Sometimes political correctness seems to lack common sense, but reading this article in the Seattle Post Intelligencer has so many cliches and exaggerations it makes me think of one of the “drinking game” stories: Take a drink at every cliche, and see who gets drunk first.

The story is about screening donors for blood banks.

Certain diseases can be spread via blood transfusion, but since some of those diseases get missed on the tests, and some diseases are not tested for, and sometimes labs make errors, the rule is to screen out those who are at high risk at spreading disease via giving blood.

So since I lived for awhile in West Africa, I am ineligible to give blood. And since I had malaria, I have a second reason that I would not be allowed to give blood.

Diseases that can be spread via blood include HIV, Hepatitis C, Hepatitis B, Syphillis, CMV, HTLV I and II (which can cause leukemia), Chagas disease, Ebstein Barr virus, West Nile Virus, acute bacterial infections, and some rare prion diseases.

Most of these diseases can only be spread during the acute infectious stage of the disease (such as West Nile Virus). But some of the diseases remain latent (hiding and not making the person sick) yet the virus will be present in the body. Examples of this are syphillis, some types of Malaria, HIV, and some Hepatitis B cases.

So, since I lived in West Africa, I’m on the “no donor” list. Smart move. I not only had Malaria (and hepatitis) but I did a lot of surgery and deliveries where my gloves broke.

Ah, but the article mentions but doesn’t discuss me. Instead the article is framed to make donating blood a civil rights issue.

If I decide to have a risky behavior with someone who also has risky behavior, it doesn’t matter: I have the right to donate blood, and how dare you be judgmental:

“It upsets me when I see signs that say, ‘We need blood, give now,’ but they don’t want my blood,” said Pete, 26, an office supervisor who lives in North Seattle. He was put on the deferral list three years ago because he had sex with a man one time.

Ah yes. He only had sex with a man one time. Sounds like all the pregnant teenagers I see in my office who “only” had sex once…but can’t identify the father of their kid.

Even if this was true (and it could be…many heterosexual/bisexual men have had only one or two homosexual encounters, often when intoxicated), this allows one to overlook that the man he had sex with might have had sex with six men, or six hundred men and infected him…and it only takes one time…

Ah, but the article doesn’t stop whining there. It then goes on to another case: you need my blood because I have a rare blood type:

Kyros Starr, 38, called the ban “flat-out discrimination.” His blood type, O negative, is the universal donor — found in less than 5 percent of the population.”It frustrates me that I’m a universal donor and I can’t give,” said Starr, a former EMT and the son of a nurse. “They won’t take our blood. They think we’re disease carriers.”

Why, yes. I think you might be a disease carrier. You are a former EMT. Would you consider it discrimination to wear gloves to stop a person’s bleeding at a car wreck? Of course not. It’s common sense.

Let’s get sensible.

The US blood banks have saved thousands of lives.

But in the past, failure to screen behavior, and because they allowed buying blood from dubious sources, thousands have been infected not only with HIV but with hepatitis C.

Even before an HIV test was found, it was known that hepatitis B was widespread in some populations.

I’m old enough to remember when they stopped buying blood from anyone in the slums. Lots of drug addicts would give blood when they ran out of money, and we saw lots of hepatitis B cases…indeed, when I trained, hepatitis was considered an occupational hazard for surgeons. Then in the early 1970’s they stopped buying blood from prisons and high risk groups.

Later, there were Hepatitis B epidemics reported in sections of the gay community (indeed, the Hepatitis B vaccine was developed with the assistance of that community). Yet the US Red Cross didn’t bother to screen for such behavior until 1983…even though by the late 1970’s, it was suspected that this new disease in the gay community and another outbreak among IV drug abusers made epidemiologists suspect it could also be spread in the same way that Hepatitis B was spread: Via certain forms of sex and via IV drug use.

By 1983, the connection between HIV and gay sex was known even by the public, and many cases of HIV had already been spread via blood transfusions, and even more via contaminated plasma products, such as factor VIII given to hemophiliacs…

Tardiness in implementing these screening tests caused thousands of lives, not only from HIV but from Hepatitis C, which is found in IV drug abusers.
Canada, whose Hepatitis C scandal from contaminated plasma collected in Arkansas prisons made headlines, has a full time line HERE and HERE. This scandal never got much attention in the US, probably because the then governor of Arkansas had become president of the US when the scandal broke out in Canada, but those of us who lived along the border were aware of the problem.

Finally, one important reason that the screening cannot be replaced by testing of blood is that HIV can remain undetectable in the blood, yet infectious for others, for several months.

So as a physician I find this statement ludicrous:

“Given modern testing and the fact that anyone can be vulnerable to infection, there is no medical or scientific rationale for this discriminatory policy,” said Joe Solmonese, president of the Human Rights Campaign.

Yes, given the fact that modern testing fails to detect the infection in many people, there is a very good medical and scientific rationale for this discriminatory policy, sir. It is a lie that “anyone can catch HIV”. No, you catch HIV in certain ways, and if you avoid these behaviors, you just don’t catch HIV.

So you can catch HIV without having sex or without injecting drugs, especially if you are a doctor or nurse or EMT treating an HIV positive person.  But the rate of HIV among monogamous non drug using people is quite low statistically, and to pretend a promiscuous gay male is at the same risk of catching HIV as a lesbian or monogamous person is scientific nonsense.
But you are right: anyone can be vulnerable to infection. That’s why we screen blood: So that a four year old after a car wreck or a 72 year old monogamous grandmother can receive a blood transfusion without a high risk of infection.


Nancy Reyes is a retired physician living in the rural Philippines. Her website is Finest Kind Clinic and Fishmarket.

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