The Industry Reacts
Did you feel the recent shockwaves coming from California? No? Well, it wasn’t the earth that was moving—it was the adult industry’s reaction (and the meta-reaction from sex positive activists and health experts) to a diagnosed case of HIV in the straight porn industry.
On June 11, the story started breaking in the online media that a case of HIV had been diagnosed in a female adult performer. AIM’s website ran a statement that day which included the following: “There has been a person who has tested positive. There were exceptionally few partners, inside and outside the industry. All partners are currently testing negative and in adult employment quarantine.”
It gives more details: On June 4, “Patient Zero” was tested for HIV; she worked on June 5, and her results came in showing positive for HIV presence in the bloodstream on June 6. At that point, her other industry sexual contacts and their non-industry partners were all tested, and will be retested. No positives were found. Patient Zero was tested previously on April 28, which is over the recommended 30 day limit for testing.
Of course, memes are the only viruses more communicable than any STD, and thus the resultant furor has been widespread and profligate. Within days, articles were up on XBiz (an industry news source), Adult Video News, and other industry specific websites; heavyweights such as Ernest Greene and Tony Comstock were weighing in on alternate sides of the issue. Sex educator Audacia Ray even guest-blogged about the status of the industry on Feministing.
Where: Most free clinics, testing clinics, and doctors offices
Cost: Very inexpensive; often cost is underwritten by various health departments & STD testing initiatives
Method: Antibody tests diagnose the presence of HIV by looking for antibodies that the body produces in response to an HIV virus infection. While most people are familiar with the blood tests, antibody tests are also available that use shed cells from the inside of the mouth (OraQuick and Orasure are the two brand names of these oral fluid tests) as well as urine samples. These samples primarily use the ELISA (enzyme-linked immunosorbent assay) test to determine whether antibodies are present, and in what quantity. All positive ELISA tests are usually re-checked using the Western Blot procedure, which opens up the antibody proteins chemically & electrically, then rechecks for the presence of HIV antibodies. Once a positive ELISA test has been confirmed using the Western Blot method, the results are then ready to report to the patient & health departments.
Accuracy: The ELISA test, especially when coupled with a confirmatory Western Blot test, are effective to within an accuracy rate of 99.7%; the chances of a false positive (a result that inaccurately reports HIV infection) are 1 in 250,000.
“Window Period”: ELISA tests require that antibodies be present, which take time for the body to manufacture. In practice, this means that most people will show testable antibodies after thirty days; the vast majority of people who have HIV will test positive at 3 months post-exposure.
Nucleic Acid-based HIV Test:
Where: Laboratories & Doctors offices, but must be specifically requested
Cost: Expensive, and not usually used outside of the adult industry unless requested.
Method: The testing sample has RNA extracted from within cells, which it isolates in search of a particular base sequence that signifies HIV infection. Because of the cost of the test, often 8-20 samples are pooled, then tested as a whole. If the pool tests positive, then each sample within the pool is tested individually. Both the RT-PCR (Reverse Transcriptase - Polymerase Chain Reaction) test and the Quantiplex bDNA (branched DNA) tests involve RNA testing; they differ in the methods that they use to access the RNA from the cellular sample.
Accuracy: Accuracy for these tests is equal to the ELISA tests; the ELISA test is occasionally used to check results for the RNA tests.
“Window period”: Because nucleic acid-based tests look for changes in the RNA of the cell, the waiting period is much shorter; positive results can be obtained as soon as twelve days after exposure.
Adult Industry Medical (AIM) uses the PCR (Nucleic Acid-based) test for its clients (which include, but are not limited to, adult industry performers and their partners); this allows them to test accurately more quickly following potential exposures.
Keep in mind that when thinking of the status of the tested person, all tests should have the “window period” added to the results; for instance, if you were tested negative last week using the ELISA test, it means that you were negative as of three months (the maximum window period) plus one week ago. In order to determine your own testing frequency, you will want to keep in mind that any potential exposures within the window period prior to your tests will not show up, and plan accordingly. For this reason, many people choose to be tested twice at both ends of the window period for the specific test that they’re using, without any new exposure potential, prior to determining their actual HIV status.
