BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SJR 26|
|Office of Senate Floor Analyses | |
|(916) 651-1520 Fax: (916) | |
|327-4478 | |
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THIRD READING
Bill No: SJR 26
Author: De León (D), et al.
Amended: 8/9/16
Vote: 21
SUBJECT: Blood donations
SOURCE: Author
DIGEST: This resolution calls upon the President of the United
States to encourage the Secretary of the United States
Department of Health and Human Services (HHS) to adopt policies
to repeal the current discriminatory donor suitability policies
of the United States Food and Drug Administration (FDA)
regarding blood donations by men who have had sex with another
man and, instead, direct the FDA to develop science-based
policies such as criteria based on risky behavior in lieu of
sexual orientation.
Senate Floor Amendments of 8/9/16 add a provision relating to
the FDA's blood donor deferral policies, make a technical
change, and add coauthors.
ANALYSIS: This resolution makes the following legislative
findings:
1)Since 1983, the FDA, an agency under the HHS, had prohibited
the donation of blood by any man who has had sex with another
man (MSM) at any time since 1977.
2)In December 2015, based on recommendations from the HHS
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Advisory Committee on Blood and Tissue Safety and
Availability, the FDA promulgated revised regulations to allow
an MSM to donate blood only if he has not been sexually active
for the past 12 months. Despite these recent steps toward a
policy change, a double standard would still exist under the
policy as it is proposed to be revised because it would still
treat gay and bisexual men differently from heterosexual men.
3)The FDA currently does not allow gay and bisexual men in
committed relationships to donate blood because, while one
partner may be monogamous, that individual cannot guarantee
that the other partner is monogamous. The FDA does not apply
this same logic to heterosexual relationships, which in effect
discriminates against gay and bisexual men.
4)The FDA is in the process of again reevaluating and
considering updating its blood donor deferral policies as new
scientific information becomes available, including the
feasibility of moving from the existing time-based deferrals
related to risk behaviors to alternate deferral options, such
as the use of individual risk assessments.
5)The American Public Health Association has stated that no
specific scientific rationale is provided to justify the
12-month deferral policy. The technology can identify within
7 to 10 days with 99.9 percent accuracy whether or not a blood
sample is HIV-positive, and the chance of the blood test being
inaccurate within the 10-day window is about 1 in 2,000,000.
6)The Williams Institute of the University of California at Los
Angeles School of Law estimates that, based on the population
of eligible and likely donors among the MSM community, lifting
the federal lifetime deferral policy on blood donation by an
MSM would result in 4.2 million newly eligible male donors, of
which 360,600 would likely donate, generating 615,300
additional pints of blood. Applying national estimates to the
California population, the Institute further estimates that
lifting the ban on MSM blood donations would add an additional
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510,000 eligible men to the current blood donor pool, of which
43,917 would likely donate, resulting in an additional 74,945
donated pints in California.
This resolution calls upon the President of the United States to
encourage the Secretary of the United States Department of
Health and Human Services to adopt policies to repeal the
current discriminatory donor suitability policies of the FDA
regarding blood donations by men who have had sex with another
man and, instead, direct the FDA to develop science-based
policies such as criteria based on risky behavior in lieu of
sexual orientation.
Background
Technological Advances in Blood Testing. One important factor
in developing blood donation deferral policies is the length of
the window period. The window period is the time span between
when a person contracts HIV and when an HIV test can detect the
virus within the person's body.
There are two main types of tests which can be used to test
blood for HIV: the antibody test and the nucleic acid test
(NAT). The antibody test assesses whether any HIV-targeted
antibodies are in a person's body. The NAT test looks for HIV
in the blood. The NAT test is what is generally used to test
donated blood because it has a shorter window period than the
antibody test does. For most people, the window period for the
antibody test is between two to eight weeks with an average of
twenty-five days. Meanwhile, the window period for the NAT test
is only nine to 11 days long.
In part because of recent advances in testing technology, the
risk of transmitting HIV through blood donation has decreased to
1 in 1.47 million. Since the NAT test can detect HIV in blood
samples within such a short span of time, this diminishes the
need for a yearlong ban on MSM. Instead, the deferral period
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for individuals who have been deemed high-risk through a
risk-assessment test can be reduced to a shorter timespan. Only
those who have participated in high-risk activity would be
deferred, and the time for which they would be deferred would be
based on advancements in the technology used to test donated
blood.
Comments
Why support a risk-assessment approach? According to the author:
An individual risk-assessment approach would evaluate the
risk-level of behaviors of potential donors instead of banning
entire "at-risk" groups from donating, such as MSM. Some
higher risk activities which could be screened for using this
model are whether or not a potential donor has engaged in
unprotected anal sex, had sex with a person of an unknown HIV
status in the past three months, or has had unprotected sex
with multiple partners in the past three months, amongst other
potentially risky behaviors.
While this list of risky sexual acts can apply to the MSM
community, it also demonstrates that heterosexual donors could
be engaging in high-risk sexual or recreational activity which
puts them at a greater risk of contracting HIV. Having
blanket deferral policies not only spreads a false
misconception that heterosexual sex is safe from HIV exposure,
but it also does not educate donors about what behaviors put
one at a greater risk. Adding these risk assessment questions
further protects the blood supply because it bans high-risk
activities that any donor, no matter their race, sexual
orientation, or gender, could partake in.
Prior Legislation
AJR 16 (Eduardo Garcia, Resolution Chapter 194, Statutes of
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2015) called upon the President of the United States to
encourage the Secretary of the HHS to adopt policies to repeal
the current and upcoming discriminatory donor suitability
policies of the FDA regarding blood donations by men who have
had sex with another man and, instead, direct the FDA to develop
science-based policies such as criteria based on risky behavior
in lieu of sexual orientation.
FISCAL EFFECT: Appropriation: No Fiscal
Com.:NoLocal: No
SUPPORT: (Verified8/5/16)
APLA Health
Access Support Network of San Luis Obispo and Monterey Counties
Equality California
Project Inform
OPPOSITION: (Verified8/5/16)
None received
Prepared by: Karen Chow / SFA / (916) 651-1520
8/10/16 15:40:28
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