Homosexual men are not permitted to donate blood - something gay associations have long criticized. The German Medical Association now recommends the policy be changed, especially because Germany lacks blood donations.
Donating blood is a good deed. Some 15,000 blood donations are required in Germany each day to cover requirements, so doctors and aid organizations are grateful for any donor willing to give blood.
But those belonging to certain risk groups are not permitted to donate blood as they have a greater chance of carrying hepatitis or HIV. Those risk groups include drug addicts, prostitutes and MSMs, or "men who have sex with men," as they are called by epidemiologists.
Potential donors are screened by way of questionnaires they are required to fill out before donating to establish whether they belong to these risk groups. But the information is voluntary, and verification is not possible. "We have to rely on people's honesty," said physician Hartmut Mösges, who works at a German Red Cross blood donation center in Cologne. Between 25 and 50 donors come each day to the center - on average, a third too few.
Relying on honesty
The questionnaires are supposed to compensate for what technology cannot yet do. "A blood test will quickly reveal whether or not a person has an infection, but there's still an up to 24-hour diagnostic gap between the time of infection and verification in the blood," Mösges explained in an interview with DW.
So blood donation centers must rely on people's forthrightness to compensate for this gap. Mösges believes the current criteria for exclusion in being permitted to donate blood are justified. "I am a dermatologist and worked for a long time at a teaching hospital, where I also treated such patients," he reflected. "I know that the risk of an HIV infection is much greater among homosexual men than among non-homosexual men. The statistics are quite clear on that."
But Martin Pfarr, of the German Lesbian and Gay Association, says excluding gay men from being able to donate blood is blatant discrimination. "We have long been calling for disbanding with this 'risk group' notion when it comes to giving blood," he told DW. "We instead have to look concretely at the possible risky behavior of individuals." The question is whether people practice safer sex or not. "If you throw everyone into the same basket, then of course you can say that the risk of HIV among gay men is higher. But that doesn't take into account people's individual behavior."
In addition, he warned, the wrong signal is sent to society. "The message given to heterosexuals up to now has been 'I'm not gay, so I can donate blood, regardless of what I do or how I behave.' That's been counterproductive," Pfarr said. There are heterosexual men and women who perform risky sexual activities, and gay men who have lived for years in monogamous relationships, he pointed out.
The German Medical Association (BÄK) is responsible for altering exclusion criteria guidelines for donating blood. The association surprised many last month when it ventured to redefine the notion of risk groups. People should be permitted to donate blood, the BÄK said, when those in question have not had risky sex for a certain period. That specific period must still be established. The medical association aims to, "within its own means," contribute to making changes at an EU level.
EU directives do not exclude gay men
But such forays are not even necessary, said Peter Liese, a physician and EU parliamentarian. EU regulations have long been more differentiated. "The sentence in the EU Directive pertaining to this says only: 'Persons whose sexual behavior puts them at high risk of acquiring severe infectious diseases that can be transmitted by blood' are deferred from donating blood," Liese noted.
Everything else is established at a national level, such as the German formulation: "Men who have sex with men." EU Commissioner for Health and Consumer Policy Tonio Borg pointed out to EU member states back in November 2012 that discrimination is widespread, and called upon member nations to adjust their national practices according to EU directives and to abandon the question to potential donors as to whether they are gay.
According to EU politician Liese, the current policy of excluding gay men from donating blood is not only unjust, it also ignores necessities in society. "We lack sufficient blood donations," he said. "And if it's possible to largely rule out risk, then why should we risk a shortage in blood donations when the possibility exists for receiving more?" Other EU countries have shown that a different approach is possible. "Countries like Portugal, Sweden and Italy no longer pose the question about 'men having sex with men.' Instead, the questions focus on risky sexual behavior - and heterosexuals are also capable of that," Liese noted.