Allowing gay and bisexual men to donate their corneas could help save the eyesight of thousands of people – but discriminatory, unscientific policies prohibit them from doing so.
The cornea, the clear outer layer at the front of the eye, enables the eye to focus light and helps people to see more clearly.
In the United States, a discriminatory policy implemented during the AIDS epidemic means that gay and bisexual men cannot donate their corneas if they had sex with another man in the last five years. In Canada, they must not have had sexual contact with a man in the preceding 12 months.
These policies mean that thousands of people are losing the opportunity to improve their eyesight every year, according to a new study.
The study, published in JAMA Ophthalmology, found that as many as 3,217 corneal donations from gay and bisexual men were rejected in 2018 alone because of the policy.
“With millions of people across the world in need of corneal transplants, these discarded corneas from gay and bisexual men could be used address the shortage and safely restore vision to thousands of patients with corneal blindness or visual impairment,” said the study’s lead author Michael A Puente, an assistant professor or ophthalmology at the University of Colorado.
‘Unscientific’ ban on gay and bisexual men donating their corneas should be overturned.
The ban was first introduced in the United States in May 1994 due to the belief that HIV could be transmitted through cornea transplants.
The policy was introduced without any scientific evidence. In fact, there has never been a reported case of HIV transmission through cornea transplant.
During the 1980s and 1990s, there were 10 reported cornea transplants where the donor had HIV prior to his death. None of the transplant recipients contracted the virus.
Despite this, the policy was introduced due to fears that HIV testing was unreliable.
This policy can be changed without increasing the risk of HIV transmission, and I would urge authorities to act as soon as possible to help patients who are waiting for sight-restoring surgery.
However, as HIV testing today is advanced and reliable, the study’s authors said there is no reason for the ban to remain in place.
“With modern virology testing and a better understanding of the low risk of HIV transmission through corneal transplants, this five-year deferral policy for gay men is not supported by current science,” Puente said.
“We ask federal regulators to reconsider these outdated policies which are depriving patients of the possibility of sight restoration.”
Many countries, such as Spain, Italy, Mexico, Chile and Argentina, allow gay and bisexual men to donate their corneas, and no uptick in HIV transmission has been reported in any of those countries.
Elsewhere, the United Kingdom only allows gay and bisexual men to donate their corneas if they have not had sex in the three months prior to their death.
Changing the policy would not increase the risk of HIV transmission.
To calculate the number of cornea donations lost every year due to the policy, Puente and his co-authors surveyed 65 eye banks in the United States and Canada.
Of those, 24 were able to provide a specific number of donations that were specifically rejected because of the donor’s sexuality.
Using this data, Puente and his co-authors estimated that between 1,558 and 3,217 perfectly suitable cornea donations were tossed aside in 2018 solely based on the donor’s sexual orientation.
“If it’s safe for gay men to donate their blood after three months of abstinence, I can think of no scientific reason to continue to require gay men to be abstinent for five years to donate their eyes,” Puente said.
“This policy can be changed without increasing the risk of HIV transmission, and I would urge authorities to act as soon as possible to help patients who are waiting for sight-restoring surgery.”
In the United States, Canada and the UK, gay and bisexual men must abstain from sex for three months in order to donate blood.
Similar policies exist across the world.