On 5/11/23, the Food and Drug Administration released updated Blood Donation Deferment Guidelines. We've listed the two policies down below
*New Policies in Red; Returning Policies Listed with Previous Number in Parentheses*
​
READ OUR STATEMENT ON THE FDA GUIDANCES RELEASED ​5/11/2023 AND THE END OF THE QUEER BLOOD BAN HERE: 
2020 Guidance
  1. Defer indefinitely an individual who has ever had a positive test for HIV (2023 #1)
  2. Defer for 3 months from the most recent event an individual who has exchanged sex for money or drugs (2023 #7)
  3. Defer for 3 months from the most recent event, an individual who has engaged in non-prescription intravenous drug use (2023 #8)
  4. Defer for 3 months from the most recent sexual contact, an individual who has had sex with a person who has ever had a positive test for HIV.  (2023 #9)
  5. Defer for 3 months from the most recent sexual contact, an individual who has had sex with an individual who has exchanged sex for money or drugs in the past 3 months. If the individual has uncertainty about when their sexual partner has exchanged sex for money or drugs, defer the individual for 3 months from their most recent sexual contact. (2023 #10)
  6. Defer for 3 months from the most recent sexual contact, an individual who has had sex with an individual who has engaged in non-prescription injection drug use in the past 3 months. If the individual has any uncertainty about when their sexual partner engaged in non-prescription injection drug use, defer the individual for 3 months from their most recent sexual contact. (2023 #11)
  7. Defer for 3 months from the most recent allogenic transfusion, any individual who has a history of receiving an allogenic transfusion of Whole Blood or blood components. (2023 #12)
  8. Defer for 3 months from the most recent exposure, any individual who has a history of contact with blood of another individual through percutaneous inoculation such as a needle stick or through contact with a donor's open wound or mucous membranes. (2023 #13)
  9. Defer for 3 months from the most recent tattoo, ear or body piercing, an individual who has a history of tattoo, ear or body piercing. However, individuals who have undergone tattooing within 3 months of donation are eligible to donate without deferral if the tattoo was applied to a state regulated entity with sterile needles and non-reused ink. Individuals who have undergone ear and body piercing within 3 months of donation are eligible to donate without deferral if the piercing was done using single-use equipment. (2023 #14)
  10. Defer for 3 months after treatment, and individual with a history of syphilis or gonorrhea, or an individual with a history of diagnosis or treatment for syphilis or gonorrhea in the past 3 months. (2023 #15)
  11. Defer for 3 months from the most recent sexual contact, a man who has had sex with another man during the past 3 months. (Removed in 2023)
  12. Defer for 3 months from the most recent sexual contact, a female who has had sex during the past 3 months with a man who has had sex with another man in the past 3 months. (Removed 2023).
2023 Guidance
  1. Defer permanently an individual who has ever had a confirmed positive test result for HIV infection (2020 #1)
  2. Defer permanently an individual who has ever taken any medication to treat HIV infection (e.e., ART). 
  3. Defer for 3 months from the most recent dose, an individual who has taken any medication by mouth (oral) to prevent HIV infection (i.e., short-acting antiviral PrEP or PEP).
  4. Defer for two years from the most recent injection an individual who has received any medication by injection to prevent HIV infection (i.e., long-acting antiviral PrEP). 
  5. Defer for 3 months from the most recent sexual contact, an individual who has had a new sexual partner in the past 3 months and who has had anal sex in the past 3 months. 
  6. Defer for 3 months from the most recent sexual contact, an individual who has had more than one sexual partner in the past 3 months and who has had anal sex in the past 3 months. 
  7. Defer for 3 months from the most recent event, an individual who has exchanged sex for money or drugs. (2020 #2)
  8. Defer for 3 months from the most recent event, an individual who has engaged in non-prescription injection drug use. (2020 #3)
  9. Defer for 3 months from the recent sexual contact, an individual who had sex with a person who has ever had a positive test for HIV. (2020 #4)
  10. Defer for 3 months from the most recent sexual contact, an individual who has had sex with an individual who has exchanged sex for money or drugs in the past 3 months. If the individual has any uncertainty about when their sexual partner exchanged sex for money or drugs, defer the individual for 3 months from their most recent sexual contact. (2020 #5)
  11. Defer for 3 months from the most recent sexual contact, an individual who has had sex with an individual who has engaged in non-prescription injection drug use in the past 3 months. If the individual has any uncertainty about when their sexual partner engaged in non-prescription injection drug use, defer the individual for 3 months from their most recent sexual contact. (2020 #6)
  12. Defer for 3 months from the most recent allogenic transfusion, any individual who has a history of receiving an allogenic transfusion of Whole Blood or blood components. (2020 #7)
  13. Defer for 3 months from the most recent exposure, any individual who has a history of contact with blood of another individual through percutaneous inoculation such as a needle stick or through contact with a donor's open wound or mucous membranes. (2020 #8)
  14. Defer for 3 months from the most recent tattoo, ear or body piercing, an individual who has a history tattoo, ear, or body piercing. However, FDA is not recommending deferral of individuals who have undergone tattooing within 3 months of donation, if the tattoo was applied by a state regulated entity with sterile needles and non-reused ink. FDA also is not recommending deferral of individuals who have undergone ear or body piercing within 3 months of donation if the piercing was done using single-use equipment. (2020 #9)
  15. Defer for 3 months after completion of treatment, an individual who has had syphilis or gonorrhea, or received treatment for syphilis or gonorrhea, in the last 3 months. (2020 #10)

What Changed?
The new policy removes all gendered language, including turning away sexually active men who have sex with men. HOWEVER, there are new provisions that may impact the queer community at a much higher rate than heterosexual individuals. Additionally, with the removal of gendered language, trans women and AMAB non-binary donors no longer have to worry about being screened by the gender assigned at their birth. 

What's the Difference?
Benefits
Queer men in monogamous relationships >3 months will be able to donate blood as frequently as they wish (barring qualifications from other deferment policies). Donors who participate in oral sex will not be deferred (a lower risk activity). Women who have been with a queer man are not penalized. Trans & non-binary donors are not screened based on their gender assigned at birth.
New Barriers
Donors who take PrEP are deferred for 3 months for oral prescriptions or 2 years for injection doses. PrEP is clinically effective in preventing HIV transmission and U=U for sexual activity. 
However, PrEP medications work by preventing the virus from replicating within the body- they don't prevent the virus from entering the body. This mechanism of action may result in an undetectable, but non-zero viral load within a blood donor. If a recipient of that blood donation was not on PrEP, the virus would be able to replicate to the point of infection.
U=U only applies for sexual activity, blood transfusion has a significantly larger volume of bodily fluids.  

What's Next?
Implementation
The FDA approved the policies that were initially released as a draft on 1/27/23. They were confirmed as the final recommendations on 5/11/23. The AABB (an organization and unified voice of blood centers in the USA) has already released a new screening process and survey for facilities (Donor History Questionnaire 4.0), which should shorten the implementation process significantly. 

The new policies still have a significant impact on the queer community, through the deferral policies regarding PrEP medication. We hope to see increased research on the topic, to answer the questions on if blood donations from donors who take PrEP and other HIV-prevention medications lead to an increased risk of transmissions through the national blood supply.