Homosexuality and blood donation.

[australopithecus]

The following debate is between ArthurWilborn and bluejatheist regarding the subject on homosexuality with regards to blood donation.

Arthur will be arguing the following points:</COLOR>

• The Red Cross is justified in excluding male homosexuals from blood donation due to increased risk of STDs.
  The higher rate of STDs in male homosexuals is principally caused by behavioral differences linked to gender.
  Education is a minor factor in risk-taking behavior among male homosexuals.

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bluejatheist will be arguing against.

Both parties have set a reply time of per week and all other debate rules will apply. As usual a discussion thread will be set up for others to comment on this debate which the debaters will not be permitted to post in: http://www.leagueofreason.org.uk/viewtopic.php?f=16&t=9377

I invite Arthur to open the debate....

 

[ArthurWilborn]

Re: Homosexuality and blodd donation.

First, let me say that this is in no way intended to slight any person or group. All groups have variations within and between them, which result in variances and trends within groups. These variations by themselves do not necessarily imply any moral superiority or inferiority of any group, or their members. Variation between individuals and groups is an expected and natural consequence of sociology, mathematics, and the human condition.

1) The Red Cross is justified in excluding male homosexuals from blood donation due to increased risk of STDs.

The Red Cross has a long list of criteria that makes people ineligible for blood donations. Among them are high risk groups for HIV, including if you:

"are a male who has had sexual contact with another male, even once, since 1977"
http://www.redcrossblood.org/donating-blood/eligibility-requirements/eligibility-criteria-alphabetical-listing

Since this is a criteria of the Red Cross, when I speak of male homosexuals I refer only to those who are sexually active with other males. This is referred to by the CDC as men who have sex with men, or MSM.

There is no argument that MSM have significantly higher rates of STDs then the general population. This is most easily demonstrated using HIV, since most research focuses on this disease. The CDC reports that HIV rates in MSM are forty or more times higher then other males or females.
http://www.cdc.gov/hiv/topics/msm/index.htm

The argument then turns to whether this is sufficient reason to exclude MSM from blood donations. I say that there is, based on duty to the recipient. It is the responsibility of the Red Cross to supply the safest blood product possible, both for the donor and the recipient. To this end the Red Cross eligibility includes less then 38% of the total population. ( http://www.redcrossblood.org/learn-about-blood/blood-facts-and-statistics ) Several of the exclusion factors relate to risk of communicable disease such as HIV. By restricting high risk groups from the donation pool, the risk of blood with disease reaching the recipient is reduced and HIV transmission via transfusion can be kept at a low rate. The current rate is about one in two million ( http://www.blutspendezurich.ch/pdf/journalclub/SusanLStramer-CurrentRisksOfTransfusion-TransmittedAgents-1.pdf ), which could only rise with the inclusion of high risk groups.

2) The higher rate of STDs in male homosexuals is principally caused by behavioral differences linked to gender.

Male homosexuals do have higher rates of STDs then other males. This can be shown for syphillis, where they account for 64% of cases. ( http://www.cdc.gov/std/stats09/syphilis.htm ) Male homosexuals accounted for 23% of gonorrhea cases in a twelve state monitoring program ( http://www.cdc.gov/std/stats10/gonorrhea.htm ) despite only representing about 2% of the total population. ( http://www.cdc.gov/hiv/topics/msm/resources/research/msm.htm ) We have already seen the wide difference in HIV rates.

Higher transmission rates in male homosexuals can be attributed principally to high sexual risk activities. ( http://www.cdc.gov/hiv/topics/msm/ ) These include sex with multiple partners, anonymous sex, failure to use condoms, alcohol and drug use, and young age. ( http://journals.lww.com/aidsonline/Fulltext/2006/03210/Risk_factors_for_HIV_infection_among_men_who_have.13.aspx?WT.mc_id=HPxADx20100319xMP , http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1404964/pdf/amjph00202-0052.pdf )

Most of these can be seen throughout humanity as being attributable to gender. Males will:

Drink more, and drink more heavily:
http://www.ncbi.nlm.nih.gov/pubmed/19686518

Use more recreational drugs:
http://www.documentacion.edex.es/docs/1101RAYwom.pdf#page=90

Be younger:
http://www.census.gov/cgi-bin/broker

Be more likely to accept anonymous sex:
http://yesmeansyesblog.wordpress.com/2011/03/03/gender-differences-and-casual-sex-the-new-research/

Condom use is, of course, a uniquely male phenomenon and cannot be compared. The number of sexual partners cannot be determined as a function of gender independently of sexual orientation, as the male-female heterosexual numbers are, of course, 1:1.

I will continue with my third point soon.

 

[ArthurWilborn]

3) Education is a minor factor in risk-taking behavior among male homosexuals.

This is what we would expect to see from teenage or older people, who often have a mixed or even negative response to risk education. Education about drug risk in high schools can be shown to actually increase the incidence of drug use. ( http://www.druglibrary.org/think/~jnr/uic.htm ) The effects of motorcycle helmet safety education are unclear. ( http://www.cdc.gov/Motorvehiclesafety/pdf/motorcycle_brief-a.pdf )

This is also seen in sexual health. Following a sharp increase in awareness and safer sex practices in the 80s and 90s, more recently there has been a backlash. Safer sex burnout can be seen to be a contributing factor to an increase in recent years of STDs. (http://www.ncbi.nlm.nih.gov/pubmed/17406079 ) This is compounded by the perceived effectiveness of HIV treatment programs. ( http://www.cdc.gov/nchhstp/newsroom/docs/FastFacts-MSM-FINAL508COMP.pdf ) Male homosexuals are largely aware of their risk, but choose to engage in it non-the-less.

I would ask bluejatheist:

1) How would you justify the increased risk of transfusion transmission of STDs by the inclusion of high risk groups?

2) How do you explain the high incidence of STDs among male homosexuals independently of gender?

3) What evidence can you provide that either male homosexuals are unaware of risk factors, or that education can prevent high-risk activity?

 

[bluejatheist]

I concede without contest, due to recent events offline I cannot set aside the time to adequately participate in this debate, and so would be wasting my opponents time more than anything, which is not acceptable.

 

[australopithecus]

Thanks to both parties for engaging in this debate.