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A little backstory: Back in 1998, Adult Industry Medical Health Services (AIM) came into being with the concept that testing performers and creating a database to ensure that test results were available to others in the industry would be a primary way to ensure that the industry didn’t experience an outbreak of massive proportions, to keep actors safe and healthy, and to become a motivator for education and information dissemination. Since then, AIM has become the single testing database for the adult industry. AIM tests performers, and confidentially makes the information available to producers and directors in order to verify that talent that they plan to work with is clean. (AIM also acts as a testing facility for the general public).
It’s interesting to note that the gay male porn industry does not require testing. Some see it as an invasion of privacy to require testing, while others make an assumption that many performers are HIV-positive, and so testing is just an extra step. However, gay male porn is overwhelmingly condom-friendly. In fact, GayVN (the Gay Video News magazine) will not consider any movie that incorporates barebacking (i.e., sex without condoms) for any of its annual awards.
If you ask those who don’t think condom use is helpful for the industry, you’ll get a number of different explanations. Ernest Greene’s blog article comments on the fact that he and his wife (porn icon Nina Hartley) believe that condom use for porn shoots is actually unhealthier for female talent than not using them. According to Greene, “latex drag” over the period of time that a porn scene is usually filmed (up to two hours in many cases) can cause abrasions and microfissures in the vaginal tissue, as well as increase the odds of condom failure due to breakage.
Meanwhile, the apparent overriding attitude in the industry is that viewers (and, therefore, revenue) will drop if condoms are the norm in straight porn. Unfortunately, this creates an atmosphere in which even talent that requests condom use is either subtly or directly discouraged from doing so—whether by outright blackballing, or through more genteel techniques, like suggesting that it might “hurt their reputation.”
Lochai, the managing director for Kink.com’s Hogtied and Everything Butt divisions, recalled a situation he recently heard about from an industry model, who was told that she was “not beautiful enough” to insist on condom use during one of her shoots. When she declined the shoot and left the set, she never got any calls back for future work. Others in the industry have made similar claims of blacklisting, both in private and on various websites, as well.
On the other side, a growing number of safer sex proponents do encourage condom use on set for straight scenes. Kink.com is one company that has a standard of ensuring that all participants in their shoots have the right to insist on barriers, even though they also require testing and utilize AIM’s database for screening.
Wicked Pictures is the only studio that features a condom-only policy, and industry giant Vivid Entertainment has left the decision about whether to use condoms or not up to its female performers. Lochai noted that at Kink.com, a few people do request (and use) condoms for their shoots, but a number of the models opt to skip the barriers for reasons of their own.
Legal and Consumer Concerns
Safer sex activists and many sex-positive voices question whether it’s ethically responsible for the adult industry to not require condoms. Whether it’s the belief that consumers need to see responsible behavior, or that testing is imperfect and shouldn’t be relied upon, a vocal number of writers and educators strongly favor a condom-only (or at least, condom-highly-recommended) system. In fact, Michael Weinstein, head of the AIDS Healthcare Foundation, says that “L.A. County Public Health officials have been asleep at the switch with regard to monitoring HIV and STD prevention and testing in the region’s porn industry,” and has called for Los Angeles County to use existing regulations to require condom use on all sets—as a matter of both preserving the health of the actors and actresses, and to protect the “public health.”
Even psychologists have taken notice of the condom issue. Steve Livingston, an Assistant Professor of Psychology at the University of Toronto and a contributor to the Psychology Today website, noted: “It is very hard to see how most pornography is instructive for contraception or disease control. Condom use is infrequent in these media—supposedly because consumers prefer viewing ‘bareback” sex—and demonstrations of other prophylaxes (e.g., dental dams for cunnilingus) are all but non-existent.”
Livingston goes on to quote a pair of 2002 studies that show “regular consumption of romance novels was associated with reduced self-reported intent to use condoms, and second, the depiction of condom use within a romantic story context increased self-reported intent to use condoms.” If that argument applies to porn via video, then that gives more credence to the need for condom use in films in order to encourage viewers, and the general public, to use them. about the problems he believes come along with using condoms during porn shoots, it’s important for us to remember a basic fact about the majority of porn out there in the world—it’s really not sex, not any more than your average bodice-ripping romance novel is about real relationships. Let’s look at some differences that affect STD transmission & barrier use:
- As Greene mentions, a boy/girl penetration shoot can run as long as 2 ½ hours—or even longer. This involves lots of different things—a still photography shoot for magazine use; teasers, cover art, a variety of sex acts in various positions, breaks for everything from water to re-setting the props, and a dozen other of starts and stops for a variety of reasons – most of which are definitely not sexy or romantic. And when you have breaks in the action, it’s not uncommon for an actor to experience some deflation – which then necessitates changing out the condom.
