San Francisco Chronicle - Friday, September 15, 2000
Christopher Heredia, Chronicle Staff Writer

The 7-to-6 vote by the Food and Drug Administration's blood products advisory committee was a disappointment for critics of the ban, who argue that modern blood testing procedures make the prohibition outdated.

Under a 15-year-old policy, all male blood donors are asked if they have had sex, even once, with another man since 1977. Those who answer yes are prohibited from donating.

Two proposals before the advisory committee yesterday would have eased the ban. One called for a one- year period of abstinence by gay and bisexual men before they donate, and the other proposed a five-year period of abstinence. In opposing any change, the majority of the committee said they wanted to see more data on assertions that new screening tests can detect the presence of HIV in blood supplies in a matter of days.

"I'm disappointed," said Dr. Michael Busch, a physician at the University of California at San Francisco who testified that advanced testing makes the current ban outmoded.

"The problem we have is that until we're ready to allow the change to be implemented, we can't evaluate it," he said.

OPPOSITION FROM RED CROSS

Blood banks, faced with blood shortages, supported easing the restrictions, but the plan was opposed by the American Red Cross.

About 12 million pints of blood are donated each year, and an average of 1 in 675,000 is found to be infected with HIV.

"We know that testing is not 100 percent," said Dr. Laurence Corash, former chief of the hematology lab at UCSF and vice president of a Concord-based biopharmaceutical company that is researching ways to make blood supplies safer.

"Despite the fact that we are facing critical shortages of blood, the decision shows the level of concern of a group of highly educated experts in the field," he said.

The AIDS crisis prompted the FDA to impose the prohibition in 1985. Before then, thousands of people developed AIDS through contaminated blood transfusions.

Advocates for lifting the ban, including gay San Francisco Supervisor Mark Leno and the Blood Centers of the Pacific, have called the current policy discriminatory because it focuses on gay and bisexual men and doesn't address the rise in HIV infections among heterosexuals.

"I'm extremely disappointed that fear and fiction prevailed over fact," Leno said. "The nation needs a safe and available blood supply, and the FDA decision will unfortunately require that a significant, safe and available blood supply will not be acknowledged and utilized."

Leno has advocated changing donor screening to query volunteers about whether they've practiced safer sex, not who they've had sex with.

"It comes home personally because I (as a donor) could help end the blood shortage crisis," he said.

RISK CALLED TOO HIGH

FDA experts estimated that modifying the policy with the five-year abstinence clause would probably result in about 62,300 gay men seeking to donate blood. From that pool, 1.7 HIV-infected units of blood might make their way into the blood supply, FDA medical officer Andrew Dayton said. Of the nation's 12 million units of donated blood, about 10 HIV-infected units get through each year, causing two to three HIV infections a year.

But any additional risk is too great, said Randy Brown, a Cameron Park insurance agent, whose family had a scare in the mid-1980s after their daughter had open heart surgery in San Francisco during the height of the AIDS epidemic.

While the girl's doctors assured Brown and his wife there was little risk of the transmitting the disease, the couple got a sobering letter 12 months later from a local blood center saying there was a 1 in 4 chance his daughter may be infected with AIDS.

Fortunately, the girl tested negative.

"I'm all for gays blending into the mainstream as much as possible. In this case, we're not certain there isn't going to be some increase in AIDS contamination," Brown said.

Only 8 million Americans donate blood, just 5 percent of eligible donors. Blood donations are decreasing by about 1 percent a year, experts say, while demand for blood is increasing by 1 percent a year.

Homosexual and bisexual men are not the only ones prohibited from giving blood. There are also bans against current and former intravenous drug users; people who have worked as prostitutes during the last 23 years; those who have had sex with prostitutes in the last year; hemophiliacs who have received clotting factor concentrates; and people who have visited or lived in Nigeria, Cameroon and six other African countries since 1977.

Last year, Blood Centers of the Pacific collected 100,000 units of blood. Three of those units tested positive for HIV.

E-mail Christopher Heredia at cheredia@sfchronicle.com. The Associated Press contributed to this report.

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