Red Cross Starts Implementing New FDA Screening Guidelines for Blood Donations

A person donates blood in Los Angeles on Jan. 13, 2022. Patrick T. Fallon/AFP via Getty Images

The American Red Cross on Aug. 7 started implementing new screening guidelines offered by the Food and Drug Administration (FDA) for prospective blood donors.

While all people who have tested positive for human immunodeficiency virus (HIV) are still barred from donating blood, other people will be allowed to donate even if they’ve engaged in anal sex in the past three months, provided that they didn’t do so with a new partner, according to the screening guidelines.

All prospective donors—instead of only men who have sex with other men and women who have sex with bisexual men—will be asked the same questions in the screenings.

“On August 7, the American Red Cross implemented the updated FDA blood donation guidelines which eliminate questions based on sexual orientation,“ the Red Cross said in a statement. ”We look forward to welcoming those who may be newly eligible to give through a more inclusive blood donation process.”

The Red Cross supplies about 40 percent of the blood in the United States.

The group and others are hoping that the changes will lead to more blood donations. In 2022, the Red Cross declared a blood crisis for the first time. It called the shortages a risk to patients; some hospitals were receiving much less blood than they were requesting.

Fewer people have been donating since the start of the COVID-19 pandemic, leading to shortages, according to the Red Cross.

A sign for the Food and Drug Administration stands outside its headquarters in White Oak, Md., on July 20, 2020. Sarah Silbiger/Getty Images

Updated Guidance

The FDA said it changed the blood screening guidelines because it wanted to make the guidelines more “gender-inclusive” and ensure there’s enough blood for patients who need donations.

“The FDA has worked diligently to evaluate our policies and ensure we had the scientific evidence to support individual risk assessment for donor eligibility while maintaining appropriate safeguards to protect recipients of blood products,” Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, said in a statement.

“The implementation of these recommendations will represent a significant milestone for the agency and the LGBTQI+ community,” Dr. Marks said.

The updated guidance is based in part on studies—including an FDA-funded project—that found that people who engage in anal sex with new or multiple partners are at the highest risk of contracting HIV, according to the FDA. The agency said that both the UK and Canada updated their guidelines in recent years and neither country has reported safety concerns following the changes.

In 1985, the FDA recommended banning gay and bisexual men from donating blood in a bid to prevent HIV, which has no cure, from being introduced into the blood supply. HIV is primarily contracted through anal sex and can lead to acquired immunodeficiency syndrome, or AIDS.

In 2015, it said the men could donate blood after abstaining from sex for one year. That abstinence period was relaxed to three months in 2020, before being partially eliminated in the new guidelines.

Now, gay and bisexual men with a single partner for more than three months will be allowed to donate blood, even if they’ve been engaging in anal sex. Those rules also apply to others who have engaged in anal sex.

Prospective donors who acknowledge having anal sex with a new partner within three months will be disqualified, as will those who have had anal sex with one person and any type of sex with at least one additional person in the past three months.

People who have had sex with a person who has tested positive for HIV infection remain disqualified, according to the Red Cross.

Donated blood is shown in Los Angeles, Calif., on Jan. 13, 2022. Patrick T. Fallon/AFP via Getty Images

Other Exclusions

Some others are also being excluded from donating blood.

People who want to donate blood but who are taking HIV medications or prophylaxis should still be prevented from donating under the updated FDA guidance, which is being adopted in full by the Red Cross. Although the medications block transmission through sex, according to the FDA, they don’t block transmission through blood transfusion.

People aren’t allowed to donate unless they defer oral medications to prevent HIV for three months and injections to prevent infection for two years, according to the updated guidance. People who’ve ever taken an HIV medication are being blocked from donating, no matter how long ago they took the medication.

And people at risk for HIV because they’re exchanging sex for money or drugs, using injectable drugs without a prescription, receiving a blood transfusion themselves, or receiving a tattoo or piercing, aren’t allowed to donate blood until three months have passed since the activity or activities stopped.

The Red Cross also said that people with fever, enlarged lymph glands, sore throat, or rashes shouldn’t donate because these could be signs of HIV infection.