
INFECTION.
UNAWARE
ABOUT IN NEW HIV INFECTIONS
IS AMONG YOUTH AGES 13-24.
1
4
MOST DO NOT KNOW THEY ARE INFECTED,
ARE NOT GETTING TREATED
, AND CAN UNKNOWINGLY PASS THE VIRUS ONTO OTHERS.
BLACKS/AFRICAN-AMERICANS
CONTINUE TO HAVE
THE
HIGHEST
RATES
HIV in the U.S.
NEW HIV INFECTIONS IN 2011 IN U.S.
0
3,000--
6,000--
9,000--
12,000--
WHITE MSM
BLACK MSM
HISPANIC MSM

HETEROSEXUAL
BLACK IVD
BLACK IVD
NUMBER OF NEW HIV INFECTIONS
11,810
7,266
10,375
What are the problems?
wHY ARE MSM permanently DEFERRED?

According to the FDA, a history of male-to-male sex is associated with an increased risk for exposure to and transmission of certain infectious diseases, including HIV.
(FDA, 2013)
“This is because MSM are, as a group, at increased risk for HIV, Hepatitis B and certain other infections that can be transmitted by transfusion.” -FDA
There are 9.2 million blood donors and 15.7 million blood donations collected in the U.S. each year.
38% of the U.S. population is eligible to donate but less than 10% actually do each year.
(American Red Cross, 2013)
blood supply
blood demand
National blood shortage
Risk for unsafe blood supply
Social inequality for MSM
Over 41,000 blood donations are needed in the U.S. every day.
Every 2 seconds a person in the U.S. needs blood.
About 1 in 7 patients that enter the hospital need blood.

Healthy People Objective BDBS 17:
“Increase the proportion of persons who donate blood.”






Healthy People Objective BDBS 19:
“Reduce the proportion of persons who did not receive a transfusion due to a blood product shortage.”
healthy people 2020
worldwide msm blood donation
Canada 5 year deferral
South Africa 6 month deferral
Britain 1 year deferral
Australia 1 year deferral
VS
Risk for inadequate blood supply for blood recipients related to antiquated policies as evidenced by lifetime deferral by fda (MSm, prositution, ivd).



risk for unsafe blood supply for blood recipients related to inadequate screening policies as evidenced by lack of in depth blood donor sexual history questionnaire.


Diagnoses:
Social inequality for msm community related to fda blood donor policies as evidenced by lifetime deferral not supported by scientific research.
Enforce
current policy
support
new policy
Community affected?
Consequences of the health problem?
Evidenced-based interventions
Gaps in current policies/interventions
Proposed public policy solution
Who gains?
nursing practice Implications:
Under the current policy

References
Outdated policy
everyone!!
Safer Blood Supply
Advances in Scientific Testing
Non-Discrimination Practice
Implication on delivery of health care
Did you know?
1 person
is only allowed
6 pints
of blood donation within a year.
please donate blood
1,087
716
Estimated Probability of Acquiring HIV from an Infected Source by Exposure Act.
Type of Exposure (Risk per 10,000 exposures)

Blood Transfusion - 9,000
Needle-sharing during IVD - 67
Percutaneous (needle-stick) - 30
Receptive anal intercourse - 50
Receptive penile-vaginal intercourse - 10
Insertive anal intercourse - 6.5
Insertive penile-vaginal intercourse - 5
Receptive oral intercourse - low
Insertive oral intercourse - low
(CDC, 2013)
the average transfusion requires
3 pints
of blood
American Red Cross. (2013). Blood Facts and Statistics. Retrieved February 13, 2014, from:
http://www.redcrossblood.org/learn-about-blood/blood-facts-and-statistics

Caplan, A. (2010). Blood Stains-Why an Absurd Policy Banning Gay Men as Blood Donors Has
Not Been Changed. The American Journal of Bioethics, 1526-1561.

