The campaign for gays to give blood has its priorities wrong

The argument has been framed purely as a homophobic discrimination and a result of stigma attached to the AIDS crisis, but other demographics can’t donate and no-one gives a fuck

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Alan Turing
A portrait of Alan Turing – the demonised, castrated computer scientist – made from the blood of gay men and commissioned by Freedom To Donate

I first donated blood to the National Blood Service in my first weeks as an undergrad at university. After the first time, I gave blood four times a year for nearly seven years. Then, one evening, in early 2013 I had sex with a man. I suddenly couldn’t donate anymore. 

When the office manager at work came round our desks asking for volunteers for a blood drive at the office, the shockjock that lives inside me briefly contemplated shouting “CAN’T ANNE – GAVE A BLOWJOB YOU SEE!!” loudly and defiantly across the office as a complete showstopper. In the end I settled for “I’m bisexual. I’m not able to donate.”

Did this restriction, after so many years of giving seem arbitrary and a bit unfair? Of course it did, especially when a sexual health test confirmed I was HIV negative and had no infections. Why was the gender of a sexual partner relevant? Once the darling of the blood donation service, I was now a rogue in exile. It seemed like a classic LGBT equality issue – I was being discriminated against because of the gender of a sexual partner. This seemed to be confirmed everywhere by my friends’ opinions and much of the mainstream gay press – it was “the gay blood ban” which unfairly targeted men who have sex with men (and trans women) based on an outdated, horrific association of gay men with AIDS.

Except, none of this is exactly accurate. As with so much in LGBT political agendas – certain rights and issues were being highlighted over others, their priority and importance magnified. In 2011, The Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO) reviewed the lifetime ban on the MSM (men who have sex with men) donating blood which had been in existence since the 80s. It found, in consultation with charities like the Terrence Higgins Trust, that the lifetime ban was no longer appropriate – due to better screening tests for donated blood which lowered the risk of contaminated – principally by HIV and hepatitis – blood products being used by the Blood Service. Instead, the ban was changed to a deferral – MSM could donate, but only after 12 months following their last sexual encounter.

For some campaigners, this was still an outrage – a 12 month deferral was still an effective ban on men who were sexually active. The findings of science were being connected to identity and were found wanting. In reality, the current policy reflects the fact that MSM are a high risk group. “The policy isn’t intended to be discriminatory”, Helen, an epidemiologist working in sexual health explains to me. “If we could be 100 per cent certain we were able to take blood from people who had few sexual partners and protected sex then that's something we would draw boundaries around, rather than sexual orientation.” Why has this not been done as yet?

“Basically questionnaires and approaches for asking questions about number of partners are difficult to create and make effective – frankly, some people will always lie or misremember – and so instead of classing people by their actual risk behaviour the policy has been defined on risk groups,” she says.

This may no longer be the case. Yesterday, it was announced that next year SaBTO will review the policy, in light of potential developments in screening processes which may make a 12 month deferral onerous. If scientists, on review, find in light of recent developments that that’s an appropriate and safe policy then I welcome it – there is a huge blood shortage and more donors would help this.

“Whenever the topic is raised, friends who believe they’re being right-on will sarcastically say ‘they don’t want my filthy blood because I’m gay’”

However, I confess to having greeted the jubilation over the announcement by the key lobby group, Freedom to Donate, lukewarmly. It came during this year’s National HIV Testing Week and the politics behind its campaign have always concerned me. Founder of the organisation, Ethan Spibey, explained that he established the campaign after attempting to donate: “The guilt and shame I felt when I couldn’t donate was horrible.”

The campaign was supported Tory MP, Michael Fabricant, whose political questioning of the ban has included, among other things, a persistent interest in why it should be applied to gay men who are married or in civil partnerships.

There is a pernicious tone to the rhetoric here. If some gay men feel guilt or shame at the blood deferral – perhaps it is necessary to examine the impulses behind this reaction. Where is the shame coming from? Perhaps it is a dislike for being associated with HIV because of one’s sexual identity. Similarly, asking for exceptions based on marital status has a clear implication -  how could people in heteronormative, monogamous partnerships be thrown in as a high-risk group when their sexual behaviour couldn’t possibly mean they are at risk of HIV.

There’s a sexual puritanism to this that, I believe, perpetuates HIV stigma. I have seen it in my own life in discussions with friends about the blood donation deferral. Whenever the topic is raised, friends who believe they’re being right-on will sarcastically say “they don’t want my filthy blood because I’m gay”. What masquerades as righteous anger in fact has dangerous and stigmatising implications – the subtext is “that’s ridiculous, I believe I am HIV negative – as is everyone else in this room – and our blood is clean.” Not only could this read as a reinforcement of the prejudice that HIV positive people are “dirty” – it’s a form of respectability politics, an assertion that the speaker themselves should not be associated with HIV.

