Critical blood shortages persist.

Blood supply shortages heightened by the effects of the Covid-19 pandemic continue to persist in the United States. Major blood suppliers report that this is the lowest level of blood supply they’ve experienced in a decade. Despite this, the Food and Drug Administration (FDA) continues to uphold a longstanding ban on donations from men who have sex with men (MSM), even those who are HIV-negative and in monogamous relationships. The current ban, revised in 2020 due to blood shortages during the pandemic, recommends deferrals for all men who report having sex with men within the last three months.

In early January of this year, the American Medical Association (AMA) sent a strong message to the FDA recommending a change in the current practices. After much external debate, the FDA recently took a significant step by initiating a national pilot study to examine these deferral policies. This study, entitled Assessing Donor Variability and New Concepts in Eligibility (ADVANCE), aimed to guide the FDA in revising the current screening questionnaire and deferral practices. Since the study’s conclusion in September, news outlets have reported that the FDA is considering revising the questionnaire to shift its focus to individual risk, based on the findings of the ADVANCE study. It has been reported that the FDA anticipates new guidance in the next few months.

More transparency needed.

By Matty Flicks/via Pxhere

While this news is encouraging, many questions remain. The FDA is mainly silent about the specific findings of the ADVANCE study. Nursing and medical researchers should review the results and offer feedback directly to the FDA. There must be more transparency about the internal work group composition assigned to policy revision decision-making. In other words, we should ask, are nurses at the table? If not, who is?

Some sources have reported that the FDA will likely change the question from “did you have sex with men who have sex with men in the last three months” to inquiries mostly related to new sexual partners during the previous three months. This option might allow MSM in monogamous relationships to donate blood only if there were no other sexual partners in the last three months. While this is promising, what happens to men who recently entered new relationships and who are also HIV-negative? Will they be excluded from donation, should the screening policies change, as many predict they will? Additionally, HIV-negative MSM who had more than one sexual partner in the last three months would be excluded. While there is no perfect solution, it is clear that the FDA still has work to do in terms of exclusionary policies related to MSM.

The FDA plans to release more details soon, including specific results of the ADVANCE study. Health care professionals should continue monitoring this situation, as these changes will affect practice and blood supply shortages. Blood shortages affect everyone in the general public. While many people are not explicitly aware of these exclusionary policies, it is essential to provide education.

Nurses can position themselves to advocate for LGBTQIA+ people, knowing that this situation involving LGBTQIA+ people is an issue that can affect every American. The next few months will be critical as nurses and others prepare to review the specific details of these changes. Nurses should begin planning the various avenues for responding to the FDA while demanding a seat at the table and a voice to advocate for humanity.

Justin Fontenot, DNP, RN, NEA-BC, FAADN, is an assistant professor of nursing in the LHC Group • Myers School of Nursing at the University of Louisiana at Lafayette.