{"id":2829,"date":"2024-05-24T10:37:08","date_gmt":"2024-05-24T10:37:08","guid":{"rendered":"https:\/\/healthynewsusa.com\/?p=2829"},"modified":"2024-05-24T10:37:10","modified_gmt":"2024-05-24T10:37:10","slug":"fda-urged-to-relax-decades-old-tissue-donation-restrictions-for-gay-and-bisexual-men","status":"publish","type":"post","link":"https:\/\/healthynewsusa.com\/?p=2829","title":{"rendered":"FDA Urged To Relax Decades-Old Tissue Donation Restrictions for Gay and Bisexual Men"},"content":{"rendered":"
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The federal government in 2020 and 2023 changed who it said could safely donate organs and blood, reducing the restrictions on men who have had sex with another man.<\/p>\n

But the FDA\u2019s restrictions on donated tissue, a catchall term encompassing everything from a person\u2019s eyes to their skin and ligaments, remain in place. Advocates, lawmakers, and groups focused on removing barriers to cornea donations, in particular, said they are frustrated the FDA hasn\u2019t heeded their calls. They want to align the guidelines for tissue donated by gay and bisexual men with those that apply to the rest of the human body.<\/p>\n

Such groups have been asking the FDA for years to reduce the deferral period from five years to 90 days, meaning a man who has had sex with another man would be able to donate tissue as long as such sex didn\u2019t occur within three months of his death.<\/p>\n

One of the loudest voices on lightening the restrictions is Sheryl J. Moore, who has been an advocate since her 16-year-old son\u2019s death in 2013. Alexander \u201cAJ\u201d Betts Jr.\u2019s internal organs were successfully donated to seven people, but his eyes were rejected because of a single question asked by the donor network: \u201cIs AJ gay?\u201d<\/p>\n

Moore and a Colorado doctor named Michael Puente Jr. started a campaign called<\/a> \u201cLegalize Gay Eyes\u201d and together got the attention of national eye groups and lawmakers.<\/p>\n

Moore said Betts was enthusiastic about becoming an organ donor when he got his driver\u2019s license. When he died at age 16, his heart, lungs, and liver were among the organs that helped prolong the lives of seven people, but his corneas went untouched.(KC McGinnis for KFF Health News)<\/span><\/figcaption><\/figure>\n
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Xander and Jackson Moore look through belongings in a room dedicated to Alexander \u201cAJ\u201d Betts Jr. at home in Des Moines, Iowa.(KC McGinnis for KFF Health News)<\/span><\/figcaption><\/figure>\n

Puente, a pediatric ophthalmologist with the University of Colorado School of Medicine and Children\u2019s Hospital Colorado, said the current patchwork of donor guidelines is nonsensical considering advancements in the ability to test potential donors for HIV.<\/p>\n

\u201cA gay man can donate their entire heart for transplant, but they cannot donate just the heart valve,\u201d said Puente, who is gay. \u201cIt\u2019s essentially a categorical ban.\u201d<\/p>\n

The justification for these policies, set 30 years ago<\/a> as a means of preventing HIV transmission, has been undercut by the knowledge gained through scientific progress. Now, they are unnecessary and discriminatory in that they focus on specific groups of people rather than on specific behaviors known to heighten HIV risk, according to those who advocate for changing them.<\/p>\n

Since 2022, the FDA\u2019s Center for Biologics Evaluation and Research has put changes to the tissue guidance on its agenda<\/a> but has yet to act on them.<\/p>\n

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\u201cIt is simply unacceptable,\u201d Rep. Joe Neguse (D-Colo.) said in a statement. He was one of dozens of Congress members who signed a letter in 2021<\/a> that said the current deferral policies perpetuate stigma against gay men and should be based on individualized risk assessments instead.<\/p>\n

\u201cFDA policy should be derived from the best available science, not historic bias and prejudice,\u201d the letter read.<\/p>\n

The FDA said in a statement to KFF Health News that, \u201cwhile the absolute risk transmission of HIV due to ophthalmic surgical procedures appears to be remote, there are still relative risks.\u201d<\/p>\n

The agency routinely reviews donor screening and testing \u201cto determine what changes, if any, are appropriate based on technological and evolving scientific knowledge,\u201d the statement said. The FDA provided a similar response<\/a> to Neguse in 2022.<\/p>\n

In 2015, the FDA got rid of a policy<\/a> dubbed the \u201cblood ban,\u201d which barred gay and bisexual men from donating blood, before replacing it<\/a> in 2023 with a policy that treats all prospective donors the same. Anyone who, in the past three months, has had anal sex and a new sexual partner or more than one sexual partner is not allowed to donate. An FDA study found that, while men who have sex with men make up most of the nation\u2019s new HIV diagnoses, a questionnaire was enough to effectively identify<\/a> low-risk versus high-risk donors.<\/p>\n

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The FDA\u2019s headquarters in White Oak, Maryland, on July 20, 2020.(Sarah Silbiger\/Getty Images)<\/span><\/figcaption><\/figure>\n

The U.S. Public Health Service adjusted the guidelines for organ donation in 2020<\/a>. Nothing prevents sexually active gay men from donating their organs, though if they\u2019ve had sex with another man in the past 30 days \u2014 down from a year<\/a> \u2014 the patient set to receive the organ can decide whether or not to accept it.<\/p>\n

