>> F.D.A. Ends Ban, Allowing Some Blood Donations by Gay Men
[spacer]
Les Etats-Unis ont supprimé, lundi 21 décembre, l’interdiction faite aux hommes homosexuels de donner leur sang, en la remplaçant par l’obligation d’une abstinence sexuelle d’un an. Cette mesure, prise par l’Agence américaine des médicaments et de l’alimentation (FDA), intervient dans la foulée de décisions similaires en France, en Australie et au Japon.
En France, la ministre de la santé, Marisol Touraine, a annoncé en novembre que le don du sang serait ouvert dès le printemps aux homosexuels n’ayant pas eu de relations sexuelles durant les 12 derniers mois précédant le don.
Cette mesure, prise par l’Agence américaine des médicaments et de l’alimentation (FDA), met fin à une interdiction prononcée aux États-Unis en 1983, au début de l’épidémie de sida, quand les experts avaient peur que cette maladie encore inconnue ne contamine les réserves de sang.
« Les données scientifiques les plus précises dont nous disposons justifient cette période d’attente de 12 mois aux États-Unis », a commenté Peter Marks, le directeur adjoint du centre de recherche de la FDA.
Pour arriver à cette décision, la FDA a expliqué « avoir pris en considération plusieurs données récentes, des études sur l’épidémiologie et les rapports d’autres pays ayant changé leur politique sur le don du sang des homosexuels ».
L’interdiction de donner son sang continuera cependant de s’appliquer aux travailleurs du sexe et aux personnes qui s’injectent de la drogue, ainsi qu’aux hémophiles, a précisé la FDA dans un communiqué.
Les personnes atteintes d’hémophilie ou d’autres troubles de la coagulation ne peuvent pas donner leur sang « à cause du danger que peuvent représenter les aiguilles utilisées », a expliqué la FDA.
Un changement de politique qui va dans le bon sens mais perpétue les préjugés pernicieux associés au VIH
« Cette nouvelle politique est toujours discriminatoire », a réagi Dan Bruner, un des responsables de la clinique Whitman-Walker Health. « Même si l’on peut dire qu’une interdiction de 12 mois vaut mieux qu’une interdiction à vie, cette nouvelle politique est toujours discriminatoire et ne correspond pas à la réalité du dépistage du VIH de nos jours ». L’établissement réclame qu’une période d’attente de 30 jours soit mise en place « étant donné qu’avec la technologie dont nous disposons, une infection par le VIH peut être dépistée quelques semaines après que le donneur a été exposé au virus », a rappelé Dan Bruner.
>> Following up on a preliminary recommendation it made a year ago, the Food and Drug Administration said on Monday that the agency would scrap a decades-old lifetime prohibition on blood donation by gay and bisexual men.
The agency continued to bar men who have had sex with men in the past year, however, saying the measure was needed to keep the blood supply safe.
Gay rights groups considered the lifting of the lifetime ban a major stride toward ending a discriminatory national policy, but had wanted blanket bans for gay men to be removed entirely.
Donations should be considered on an individual basis, critics said, as some gay men — like some heterosexual men and women — are at far higher risk of H.I.V. infection than others.
GMHC, the advocacy group formerly known as Gay Men’s Health Crisis, harshly criticized the 12-month delay. Kelsey Louie, the group’s chief executive officer, said it “ignores the modern science of H.I.V.-testing technology while perpetuating the stereotype that all gay and bisexual men are inherently dangerous.”
The Food and Drug Administration enacted the lifetime ban in 1983, early in the AIDS epidemic. The virus that would become known as H.I.V. was discovered that year, and no way to test for it in donations existed.
Now, however, tests can tell whether donated blood contains the virus in as little as nine days after the donor has been infected. The “window period” — during which a unit of donated blood might test negative but still infect the recipient — is the reason for continuing time-based bans on people who engage in various kinds of high-risk behavior.
Both men and women have sex with strangers who might be infected, of course, but H.I.V. is much more common among gay men, so the perception that they have a higher inherent risk was used to justify the lifetime ban and now underlies the continuation of a 12-month deferral period.
In a news conference on Monday, Dr. Peter W. Marks, the deputy director of the Food and Drug Administration’s Center for Biologics Evaluation and Research, said the 12-month period was “supported by the best available research” and was similar to deferral periods imposed in Britain and Australia.
It is based, he explained, both on how the disease circulates in this country and on how donors here are screened.
Other countries try to assess donors’ risks individually, but their H.I.V. epidemics and blood-collecting practices differ in important ways from those in the United States.
In South Africa, many heterosexuals are infected, so blood-collection agencies try to assess risks by asking, for example, how many sexual partners a potential donor has had. In Italy, screening is done by doctors trained to spot risky donors.
In the United States, donors answer a list of routine questions posed by a computer or a “blood technician” who often has little training. But no screening method or more probing set of questions has been proved better at spotting higher-risk donors, Dr. Marks said.
Twelve-month waiting periods are used in other instances. Anyone who has had a tattoo, a piercing or an accidental needle stick in a hospital, for example, must wait 12 months before donating blood. So must anyone successfully treated for syphilis or gonorrhea.
The newest blood tests are “highly accurate but not perfect” because of the nine-day window, Dr. Marks said. “That is why the elimination of all deferrals is not feasible at this time.”
Even with the newest tests and current policies, the risk of a patient receiving an infected unit of blood is now one in 1.5 million. The Food and Drug Administration calculates that dropping all time-related deferrals would quadruple that risk, Dr. Marks said, making it unacceptably high.
The new guidelines recommend that the gender of donors “be taken to be self-identified and self-reported.” Some experts had raised the possibility that transgendered women would not be covered by a rule change specifically pertaining to men having sex with men.
The new guidelines say any woman who has had sex with a man who has had sex with men should also wait 12 months after that encounter before donating blood.
avec l’AFP
