Why reject blood donors because they are gay?

The blood service should stop spreading panic and encourage donors from all sections of society

There's a slight air of ingratitude, on the face of it, about the National Blood Service's decision to turn away tens of thousands of potential donors. You are no longer allowed to give blood if, in the last 25 years, you have had a blood transfusion. The new rule is imposed due to the risk that such people may be contaminated with variant CJD, the human strain of BSE. It's difficult to think of any comparable rule being imposed on anyone but blood donors. Although you yourself have benefited from our service, you may not now pay back a debt of gratitude. Moreover, the blood service appears to believe its supply forms the principal source of CJD transmission; people at risk of acquiring CJD from other means are not explicitly excluded.

Struck by what, on the surface, seems a curious and rather frightening way of controlling risk - I mean, this arbitrary exclusion hardly seems likely to be the most effective way of guaranteeing the safety of your product - I paid a visit to the blood service's website. The qualifications for giving blood are far more stringent than anyone would, in fact, suppose. You must be, in most cases, between 17 and 59; may not have given blood in the last 16 weeks; may not have a cold; may not be pregnant or have recently given birth; be on antibiotics; have hepatitis or jaundice, have had tattoos, body-piercing, including pierced ears or acupuncture in the last 12 months. Of course, if you have HIV, or think you may, you are ruled out. If you are a man who has ever had sex with another man, even - the website specifies - according to safe-sex guidelines, you may not give blood. If you have ever received payment for sex with money or drugs, you may not give blood. Nor may you if you have ever injected drugs. If, in the last 12 months, you have had sex with a man who has had sex with another man, had sex with anyone who has received money or drugs for sex, been sexually active in Africa (with a few exceptions) or had sex with an intravenous drugs user, you are ruled out.

The list goes on, and is apparently very daunting. Personally, however, I find the existence of this list very worrying. Alongside some obviously sensible medical precautions are some proscriptions which make one wonder about the checks in place. For instance, there is a firm rule stating that if you are a man who has ever had sex with another man, you may not give blood. Now, there is a somewhat higher risk that such people may be carrying HIV, but as the blood service's colleagues elsewhere in the NHS will tell them, a man who has always had protected sex with his partners is probably at lower risk than large numbers of promiscuous heterosexuals. If a homosexual is HIV negative, then there is no purpose whatever served by forbidding him to give blood.

This rule, as with the wide-ranging one applying to anyone who has had a transfusion themselves, has rather a disturbing implication. If the screening of the blood for variant CJD or HIV is efficient, there should be no need for such specific rules. All that should be needed is a simple: "If you think you may be carrying variant CJD, HIV or hepatitis, please save our time and yours by not giving blood."

If, however, the screening process is not reliable, and may overlook blood which could transmit such viruses, then imposing these blanket bans is not going to solve the problem. There is probably a large number of heterosexuals who have been exposed to HIV without, in their perception, indulging in anything approaching promiscuous behaviour. All they have done is had unprotected sex, and have no suspicion that they are carrying HIV.

Homosexuals have lived for nearly 25 years with the knowledge of how HIV is transmitted, and are far more likely to know whether they may have been exposed to HIV. If the screening process is efficient, what end is served by imposing this ban? It is evidently efficient: last year, only six cases of problems arising from the transmission of infection through blood transfusion were reported.

The only rationale I can see for retaining some of these bans is scaremongering. Of course, no one would argue that the safety and quality of donated blood should be compromised in any way; to minimise the labour of the blood service, it may even be justified to advise people that if they have had high-risk, unprotected sex in the recent past, it would be in their own interests to take an HIV test before deciding to give blood.

But to stop people from giving blood if, say, they have ever had homosexual sex of any sort seems extreme and rather unhelpful. It isn't advice which blood services in other parts of the world find it necessary to offer, and I wonder why our service, backed up by a reliable screening process, finds it necessary to impose this unworkable proscription. On the whole, it looks to me like a gratuitous and outdated assumption which, in a small way, encourages ignorant attitudes towards minorities, and a deplorable complacency in the majority towards its own behaviour. It would be much better all round if the blood service stopped spreading panic, relied on its own excellent checks, and encouraged donors from all sections of society.