But Puente said gay men like him cannot donate their corneas unless they were celibate for five years prior to their death.<\/p>\n

He found that, in one year alone, at least 360 people were rejected as cornea donors<\/a> because they were men who had had sex with another man in the past five years, or in the past year in the case of Canadian donors.<\/p>\n

Corneas are the clear domes that protect the eyes from the outside world. They have the look and consistency of a transparent jellyfish, and transplanting one can restore a person\u2019s sight. They contain no blood, nor any other bodily fluid capable of transmitting HIV<\/a>. Scientists suspect that\u2019s why<\/a> there are no known cases of a patient contracting HIV from a cornea transplant, even when those corneas came from donors of organs that did infect recipients.<\/p>\n

Currently, all donors, whether of blood, organs, or tissue, are tested for HIV and two types of hepatitis. Such tests aren\u2019t perfect: There is still what scientists call a \u201cwindow period\u201d following infection during which the donor\u2019s body has not yet produced a detectable amount of virus.<\/p>\n

But such windows are now quite narrow. Researchers with the Centers for Disease Control and Prevention found that nucleic acid tests<\/a>, which are commonly used to screen donors, are unlikely to miss someone having HIV unless they acquired it in the two weeks preceding donation. Another study estimated that<\/a> even if someone had sex with an HIV-positive person a couple of weeks to a month before donating, the odds are less than 1 in a million that a nucleic acid test would miss that infection.<\/p>\n

\u201cVery low, but not zero,\u201d said Sridhar Basavaraju, who was one of the researchers on that study and directs the CDC\u2019s Office of Blood, Organ, and Other Tissue Safety. He said the risk of undetected hepatitis B is slightly higher \u201cbut still low.\u201d<\/p>\n

At least one senior FDA official has indirectly agreed. Peter Marks, who directs the FDA\u2019s Center for Biologics Evaluation and Research, co-authored a report last year<\/a> that said \u201cthree months amply covers\u201d the window period in which someone might have the virus but at levels too low for tests to pick up. Scott Haber, director of public health advocacy at the American Academy of Ophthalmology, said his group\u2019s stance<\/a> is that the tissue donation guideline \u201cshould be at least roughly in alignment\u201d with that for blood donations.<\/p>\n

Kevin Corcoran, who leads the Eye Bank Association of America, said the five-year abstinence required of corneal donors who are gay or bisexual isn\u2019t just \u201cbadly out of date\u201d but also impractical, requiring grieving relatives to recall five years of their loved one\u2019s sexual history.<\/p>\n

That\u2019s the situation Moore found herself in on a July day in 2013.<\/p>\n

Her son loved anime, show tunes, and drinking pop out of the side of his mouth. He was bad at telling jokes but good at helping people: Betts once replaced his little sister\u2019s lost birthday money with his own savings, she said, and enthusiastically chose to be an organ donor when he got his driver\u2019s license. Moore remembered telling her son to ignore the harassment by antigay bigots at school.<\/p>\n

\u201cThe kids in show choir had told him he\u2019s going to hell for being gay, and he might as well just kill himself to save himself the time,\u201d she recalled.<\/p>\n

That summer, he did. At the hospital, as medical staff searched for signs of brain activity in the boy before he died, Moore found herself answering a list of questions from Iowa Donor Network, including, she recalled: \u201cIs AJ gay?\u201d<\/p>\n

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\n\t\t\t\t\t\t\tMoore said her son\u2019s organs helped save or prolong the lives of seven other people, including a middle-aged woman who received his liver and with whom she sometimes exchanges messages on Facebook.\t\t\t\t\t\t(KC McGinnis for KFF Health News)<\/span><\/figcaption><\/figure>\n<\/p><\/div>\n
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\n\t\t\t\t\t\t\tBetts\u2019 internal organs were transplanted, but his eyes went untouched because of an FDA rule that essentially bans sexually active gay men and boys from donating tissue.\t\t\t\t\t\t(KC McGinnis for KFF Health News)<\/span><\/figcaption><\/figure>\n<\/p><\/div>\n<\/p><\/div>\n<\/div>\n

\u201cI remember very vividly saying to them, \u2018Well, what do you mean by, \u201cWas he gay?\u201d I mean, he\u2019s never had penetrative sex,\u2019\u201d she said. \u201cBut they said, \u2018We just need to know if he was gay.\u2019 And I said, \u2018Yes, he identified as gay.\u2019\u201d<\/p>\n

The Iowa Donor Network said in a statement that the organization can\u2019t comment on Moore\u2019s case, but said, \u201cWe sincerely hope for a shift in FDA policy to align with the more inclusive approach seen in blood donation guidelines, enabling us to honor the decision of all individuals who want to save lives through organ and tissue donation.\u201d<\/p>\n

Moore said her son\u2019s organs helped save or prolong the lives of seven other people, including a boy who received his heart and a middle-aged woman who received his liver. Moore sometimes exchanges messages with her on Facebook.<\/p>\n

She found out a year later that her son\u2019s corneas were rejected as donor tissue because of that conversation with Iowa Donor Network about her son\u2019s sexuality.<\/p>\n

\u201cI felt like they wasted my son\u2019s body parts,\u201d Moore said. \u201cI very much felt like AJ was continuing to be bullied beyond the grave.\u201d<\/p>\n