Reversing the ban on sperm donations from MSM

The US Food and Drug Administration (FDA) currently bans men who have sex with men (MSM) from donating sperm. The FDA’s guidelines were put in place to reduce the risk of HIV transmission in 1983, when the virus was considerably less understood. Over the past 30 years, there have been dramatic improvements in HIV screening technology that make these guidelines unnecessary. In a new commentary, UCSF and Bixby Center researchers argue that it’s time to update policies regarding sperm donations from MSM. They contend that the current ban may result in discrimination.

Currently, sperm donors must complete an HIV test, and may also be questioned about their sexual practices or required to undergo a physical exam to look for signs of anal intercourse. However, there is no evidence that these questions or the physical exam affect the chance of catching a false-negative HIV test. That’s because:

• HIV tests used to screen donated sperm are highly sensitive.
• There is no way to accurately detect anal intercourse through a physical exam.
• Asking people about stigmatized sexual behaviors is not an accurate way to screen.
• Using statistics about a group of people—such as the prevalence of HIV among MSM—is a form of discrimination against individuals.

Eliminating the risk of HIV transmission via donated sperm is important and deserves accurate, evidence-based screening strategies. In place of the current policy, universally testing all donated semen with modern HIV tests will objectively identify HIV. It’s time for the FDA to update its policy on sperm donation to reflect the latest scientific evidence, much like the agency did with its recent policy change regarding blood donation.