美国打破男同性恋不能献血禁令

F.D.A. Lifting Lifetime Ban on Gay Blood Donors

美国打破男同性恋不能献血禁令

WASHINGTON — The Food and Drug Administration announced Tuesday that it would scrap a decades-old lifetime prohibition on blood donation by gay and bisexual men, a major stride toward ending what many had seen as a national policy of discrimination.

华盛顿——周二，美国食品与药品管理局(Food and Drug Administration，简称FDA)宣布将废止同性恋与双性恋男性终身不得献血的规定，该规定已经实施了几十年。此举朝终结许多人眼中的全国性歧视政策，迈进了一大步。

However, the agency will continue to ban men who have been sexually active in the last year, saying that the barrier is necessary to keep the blood supply safe, a move that frustrated rights groups that were pushing for the ban to be removed entirely.

不过，FDA仍然禁止在过去一年中性活跃的男性献血，并称这是保障供血安全的必要限制。呼吁完全废除禁令的权益组织对这一决定感到失望。

The F.D.A. enacted the ban in 1983, early in the AIDS epidemic. At the time, little was known about the human immunodeficiency virus, which causes the disease, and there was no quick test to determine whether somebody had it. But science — and the understanding of H.I.V. in particular — has advanced in the intervening decades. On Tuesday the F.D.A. acknowledged as much, lifting the lifetime ban but keeping in place a block on donations by men who have had sex with other men in the last 12 months.

1983年，FDA颁布了这项禁令，当时是艾滋病(AIDS)流行的早期阶段。那个时候，人们对引发艾滋病的人类免疫缺陷病毒(human immunodeficiency virus，简称HIV)知之甚少，而且也没有快速的检测方法来确定病毒感染者。但是，科学在这几十年间取得了进步，尤其是对HIV的了解。周二，FDA 也承认了这一点，取消了终身禁令，但是仍然禁止曾在过去12个月中与另一名男子发生性关系的男性献血。

The new 12-month waiting period imposes on gay men the same restriction as that imposed on heterosexuals who engage in high-risk behavior, including sex with prostitutes or with people who inject drugs.

新规定中12个月的等待期，使男同性恋者与存在高危行为的异性恋者，受到了同样的限制。这些行为包括与卖淫者或注射毒品者发生性关系。

Although the most modern tests can detect the virus in blood in as little as nine days after infection, the restrictions on heterosexuals were written before the tests became that refined, when it might take several weeks before the virus or antibodies to it could be detected. Also, blood banks know that donors do not always tell the truth about their sexual activity on questionnaires. A yearlong prohibition on dangerous sexual activity gives them a larger margin of error.

虽然最先进的检测手段可以在感染仅九天后，查出血液中的病毒，但是针对异性恋的限制是在检测手段还没有这么先进时设定的;当时，发现病毒或病毒抗体可能需要数周时间。此外，血库也明白献血者不一定会在问卷上如实回答涉及性行为的问题。所以，将禁止危险性行为的时间保持在一年，就可以降低出错的几率。

In written remarks, the agency said it was keeping the 12-month ban because “compelling scientific evidence is not available at this time to support a change to a deferral period less than one year while still ensuring the safety of the blood supply.”

FDA在书面声明中说，之所以保持12个月的禁令，是因为“目前还没有可靠的科学证据表明，把等待期缩短到一年以下，仍然能保证供血安全”。

The shift puts the United States on par with many European countries, including Britain, which adjusted its lifetime ban in favor of a 12-month restriction in 2011.

这个转变使美国与包括英国在内的许多欧洲国家，采用了同样的规定。2011年，英国也对其终身禁令做出了调整，转而采取为期12个月的限制。

The F.D.A. rules on blood donation generally include very wide margins of error. For example, it bars anyone who has traveled in areas where malaria is common from giving blood for a year, even though malaria symptoms are almost unmistakable — chills and fever — and virtually always appear within 40 days.

FDA对献血的规定中，预留了很大的容错空间。例如，它规定，所有曾去往疟疾高发区的人，在一年内不得献血，尽管疟疾的症状非常明显——打冷颤和发烧——而且这些症状几乎总会在40天内出现。

Most men’s health advocates called the move long overdue, and said that the overall ban was not based on the latest science and that it perpetuated stigma about gay men as a risk to the health of the nation. Legal experts said the change brought an important national health policy in line with other legal and political rights for gay Americans, like permitting gay people to marry and to serve openly in the military.