Anyone of any sexuality who has been sexually active in sub-Saharan Africa is also deferred – the campaign makes no claims of racist discrimination on this point – nor does it query why recovering drug addicts or anyone who has engaged in any kind of sex work are also deferred. The campaigns are silent on these groups – instead the argument has been framed purely as a homophobic discrimination and no coalition with other activist groups is sought. Perhaps it’s thought these groups would sully the campaign message of respectable gay relationships and assimilation into heterosexual society. At its core, HIV stigma persists on false dichotomies between the sexually promiscuous or reckless and those who are sensible, monogamous, chaste. It relies on an unconscious distinction between the ‘good’ gays vs the sluts -  a queer version of the Madonna/whore binary.

That a campaign which even tacitly feeds on this misunderstanding has pushed its agenda so vehemently in HIV Testing Week and in the run up to World AIDS Day is unpleasant and regrettable. The message of HIV Testing Week is clear – HIV infection rates have risen in the UK, in London alone one in seven men who have sex with men are HIV positive. Many do not know – not getting tested because of fear or ignorance, both of which assist the virus and its transmission. Sexual stigma persists against men already living with HIV – despite the fact that those aware and being treated with antiretrovirals often have such low viral loads they present a significantly limited risk of transmission. All three conspirators – fear, ignorance and stigma must be dismantled for HIV to be eliminated in the LGBT community as well as outside it.

A political, ideological pre-occupation with blood donation based on a sense of entitlement by particular individuals citing their own sex lives is a misdirection of political energy – an energy which has attracted money, media platforms and Parliamentary time. It is an individualist message, which renounces solidarity with those gay, bi or trans people living with HIV and hepatitis, in particular. It doesn’t engage with the cause of ending HIV for all but limits itself to marking it as “other people’s problem”. The way in which a sense of personal affront and an overzealous idea of persecution inhabits the discussion was best ahown earlier this month by the unveiling of an artwork by Conor Collins in support of Freedom to Donate. It is a portrait of codebreaker Alan Turing painted with the blood of gay men. The parallel it draws makes little to no sense. Turing was chemically castrated in the 50s for homosexuality and killed himself – the identification of this terrible blot in British history with the current donor policy is as hysterical as it is ahistorical.

The truth is that no gay or bisexual man can or should say HIV is not their issue – even on a coldly statistical basis: a broken condom, a partner’s extra marital encounter, drunken recklessness, deliberate risk taking: just one or any of these could make HIV a personal reality as long as the infection and transmission rates stay as they are. I object to the priorities of the Freedom to Donate campaign on this basis: if we aimed to reduce the prevalence of HIV, the need for the blood deferral would become redundant.

Ben Collins at International HIV Partnerships, agrees: “Here’s what I care about: in almost 50 per cent of all new HIV diagnoses, the person is deemed a late presenter meaning their immune system shows signs of deterioration. People are often diagnosed when they are already sick, with wiped out immune systems, trauma and often irrecoverable damage. This is a huge waste of spirit and money.”

In light of this – the drive for awareness around regular testing becomes even more crucial. Furthermore, sexual health campaigners continue to go unheard for the availability of Pre-exposure prophylaxis (‘PrEP’) a preventative drug that is proven to be highly effective in preventing transmission. Unlike the Freedom to Donate campaign, which has enjoyed great popularity and success with its upbeat message of equality, this more important health campaign has fallen on deaf ears by policy makers.

“I don't think anybody knows if or when PrEP will be approved in the UK. People were saying April 2016 and then that timeframe went away”, explains Ben. Simon Collins, who works for HIV advocacy organisation, HIV i-Base, tells me that “currently PrEP can be purchased privately online” and i-Base provides guidance for those wishing to do so.

I wonder if Michael Fabricant MP and other parliamentary supporters, media editors and campaigners would devote as much time to this issue as the blood deferral. The evidence suggests there is more that could be done for HIV healthcare that aims to lift the wellbeing of all gay, bi or trans people that is both cost effective and medically effective. Yet it is being ignored.

Finally, there’s a further point to be made here – this shouldn’t merely be about statistics, funding and logic. It is about community and solidarity. HIV is not relevant to me just because I’m in a medically-defined “high risk group”. As a queer person, I have a dual history. My racial, class and family history can be traced back via bloodlines and physical heritage. My queer identity has a different heritage – it doesn’t come from straight parents, supportive as they may be. It comes from those queers who lived before me, whose lives bore witness to my identity in times of prejudice and strife before I was even born. By living visibly in the world my freedoms are bound to their histories and their lives. 

Gay and bisexual men my age are at a generational remove from the AIDS crisis – so much so those coming out now may not even know much about it. It’s only been in conversations with older gay friends who lived through it that I have any sense of its trauma. When they tell you of how their friends died, how their lovers died – you realise we’re a community still recovering from that loss. I am heir now to only the second hand oral histories of those whose own voices were atrophied by the cruelty of HIV and AIDS. Men who I never knew, many of whom died in a cloud of stigma and prejudice.

To disavow them and those HIV+ people of my own generation who have inherited the same prejudice feels immoral. I am bound to them, almost spiritually, by our shared history and community and therefore any struggle to end HIV is my struggle, my priority as their sibling, too.

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