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The great gay blood donation debate (updated 18/11/09)

Sun 15 Nov 2009 In: Health and HIV View at Wayback View at NDHA

Is a policy which seeks to prevent sexually active gay and bi men from donating blood discriminatory or a sensible element of a process designed to keep nasties such as HIV out of the blood supply? The NZ Blood service, charged with protecting the medical blood and blood products supply, will not accept blood HIV-positive people or from men who admit to having had protected or unprotected oral or anal sex with another man within the past five years. To glbt lobby group Rainbow Wellington this is discriminatory, and the group is trying to challenge the matter through the Human Rights Commission. To the NZ AIDS Foundation, which has provided advice to the Blood Service, it is a realistic, science- and behaviour-based element of the blood screening policy. Around the world various nations and states have adopted a variety of policies. In Russia, for instance, there is no stand down period, they rely solely on post-donation biological screening to keep the virus out of the blood supply. In Tasmania there is a stand down of just one year, plus screening. Many countries refuse to accept blood from gay or bi men at all. Rainbow Wellington's stance is influenced by the views of some that scientifically proven facts should not be the only criteria for policy-making, that policies should be influenced by issues such as an on-going striving for glbt emancipation. Rainbow Wellington, according to one of its members who attended a recent community forum in the Capital where various views on this issue were aired, argues that to accept the current five year stand-down is to cooperate with the oppression of gay men, and therefore it should be resisted. "SAFETY" AND "RISK" Neither Rainbow Wellington or the NZAF have any quibble with the primary objective of maintaining the integrity of the national blood supply. After all, HIV is incurable and those who receive blood products have no alternative but to trust that the fluid flowing into their veins is as safe as it is possible to be. Whilst practicing anal sex with a condom and oral sex without a condom constitutes 'safe' sex, there is still a very small risk of HIV transmission if, for example, a condom breaks. Safe sex is all about risk reduction, it is not risk free, but it is sufficient to halt the spread of the HIV epidemic, according to the NZAF.  "Safe sex will almost certainly protect individuals from HIV infection, and will be sufficient to end the sexually-transmitted HIV epidemic among MSM if consistently practiced. However, risk reduction is not sufficient to fully protect the blood supply, which instead requires a 'higher bar' of 100% risk elimination to ensure blood safety."   A higher bar for the blood supply is deemed necessary because of the very high risk of infection via blood transfusion, and because people in urgent need of blood services have little or no choice as to whether they accept blood given to them. The NZAF notes that population groups "who engage in activities that involve a greater risk of HIV transmission, and who also have high levels of HIV prevalence, will inevitably pose a greater risk to the blood supply." As a result, it says, "blood safety policy must take account of the prevalence of HIV in specific population groups as well as individual risk behaviours, and the only practical way to do this is by epidemiologically-based donor deferral." INTERPRETING THE FACTS But Rainbow Wellington asserts that while there is a growing body of scientific and medical data available on the measure of such risk, "the meaning of this in translating it into policy and administrative applications is disputed within scientific circles." On the contrary, says the NZAF, "the research, evidence, data and best practice on blood donor deferral criteria are unequivocal. There is no debate within expert circles and while the NZAF understands that people may have other opinions, that is not the same as scientific or medical evidence which supports the recommendations of the committee." Rainbow Wellington's Tony Simpson goes further: "Although scientific data is the only real basis for policy making in this field it is not the whole basis. Science is not just a technique, it is also a culture and like any culture it has a political dimension. Once an orthodoxy is established in science that culture is notoriously conservative and the interpretation of scientific data is sometimes more to do with the hierarchies of the scientific establishment than it is to do with the data itself." "The NZ Blood Service has made a decision that is neither conservative nor discriminatory and one that is based on scientific evidence, not a perceived cultural bias, establishment or orthodoxy," counters the NZAF. "The blood donor deferral policies of the NZBS reflect current local and global realities, and position New Zealand as having one of the least restrictive deferral criteria in the world, while still ensuring the safety of our blood supply." SCIENCE AND SEDUCTION But 'Pete,' a Rainbow Wellington member whose views were published by the group recently, believes that in modern Western societies a problem with science is it can come to see the body of knowledge it creates as the only knowledge that is real." This is a dangerous illusion," he says, "no different from the belief religious knowledge is the only knowledge that is real. The absolute claims of religion have been put to bed, but it’s not the only form of seduction available to us regarding how we see different bodies of knowledge."   "Science offers us a discourse," Pete believes, "and we use it in combination with other discourses... to form a basis for what we do. As individuals and groups we appropriate discourses all the time. This practice of mixing and matching of discourses is at the centre of what this article is about, it is central to how gender is done and it is central to how identity is constructed. This troubled interface of fact and belief is at the heart of the NZAF/Rainbow Wellington divide. "Science is dependent on knowledge while religion depends on belief," observes the NZAF. "We know beyond all doubt that HIV is an incurable virus and that gay and bisexual men are the group most at risk of HIV in New Zealand. Opinion, discourse and beliefs about gender and identity, while valuable in their own way, will not protect [a person] from HIV transmission." The NZAF is adamant that the current policy does not discriminate on the basis of gender or sexuality. "The five year deferral is specific to a gay or bisexual man’s sexual behaviour, not their sexual orientation or identity. Only anal or oral sex, with or without condoms, results in deferral. Gay and bisexual men are not deferred if they have only engaged in sexual activities that carry essentially no biological risk of transmission, such as mutual masturbation or kissing, in the past 5 years and are free to donate blood. Underscoring its view that donor deferral in New Zealand is not based on sexual orientation but on sexual behaviour, the NZAF points out that "lesbian women have no deferral period if they satisfy all the other criteria like everyone else."   Whilst the NZAF's firm belief that a scientifically based blood safety policy is the only appropriate one is more likely to find favour with the NZ Blood Service, it is clear that Rainbow Wellington remains determined that any policy must take a broader view and it is unlikely to rest until all avenues to influence that policy have been exhausted. And, failing all else, in four years' time the whole policy will be up for formal review once again. Following our publication of this item Rainbow Wellington's Tony Simpson sent the following to clarify some points: I read your piece on this with interest. It doesn't quite get our position right so I should make a couple of observations on behalf of Rainbow Wellington. Far from saying that we thought scientifically proven facts should not be the only criterion I said exactly the opposite in response to a comment from the floor of the forum. I said that the scientific facts were the only basis on which to proceed but that these were reconcilable with our view that the current guidelines were discriminatory. Where we differ from the AIDS Foundation is in the meaning of that scientific data. Contrary to what the AF people are saying there is significant disagreement on that point. Anyone who doesn't think so is referred to the evidence presented at the recent Tasmanian enquiry (where, incidentally, the evidence used in the current context by the AF to support the five year ban was used to justify a one year status quo ban by the opponents of change). Secondly I don't know where someone got the idea that RW says that to accept current guidelines is to co-operate with the oppression of gay men. RW has never said anything of the sort. I don't use vocabularies of that sort in any event because they sensationalise the issue and miss the point. What I did say in response to someone who said that pursuing this matter will only encourage homophobes was that homophobia was not my problem and I was not going to take responsibility for it in this or any other context, but that we had to take account of it as a political factor in any discussion of gay issues. You quite rightly report me as saying that science is not just a technique but a culture. I did not use the expression 'cultural bias' however, because that's not what I am talking about. Clearly the AF people don't know what I am talking about either. I recommend a course in cultural anthropology. I did however quote William Blake who said apropos of science: "God us keep, from single vision and Newton's sleep". It was a joke but I don't think the scientists from the AIDS Foundation got that either. They certainly looked a bit bewildered by it. Finally the contribution from 'Pete' was included in our newsletter at his request. We encourage members to express their views but as the newsletter makes clear that does not mean they are the views of RW. Cheers Tony Simpson Subsequently, Peter Hooper, a Rainbow Wellington member referred to as 'Peter' in the material we received from the group, forwarded this clarification: In a piece I wrote in the Rainbow Wellington Newsletter recently I was called "Pete". It did not seek to be anonymous, I guess I am well known to the Wellington crowd and so the person who drafted the newsletter simply used my first name. My full name is Peter Hooper. My note here is to clarify a misunderstanding in how my text has been read. It is not my view that Rainbow Wellington is about beliefs and the AIDs Foundation are about facts. Both groups are talking about knowledges, one inside the world of science and the other inside the world of social discourse. It is unhelpful and misleading I believe to privilege science as somehow more real than anything else when speaking about life. If a reader wants to follow the background for what I write then I'd suggest reading Michel Foucault. Simply put he argues all knowledge lives inside and is shaped by regimes. This is as true for science as it is for any other body of knowledge. Science has rules about 'verification', broadly speaking it has ideas of how things are done when generating knowledge about the world. In its widest sense these regimes exist across disciplines and I'd argue the regime of science has become a kind of 'template' for truth-telling in many if not most areas that claim to provide us with knowledge. A central part of what I argued for in what I wrote in the Rainbow Newsletter is the idea that the gay community now, post-1986, is a mixture of voices, all with things to say. If the AIDs Foundation are saying because we deal with life and death, therefore we deal with facts, and all other knowledge is somehow of a weaker kind, I would be very surprised. This is precisely what the voice of authority stated in the middle ages, and Galileo paid a high price because he saw the flaw in that position. Finally, I see Rainbow Wellington, like all groups as made up of people with different views. Tony Simpson is right, I am not Rainbow Wellington's voice, I am one of the voices of those who are inside the group. I am very interested in other voices as well. I live inside other groups as well, as we all do. Peter Hooper Jay Bennie - 15th November 2009    

Credit: Jay Bennie

First published: Sunday, 15th November 2009 - 12:10pm

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