大多数男性健康倡导者都称此举来得太晚，还说这种全面的禁令并没有以最新的科学发现为基础，而且延续了男同性恋对国民健康构成威胁的观念。法律专家表示，这一调整使一项重要的全国性卫生政策与美国同性恋者的其他法律和政治权利达成了一致，比如同性恋拥有结婚和公开以同性恋身份在军队服役的权利。

GMHC, the advocacy group formerly known as Gay Men’s Health Crisis, called the new policy “offensive and harmful.” AIDS United, a Washington-based lobbying group, said that it was a “step forward,” but that it “continues to perpetuate discrimination against gay and bisexual men.”

倡导组织GMHC称这项新政策“令人反感且有害”，该组织过去名为“男同性恋健康危机”(Gay Men’s Health Crisis)。总部位于华盛顿的游说团体AIDS United则表示，这是一个“进步”，但它“延续了对同性恋和双性恋男性的歧视”。

In a statement, the agency said that it had “carefully examined and considered the scientific evidence” and that it intended to issue a draft guidance detailing the change in 2015. An F.D.A. official told reporters there was not enough science to support lifting the 12-month ban, an assertion that men’s health groups dispute.

FDA在一份声明中表示，它对“科学证据进行了仔细研究和考虑”，并计划于2015年发布一份详细介绍相关变化的指导草案。一名FDA官员告诉记者，没有充分的科学证据能支持解除12个月禁令的做法，但男性健康团体并不同意这种说法。

“At this time we simply do not have the evidence to suggest that we can go to a shorter period,” said Dr. Peter Marks, deputy director of the F.D.A.'s Center for Biologics Evaluation and Research.

FDA生物制品评价和研究中心(Center for Biologics Evaluation and Research)副主任彼得·马克斯(Peter Marks)说，“现在根本没有足够的证据表明我们可以缩短这个时间。”

The agency’s decision seems to have been guided by data that emerged after similar policy changes in other countries. For example, Dr. Marks cited data from Australia, where studies have shown no increased risk to the blood supply after the country changed the ban from lifetime to a year.

在其他国家做出类似的政策变动后，又有一些数据公布了出来，FDA似乎就是以这些数据为指导而做出决定的。例如，马克斯就引用了来自澳大利亚的数据。澳大利亚的研究表明，在把禁止同性恋者献血的时间从终身缩短到一年之后，供血方面的风险并没有增加。

Other groups applauded the shift, pointing out that it had been pushed for years by medical experts, blood banks and gay men’s health organizations who argued that the policy had long outlived its usefulness for safety in the blood supply.

还有一些组织对这种转变表示欢迎，并指出，数年来，医学专家、血库和男同性恋健康机构一直在呼吁做出这种转变。他们认为，这项政策在保证供血安全方面早已失效。

“A lot has changed since 1983,” said Sean Cahill, director of health policy research at the Fenway Institute. He called the shift “an important incremental step toward a better policy. That’s how policies often change — incrementally.”

“自1983年以来，发生了很多变化，”芬威研究所(Fenway Institute)卫生政策研究的负责人肖恩·卡希尔(Sean Cahill)说。他说这项变化“在政策逐步改善的过程中是一个步骤。政策通常就是这样变化的——逐步进行。”

While the burden of H.I.V. in the United States falls disproportionately on gay and bisexual men — Mr. Cahill cited estimates from the Center for Disease Control and Prevention that two-thirds of an estimated 50,000 new H.I.V. infections in the United States each year occur among men who have sex with men — the vast majority of gay and bisexual men are not H.I.V. positive, a fact that the 1980s-era policy essentially ignored by counting every single man who had had sex with a man since 1977 as suspect.

虽然美国的HIV感染者中，同性恋或双性恋男性所占的比例异常地大——卡希尔引用美国疾病控制与预防中心(Centers for Disease Control and Prevention)的估计数据称，美国每年大约5万名新增HIV感染者中，有三分之二都是曾与男性发生性关系的男性——但绝大部分同性恋和双性恋男性都不是HIV携带者。上世纪80年代的政策基本都忽略了这个事实，而是把从1977年来曾与男性发生过性关系的每个男性都当成了疑似患者。