You aren’t eligible to donate plasma if you’re living with HIV, regardless of whether your viral load is detectable or undetectable. Your sexual partner(s) may also be ineligible to donate.

Eligibility for blood or plasma donation — and the potential for disease transmission as a result — is still a highly stigmatized discussion. This is especially true for prospective donors who are at an increased risk of contracting HIV.

In May 2023, the Food and Drug Administration (FDA) finalized recommendations to shift public policy away from blanket statements of eligibility toward standardized measures of individual risk assessment.

But anyone who’s ever tested positive for HIV remains ineligible to donate blood or blood components like plasma and platelets.

The phrase ”U=U” is commonly used to discuss HIV treatment and prevention. It stands for ”undetectable equals untransmittable.”

U=U is most relevant when it comes to sexual transmission of the virus. A person living with undetectable HIV has less than 200 copies of HIV per milliliter of blood.

This is considered an extremely low viral load — too low to transmit the virus through sexual contact. But the same can’t be said for other forms of exposure, particularly blood or plasma transfusion.

Someone receiving a blood or plasma transfusion will be exposed to a larger volume of blood or blood components than someone engaging in penetrative sex or other sexual activity.

The more blood or blood components containing HIV that you’re exposed to, the more likely you are to contract the virus.

Many different medical conditions can render a person ineligible to donate plasma, blood, or other components. Although some — like syphilis and hepatitis B — have to do with sexual or reproductive health, many do not.

According to the FDA, you’re ineligible to donate plasma if you have:

Certain circumstances can also affect your eligibility, though this can vary from state to state.

For example:

The FDA oversees all plasma donations in the United States.

For your plasma to be used, you must donate twice within a 6-month period. The FDA requires each person’s plasma to be tested on two separate occasions before it can be shared with others.

Plasma, blood, and other blood components are generally tested for:

Donating blood, plasma, or other blood components isn’t a way to get tested for HIV.

Although your donation will be tested for HIV and other conditions — and you’ll be notified if you receive a positive result — it’s better to seek out HIV testing prior to donation.

There are many ways to access free or lower-cost HIV testing, as well as specific events, like National HIV Testing Day, dedicated to supporting you and your health.

PrEP and postexposure prophylaxis (PEP) are preventive medications designed to reduce your risk of contracting HIV. Both medications affect the virus’s ability to replicate within the body.

It’s possible that PrEP and PEP could interfere with the screening tests used to detect HIV in blood and its components.

This could inadvertently mask an acute HIV infection, though more research is needed to truly understand the potential risk.

People who’ve recently used or are currently using either medication are ineligible to donate blood, plasma, or other components.

You may be eligible to donate in the United States if 3 months have passed since your last dose of oral PrEP or PEP, or if 2 years have passed since your last PrEP injection.

Anyone who’s received an HIV diagnosis is ineligible to donate blood, plasma, or other components. Your viral load — whether detectable or undetectable — doesn’t affect your overall eligibility.

John Loeppky is a disabled freelance journalist who currently resides in Saskatoon, Saskatchewan, Canada on Treaty 6 territory. His work has appeared for CBC, FiveThirtyEight, Defector, Insider, and a host of other publications. He can be reached at John@Jloeppky.com and his goal in life is to have an entertaining obituary to read.