More on gay sperm donation

I am called out as "poorly informed, at best, and downright homophobic at worst" based on this post, by Iatrogenic Causes, an anonymous blogger, who drops the intriguing hint that she has met me personally. Based on certain details in other posts I am 98% sure I know who he/she is, but his/her secret is safe with me.

You can read both posts and decide if I'm really homophobic. I would certainly deny that charge. Iatrogenic Causes goes on to make a fairly convincing case that rules against gays donating sperm are not rational. As I hope was clear from my original post, I am in no way a priori against gays donating sperm, but feel the overriding concern has to be to prevent HIV transmission: if excluding gays helps accomplish that I'm for it, if not I'm against it.

IC notes this article from the American Council on Science and Helath, laying out the case for gay sperm donation. If IV drug users and straight men who use prostitutes are not excluded, as the article claims (I can't find the actual rules anywhere on the FDA site) they should be. I do not however, find the argument that becasue some gay men are at lower risk than some straight men the ban is irrational, convincing

In contrast, here is the argument against gay blood donation, laid out in a publication from Gay Men's Health Crisis of all places(I'm aware this article is in regards to gay blood donation but the issues are similar):

the problem with allowing gay men to donate blood can be considered in a simple arithmetical way: Gay men continue to be at very high risk for HIV and there are relatively few gay men. Depending on which study you believe, gay men comprise certainly no more than 10 percent of the population and probably less than 5 percent.

Of course safe sex works, and many gay men are in monogamous relationships. But HIV prevention is not perfect. Gay men continue to become infected with HIV in substantial numbers, despite the best prevention efforts. Researchers put the annual infection rate for urban gay men in their teens or twenties as 1 to 3 percent annually. This number sounds small, but it is cumulative. In some major cities, like New York, around 15 to 20 percent of gay men are now infected with HIV -- and the prevalence is higher in some regions and ethnic groups. Furthermore, gay men in monogamous relationships still become infected. People cheat on their lovers, whether gay or straight, but the risks of such cheating, especially if unsafe sex is involved, are increased for gay men because of the high prevalence of HIV in the pool of potential sex partners.

I think the best agrument for allowing gay sperm (and blood) donation would be that gay men pose no additional risk of HIV transmission. Unfortunately, that argument is untenable in the face of the above numbers. Statistically, the gay man who thinks he is in a monogamous relationship but whose partner cheats on him is at much higher risk than a similar heterosexual man in the same situation.

So opponents of the ban fall back on the argument of the form "some men allowed to donate sperm under current guidelines are at higher risk of HIV than some gay men," which is a much less convincing argument. Of course no set of guidelines will be perfect and one could come up with exceptions to even very complex critieria for donation. I remain unconvinced by this argument.

The article also points out the potential risk of other, perhaps unknown viruses in gay men and cites that as one of the reasons the FDA declined to loosen blood donor eligibility in 2000.

Note also that exclusion critieria for blood and sperm donation has been changed to only exclude men who have had homosexual sex in the last 5 years; previously it was anytime since 1977, which is clearly archaic.

I think this is a tough issue and resent accusations of homophobia just because I don't toe the politically correct line. My final impression is that the risk from any donor is extremely low, but that excluding gay men may lower the risk even further. I remain receptive to evidence to the contrary.