- Ever had sex with a condom and insufficient lube? Then you’ll understand his term “latex drag” – it’s the friction that comes when vaginas & anuses get rubbed repeatedly with a latex covered penis or toy. Often, especially if one is in the heat of the moment, it might not be obvious that it’s happening until the next day.
- Porn sex is filmed with the viewer in mind; this means that the positions you see the actors in are usually a modification solely so that the camera can capture close ups of the action, as well as see the bodies of the actors for added visual stimulation. This means that condoms may have to overcome more “engineering problems”, as the angles and positions change more often, and in more ways, than the average non-porn sexual escapade would include.
- There are niche markets that specifically serve porn consumers that wish to see behavior that is riskier, such as “creampie” (internal ejaculation) or gay male “bareback” (unprotected anal sex) – and producers of these niche porn films will often pay significantly more than more mainstream producers will pay. This is a lure for people who aren’t established in the porn industry, and who are willing to take more chances with their health.
- Actors and actresses often change their off-screen behavior because of their on-screen employment; some stars only date within the porn industry, and others require barriers for all non-industry partners. Seeing someone having on-screen unbarriered sex, then, is not necessarily an indication that they’re using barriers on their personal time, as well. For most actors, the desire to keep their bodies healthy and in good shape (both in appearance, and sexual health-wise) leads them to make choices for themselves to enable them to continue working. After all, if you find a job that you like and that pays you well, you’d want to keep it as long as you could, right?
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Throw into the mix the issue of the California Occupational Health & Safety Administration. Cal/OSHA’s laws about bodily fluid exchange are obviously being broken. However, some feel that if the industry were to be more tightly regulated in California (following OSHA guidelines), it would drive many mainstream companies out of business and would lead to more underground filming. AIM and the testing standards that are followed in the industry would no longer be standard practice, which might ultimately result in losing safety precautions that are currently in place.
Cal/OSHA’s website clearly states that the blood borne pathogens standards require “employers to use feasible engineering and work practice controls to protect workers from coming into contact with blood or other disease-carrying body fluids”—including semen and vaginal fluids. They detail various examples of how to do so, including simulating sex acts though acting and post-production, ejaculating outside of the orifice in question, and the use of condoms and dental dams. OSHA also states that employers may not discriminate against any worker who complains about unsafe working conditions, which means that actors who request condoms and are suddenly dropped from call lists could conceivably choose to bring complaints forward and put to the industry. During the 2004 outbreak, Cal/OSHA followed up on complaints by investigating and fining two production companies for failing to comply with bloodborne pathogen standards. During the past week, Cal/OSHA has reportedly visited the AIM offices, and plans, as of this writing, to subpoena records to determine which producer hired the infected actress.
So, what is the future of the porn industry? Likely to not change, in the long run. Apparently the current outbreak is due to one actress, who was not tested prior to performing after more than 30 days since her last test. Whether the production company chose to not check the database, or to ignore the “past due” testing status, or whether there was actual lying involved on the part of the actress, has yet to be ascertained; what we do know is that over the 11 years since AIM came into existence, a total of six performers have tested positive, according to AIM (who reported an additional 12 people that they noted were not adult industry performers)—and that is without any industry-wide standards that regulate the use of any barriers (including condoms) for what are unquestionably high-risk activities for STI transmission.
The adult industry is run on trust—handshake agreements that everyone is supposed to abide by, yet, obviously, not all do. In a perfect world, trust would be enough—the actors trust the production companies to watch out for their collective health, the production companies trust the actors to be truthful and practice safer sex. But, with that trust showing signs of abuse, is trust enough for porn stars to risk their lives on? And even if they are willing to do so – is it ethically and morally responsible for an industry that is based on the marketing of fantasy to put that fantasy before the potential for disease that they expose their own workers to? Do we, as a society, really need for our porn to be made and marketed in a bubble of faux safety, where we simply don’t see any indications of responsible sexual practices? Or is it past time, as some commentators believe, for the porn industry to reflect safer sex practices in a demonstrable way, not only encouraging healthier behavior for consumers but also protecting the health of actors and actresses in the industry. ]