Christopher Park, Caroline Gellman, Madeline O'Brien, Benjamin Asriel, Andrew Furlow, Michael Mullen, Girish Nadkarni, Sulaiman Somani, Keith Sigel, and David L. Reich are with the Icahn School of Medicine at Mount Sinai, New York, NY. Andrew Eidelberg is with the Weill Cornell School of Medicine, New York, NY. Ipsita Subudhi and Elizabeth F. Gorodetsky are with the New York University Grossman School of Medicine, New York, NY.
Am J Public Health. 2021 Feb;111(2):247-252. doi: 10.2105/AJPH.2020.305974. Epub 2020 Nov 19.
In April 2020, in light of COVID-19-related blood shortages, the US Food and Drug Administration (FDA) reduced the deferral period for men who have sex with men (MSM) from its previous duration of 1 year to 3 months.Although originally born out of necessity, the decades-old restrictions on MSM donors have been mitigated by significant advancements in HIV screening, treatment, and public education. The severity of the ongoing COVID-19 pandemic-and the urgent need for safe blood products to respond to such crises-demands an immediate reconsideration of the 3-month deferral policy for MSM.We review historical HIV testing and transmission evidence, discuss the ethical ramifications of the current deferral period, and examine the issue of noncompliance with donor deferral rules. We also propose an eligibility screening format that involves an individual risk-based screening protocol and, unlike current FDA guidelines, does not effectively exclude donors on the basis of gender identity or sexual orientation. Our policy proposal would allow historically marginalized community members to participate with dignity in the blood donation process without compromising blood donation and transfusion safety outcomes.
2020 年 4 月,鉴于与 COVID-19 相关的血液短缺,美国食品和药物管理局 (FDA) 将男男性行为者 (MSM) 的献血延期期限从之前的 1 年缩短至 3 个月。尽管最初是出于必要而制定的,但由于 HIV 筛查、治疗和公众教育方面的重大进展,几十年来对 MSM 献血者的限制已经得到缓解。目前 COVID-19 大流行的严重程度——以及应对此类危机所需的安全血液产品的迫切需求——要求立即重新考虑 MSM 的 3 个月延期政策。我们回顾了 HIV 检测和传播的历史证据,讨论了当前延期期限的伦理影响,并研究了不遵守献血者延期规则的问题。我们还提出了一种资格筛选格式,涉及基于个体风险的筛选方案,与当前 FDA 指南不同,不会基于性别认同或性取向有效地排除献血者。我们的政策建议将允许历史上被边缘化的社区成员有尊严地参与献血过程,而不会影响献血和输血的安全结果。