Center for Disease Control. (2013). Estimated Per-Act Probability of Acquiring HIV from an Infected Source. Retrieved March 20, 2014, from:
http://www.cdc.gov/hiv/policies/law/risk.html

Food & Drug Administration. (2013). Blood Donations from Men Who Have Sex with Other Men
Questions and Answers. Retrieved , February 13, 2014, from:
http://www.fda.gov/biologicsbloodvaccines/bloodbloodproducts/questionsaboutblood/ucm108186.htm

Gay Men's Health Crisis. (2013). Retrieved February 16, 2014, from:
http://www.gmhc.org/advocate/key- issues/msm-blood-ban#whataregmhcs

Goldberg, N. G., & Gates, G. J. (2010). Effects of Lifting Blood Donation Bans on Men Who Have
Sex with Men. Retrieved February 20, 2014, from The Williams Institute:
http://wiliamsinstitute.law.ucla.edu/wp-content/uploads/Gates-Goldberg-MSM-Blood-Ban-Jun_2010.pdf

Healthy People.gov. (2013). Blood Disorders and Blood Safety. Retrieved , February 13, 2014, from:
http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=4

Huffington Post. (2013). Elizabeth Warren Calls for Changes To Ban On MSM Blood Donations. Retrieved
February 13, 2014, from:
http://www.huffingtonpost.com/2013/08/02/elizabeth-warren-msm-blood-ban_n_3695965.html

Quigley, M., Baldwin, T. Enzi, M., Warren, E., & Barbara, L. (2013). Letter to The Honorable
Kathleen Sebelius. Retrieved February 20, 2014, from
http://www.warren.senate.gov /files/documents/Bicameral%20MSM%20Blood%20Ban%202013.pdf

U.S. Department of Health and Human Services. (2005). The 2005 Nationwide Blood Collection
and Utilization Survey Report, Department of Health & Human Services. Retrieved February 18, 2014, from:
http://www.bloodcenters.org/blood-donation/facts-about-blood-donation/

U.S. Department of Health and Human Services. (2013). Vaccines, Blood, & Biologics. Retrieved
February 18, 2014, from U.S. Food and Drug Administration:
http://www.fda.gov/biologicsbloodvaccines/bloodbloodproducts/questionsaboutblood/ucm108186.htm

Due to current policy: Men who have sex with men (MSM), even once since 1977, have a lifetime deferral for blood donation & lack of thorough blood donor sexual history questionnaire...
(FDA, 2013)
Update the Donor History Questionnaire

The ban be replaced with a policy that identifies a reliable subset MSM that defers high-risk MSM.

As of July 2013, 21 countries have replaced lifetime MSM blood bans with deferral periods for MSM that vary in length from six months to five years.
It supports a false perception that heterosexual people are at low risk for HIV infection.

It reduces the availability of blood across the country.

There is strong opposition to blood drives at many colleges.

It reinforces negative stereotypes about gay and bisexual people.
If a donor has paid for sex or is a female who had sex with MSM =
1 year deferral
If a donor has ever, even only once, received money for sex, did IVD, or male MSM =

lifetime deferral
BUT still requires a total of
5 donors
to make
1 pint
.
Blood recipients
Russia NO ban
Mexico NO ban
because not everyone can!
Nucleic Acid Testing (NAT)
Please sign the petition to show your support and go to:
http://banned4life.org
Possibility of inappropriate release of quarantined blood or blood products
MSM population
nursing practice Implications:
Under the new proposed policy
"Giving blood is not a right, it is a gift."
- Dr. Carolyn Young, Vice President and Chief Medical Officer at RI Blood Center.

"For me, this has been a basic issue of fairness and of science - blood donation policies should be grounded in science, not ugly and inaccurate stereotypes."
- Senator Elizabeth Warren of Massachusetts

"Not a single piece of scientific evidence supports the ban."
- Senator John Kerry of Massachusetts
Local Views on MSM blood donation
If only
one more percent
of all Americans would give blood,
blood shortages
would disappear for the foreseeable future.
Lifetime Deferral
Nurses are forced to discriminate despite current scientific advancements in testing and screening.

Nurses are forced to reduce the blood supply by deferring people.

Nurses are forced to put the blood supply at risk by not screening out other individuals who participate in even higher risk behavior.


11,903
Lifting of Blood Donation Ban
One-Year Deferral
Five-Year Deferral
# Eligible to Donate
2.6 MILLION
OVER 1 MILLION
>845K
# Of Pints Donated
>219K
>89K
>71K
could
Nurses will have to use a new questionnaire.

Now the nurses role is to go through the new questionnaire on a more personal level, specifically regarding sexual practices rather than sexual orientation.

Provides an opportunity for community education.

Nurses would need to provide more education including info
about the Nucleic Acid Testing.
Blood screening/NAT testing window period
Deferral of donors with high-risk exposure depend on reliable responses
Current policy defines high risk as being a MSM
(American Red Cross, 2013)
(CDC, 2013)
(CDC, 2011)
(Goldberg, N.G. & Gates, G.D. 2010)
Full transcript