A Drive For Change: Reforming U.S. Blood Donation Policies

Published: January 1, 2009

A Drive For Change: Reforming U.S. Blood Donation Policies

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TABLE OF CONTENTS

EXECUTIVE SUMMARY………………………………………………………………………………………. ii
INTRODUCTION………………………………………………………………………………………………….6
BACKGROUND……………………………………………………………………………………………………8
     OVERVIEW OF CURRENT MSM DONOR POLICY…………………………………………8
     ORIGINS OF THE POLICY ……………………………………………………………………..9
     BLOOD DONATION POLICIES FOR OTHER HIGH-RISK GROUPS ……………………11
     IMPACT OF THE CURRENT POLICY………………………………………………………..11
     OPPOSITION TO THE POLICY……………………………………………………………….12
INTERNATIONAL CONTEXT……………………………………………………………………………….13
     MANY COUNTRIES HAVE MSM POLICIES SIMILAR TO THE U.S. POLICY ………..13
     AN INCREASING NUMBER OF COUNTRIES HAVE REFORMED MSM POLICIES…..13
     SOME COUNTRIES ASK NON-MSM DONORS QUESTIONS ABOUT HIGH-RISK
     SEXUAL ACTIVITY …………………………………………………………………………….14
RECENT DEVELOPMENTS…………………………………………………………………………………16
     ADVANCEMENTS IN HIV SCREENING …………………………………………………….16
     RECENT ACTIONS BY THE FDA……………………………………………………………17
THE D.O.N.A.T.E. FRAMEWORK: THE ESSENTIAL ELEMENTS OF A SAFE AND
EFFECTIVE BLOOD DONATION POLICY …………………………………………………………….20
WHY THE CURRENT POLICY FAILS …………………………………………………………………..22
ASSESSING THE ALTERNATIVES ………………………………………………………………………25
     ALTERNATIVE 1: INSTITUTE A TEMPORARY DEFERRAL PERIOD FOR MSM
     DONORS………………………………………………………………………………………..25
     ALTERNATIVE 2: ELIMINATE MSM BAN BY REVISING AND CONFORMING
     DEFERRAL PERIODS FOR ALL PROSPECTIVE DONORS BASED ON OBJECTIVE
     RISK FACTORS……………………………………………………………………………….. 30
CONCLUSIONS AND RECOMMENDATIONS……………………………………………………….33
QUESTIONS FOR FUTURE RESEARCH………………………………………………………………36
APPENDIX A: DONOR HISTORY QUESTIONNAIRE……………………………………………..38
APPENDIX B: ROSTER OF THE BLOOD PRODUCTS ADVISORY COMMITTEE……..41
NOTES……………………………………………………………………………………………………………..44

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