Can You Donate Blood When You're Undetectable?

I was recently asked: could I donate blood as someone living with HIV? I’m 50, with an undetectable viral load that’s almost old enough to buy its own beer. This means it’s impossible for me to transmit HIV to my wife partner, Gwenn.

So, what about donating my blood?

What the FDA and Red Cross say about HIV and blood donation

Currently, people living with HIV are prohibited from donating blood — a rule that remains in place regardless of viral load or treatment status.

Here’s what the FDA says:¹
"Although undetectable equals untransmissible (U=U) for sexual transmission, this does not apply to transfusion transmission."

In regard to the future possibility of people with HIV donating, the Red Cross says:²
“The Red Cross and FDA are involved in ongoing research, data collection and assessment related to transfusion safety, including the use of HIV preventative medications, and will continue to seek opportunities that could potentially help lead to additional changes.”

That sounds promising- I’ll take it.

What about gay and bisexual donors?

For decades, gay and bisexual men were banned from donating blood — a policy born out of the HIV/AIDS crisis in the 1980s. In 2023, the FDA finally eliminated all blanket restrictions based on sexual orientation. Today, gay and bisexual men are welcome to donate under the same gender-neutral eligibility criteria applied to all donors.³

The one caveat: anyone who has had a new or multiple sexual partners in the past three months and engaged in anal sex during that time will be asked to wait three months before donating. Those taking PrEP or PEP face additional waiting periods, as these medications can affect HIV screening accuracy. It's imperfect, but it's a far cry from the blanket ban that defined the first four decades of the AIDS era.

My personal history with HIV and blood screening

My history with HIV and blood screening regulations has been a long and difficult road. If you’re up for it, I’m happy to guide you on a trip down memory lane, where the street lights still shine brightly. They just don’t stay on as long as they used to.

As a kid with hemophilia in the 1980s, I was in a high-risk group for HIV due to my reliance on the blood product treatments I required. Before I learned cursive, I learned that I’d contracted hepatitis B as a result of poorly screened blood products.

Same with HIV.

When I tested positive, I was expelled from the 6th grade. The same year, ACT-UP formed, pressuring the government to educate the public about safer sex and making HIV drug research a life-and-death priority. Simultaneously, the bleeding disorders community was demanding accountability for the catastrophic results of unregulated blood screening standards.

So, while my parents spent the summer of 1987 fighting to get me back into public school, activists were hard at work. Years before, one of the first industry safeguards was a ban restricting gay men from donating blood - the very same policy I mentioned earlier, which wouldn't be overturned until 2023.

It's a reminder of how long progress can take — especially when you've lived through the era that created them and suffered the consequences of poor blood screening regulations firsthand.

The ongoing inequity: HIV-negative partners deserve better

HIV wasn’t the final “failed” blood test for me. At 18, I contracted hepatitis C as a result of tainted blood products. I am truly lucky to be here to benefit from the advancements in HIV treatment. I also appreciate the sensitivity shown in modern blood donation requirements. There is one thing that rubs me the wrong way: the negative partners of people with HIV are prohibited from donating blood. To be precise, they can donate — but only if they haven't had sexual contact with their HIV-positive partner in the past three months, as the FDA requires a 3-month deferral following any such contact, in keeping with its individual risk assessment approach.⁴

I, of all people, certainly understand why it’s better to be safe than sorry with blood safety. Modern times bring modern adversity, like restricting access to care, which includes medications that keep HIV under control. It’s the same short-sightedness and cruelty that birthed medical activism.

When someone with HIV can’t get their medications, it doesn’t just put their health in danger, it also makes the virus more transmittable.

Every drop counts

Still, I believe HIV-negative partners deserve a more nuanced approach than a blanket 3-month abstinence requirement. Someone like Gwenn, who has remained HIV-negative for decades while living with a partner who has been undetectable for years, faces the same deferral as someone in a far higher-risk situation — and that feels like a blunt instrument in an era that claims to prioritize individual risk assessment. With all of the natural disasters and mass tragedies in the United States, every drop of blood counts.

Every donation could literally save a life.