Post a Comment On: Vigilance

There is a local Montgomery County angle to the HHS hearings on gay blood donors.

Third-term MCPS sex-education advisor Peter Sprigg will be testifying today, according to PR Newswire.
[Thurs, June 10, 2010] Peter Sprigg, Family Research Council's Senior Fellow for Policy Studies, made the following comments in advance of tomorrow's public hearing:

"I will urge the committee to maintain the current policy which permanently defers men who have had sex with men since 1977 as blood donors. This policy is based on a well-documented behavioral risk — nothing more, and nothing less.

"Any change in this policy should occur only if it can be demonstrated that it will improve both the availability and the safety of the nation's blood supply. No such evidence is available."

The Food and Drug Administration itself has noted, "Men who have had sex with men since 1977 have an HIV prevalence... 60 times higher than the general population, 800 times higher than first time blood donors and 8000 times higher than repeat blood donors."

(http://www.fda.gov/BiologicsBloodVaccines/BloodBloodProducts/QuestionsaboutBlood/ucm108186.htm)

Sprigg also added, "I understand that there are many people who wish to advance the socio-political goal of winning greater acceptance of homosexuality. However, the blood donation policy does not exist to serve socio-political purposes, nor should it be changed to advance them."

"Only the scientific evidence matters, and it indicates that the current policy should remain in place," concluded Sprigg.

The ACBSA meeting will hear public comments from 8:30 a.m. to 5:00 p.m. EDT on Friday, June 11, at the Universities at Shady Grove, 9630 Gudelsky Drive, Rockville, MD 20850. FRC to Testify in Support of Current Blood Donation Policy
Peter Sprigg is serving his third term on the Montgomery County Public Schools Citizens Advisory Committee for Family Health and Human Development, advising our public school district on its sex-education curriculum and materials.

I would agree with his statement that only the scientific evidence matters -- though as usual he presents only the "scientific evidence" that can be taken out of context to support his anti-gay position. Since the percentages are known, it should be a straightforward matter to calculate the change in risk resulting from various policy modifications. Questions are:
How many HIV-positive gay men will report being HIV-negative and donate their blood? (This includes both liars and those who don't know they are infected.)
All blood is tested, with a known false-negative failure rate that currently results in infection in 1 of every 2,500,000 transfusions; what is the likely change in that probability given the addition of self-reporting gay men to the donor queue?
How will the policy change affect the availability of blood products to patients?
How much increase in patient risk is justified by the increase in availability of blood products, e.g., if X more people per year die because of infection but Y more are saved by blood products that would be unavailable under current policy, what ratio of X:Y will justify adopting the policy?
These calculations should be made over a range of policies until an optimal solution is found.

It is meaningless to say that men who have had sex with men since 1977 (call them MSM-77) have 60 times the prevalence of HIV as the general population, because we are not randomly sampling the MSM-77 population. Very few people who know they have HIV will try to donate blood. The relevant proportion, under proposed policy changes, is the proportion of MSM-77 men who have not had sex with a man in the past year and are HIV-infected who will show up to donate blood, claiming to be HIV-negative. I think that percentage will be pretty small.

The policies that have been proposed will eliminate individuals who have engaged in male-with-male sex within the past year or some other timeframe, but will not do anything about straight men and women who are infected by their heterosexual partners; it is likely that the probability of infection during transfusion will not go up at all.

Here's a question for you. Why isn't Peter Sprigg calling for a prohibition of female African-American blood donors? Their HIV rate is 23 times the national average.

Peter Sprigg devotes his life to opposing gay people. He has said we should not allow them into our country from abroad. He has said people should be imprisoned for "homosexual behavior." Sprigg likes the rule that says that gay people are too unclean to selflessly give their own blood to help a stranger, it is a nice graphic way of reinforcing his ugly stereotype of gays. Anything that can keep the stigma going is all right with "everstraight" Peter Sprigg.

It is possible that the statistical models will reveal that adding MSM-77s to the donor pool increases risk dangerously. If that is found, then we as a society will agree rationally to continue the policy of prohibiting MSM-77 donors. More likely, though, the models will show that adding them to the donor pool will significantly increase the number of patients who can be helped by the donated blood, with an immeasurably small increase in the probability of infection from the blood supply, if any. If that is the finding, then the only reason to continue the current policy is discrimination. And really, people, we need the blood.