美國打破男同性戀不能獻血禁令

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

美國打破男同性戀不能獻血禁令

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.

華盛頓——周二，美國食品與藥品管理局(Food and Drug Administration，簡稱FDA)宣布將廢止同性戀與雙性戀男性終身不得獻血的規(guī)定，該規(guī)定已經(jīng)實施了幾十年。此舉朝終結許多人眼中的全國性歧視政策，邁進了一大步。

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.

不過，F(xiàn)DA仍然禁止在過去一年中性活躍的男性獻血，并稱這是保障供血安全的必要限制。呼吁完全廢除禁令的權益組織對這一決定感到失望。

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，F(xiàn)DA頒布了這項禁令，當時是艾滋病(AIDS)流行的早期階段。那個時候，人們對引發(fā)艾滋病的人類免疫缺陷病毒(human immunodeficiency virus，簡稱HIV)知之甚少，而且也沒有快速的檢測方法來確定病毒感染者。但是，科學在這幾十年間取得了進步，尤其是對HIV的了解。周二，F(xiàn)DA 也承認了這一點，取消了終身禁令，但是仍然禁止曾在過去12個月中與另一名男子發(fā)生性關系的男性獻血。

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.

新規(guī)定中12個月的等待期，使男同性戀者與存在高危行為的異性戀者，受到了同樣的限制。這些行為包括與賣淫者或注射毒品者發(fā)生性關系。

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.

雖然最先進的檢測手段可以在感染僅九天后，查出血液中的病毒，但是針對異性戀的限制是在檢測手段還沒有這么先進時設定的;當時，發(fā)現(xiàn)病毒或病毒抗體可能需要數(shù)周時間。此外，血庫也明白獻血者不一定會在問卷上如實回答涉及性行為的問題。所以，將禁止危險性行為的時間保持在一年，就可以降低出錯的幾率。

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在書面聲明中說，之所以保持12個月的禁令，是因為“目前還沒有可靠的科學證據(jù)表明，把等待期縮短到一年以下，仍然能保證供血安全”。

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.

這個轉變使美國與包括英國在內(nèi)的許多歐洲國家，采用了同樣的規(guī)定。2011年，英國也對其終身禁令做出了調(diào)整，轉而采取為期12個月的限制。

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對獻血的規(guī)定中，預留了很大的容錯空間。例如，它規(guī)定，所有曾去往瘧疾高發(fā)區(qū)的人，在一年內(nèi)不得獻血，盡管瘧疾的癥狀非常明顯——打冷顫和發(fā)燒——而且這些癥狀幾乎總會在40天內(nèi)出現(xiàn)。

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.

大多數(shù)男性健康倡導者都稱此舉來得太晚，還說這種全面的禁令并沒有以最新的科學發(fā)現(xiàn)為基礎，而且延續(xù)了男同性戀對國民健康構成威脅的觀念。法律專家表示，這一調(diào)整使一項重要的全國性衛(wèi)生政策與美國同性戀者的其他法律和政治權利達成了一致，比如同性戀擁有結婚和公開以同性戀身份在軍隊服役的權利。

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.”

倡導組織GMHC稱這項新政策“令人反感且有害”，該組織過去名為“男同性戀健康危機”(Gay Men’s Health Crisis)。總部位于華盛頓的游說團體AIDS United則表示，這是一個“進步”，但它“延續(xù)了對同性戀和雙性戀男性的歧視”。

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在一份聲明中表示，它對“科學證據(jù)進行了仔細研究和考慮”，并計劃于2015年發(fā)布一份詳細介紹相關變化的指導草案。一名FDA官員告訴記者，沒有充分的科學證據(jù)能支持解除12個月禁令的做法，但男性健康團體并不同意這種說法。

“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生物制品評價和研究中心(Center for Biologics Evaluation and Research)副主任彼得·馬克斯(Peter Marks)說，“現(xiàn)在根本沒有足夠的證據(jù)表明我們可以縮短這個時間。”

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.

在其他國家做出類似的政策變動后，又有一些數(shù)據(jù)公布了出來，F(xiàn)DA似乎就是以這些數(shù)據(jù)為指導而做出決定的。例如，馬克斯就引用了來自澳大利亞的數(shù)據(jù)。澳大利亞的研究表明，在把禁止同性戀者獻血的時間從終身縮短到一年之后，供血方面的風險并沒有增加。

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.

還有一些組織對這種轉變表示歡迎，并指出，數(shù)年來，醫(yī)學專家、血庫和男同性戀健康機構一直在呼吁做出這種轉變。他們認為，這項政策在保證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年以來，發(fā)生了很多變化，”芬威研究所(Fenway Institute)衛(wèi)生政策研究的負責人肖恩·卡希爾(Sean Cahill)說。他說這項變化“在政策逐步改善的過程中是一個步驟。政策通常就是這樣變化的——逐步進行。”

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.

雖然美國的HIV感染者中，同性戀或雙性戀男性所占的比例異常地大——卡希爾引用美國疾病控制與預防中心(Centers for Disease Control and Prevention)的估計數(shù)據(jù)稱，美國每年大約5萬名新增HIV感染者中，有三分之二都是曾與男性發(fā)生性關系的男性——但絕大部分同性戀和雙性戀男性都不是HIV攜帶者。上世紀80年代的政策基本都忽略了這個事實，而是把從1977年來曾與男性發(fā)生過性關系的每個男性都當成了疑似患者。