In a long-overdue policy change, the FDA told blood banks that they could start accepting donations from gay and bisexual men in monogamous relationships without requiring a period of abstinence prior to donation.

A complete ban on blood donations from men who have sex with men (MSM) was put in place at the beginning of the HIV epidemic in 1983 before transmission and testing were fully understood. It remained unchanged despite scientific advances and the fact that all blood is screened for HIV, syphilis, hepatitis C, and other blood-born infections. For years, advocates argued that the policy was based on fear, misinformation, and discrimination rather than science and public health concerns.

In 2015, the FDA revised the policy to say that MSM could give blood as long as they had not had sex with a man, including a long-term monogamous partner, for one year. As the country faced a blood shortage during the pandemic, the FDA shortened the abstinence period to three months. Still, the abstinence requirement was not applied to those in heterosexual relationships.

The new policy gets rid of the abstinence requirement altogether. Instead, all potential donors will be given a new questionnaire that evaluates their individual risks for HIV based on sexual behavior, recent partners, and other factors like whether they’ve ever injected drugs or have recently gotten a tattoo. Potential donors who report having multiple sexual partners or anal sex with new partners in the last three months—regardless of their gender or sexual orientation—will not be accepted.

People who have ever tested positive for HIV will still not be able to give blood nor will people who have used Pre-Exposure Prophylaxis (PrEP), medication that prevents HIV, within the last three months. PrEP is highly effective, but the medication can interfere with the detection of HIV during the blood screening process.

These rules more closely mirror current public health understanding that risk follows behaviors rather than individuals. It also brings the U.S. in line with Canada and the UK which have similar policies.