June 20th, 2009

More HIV in the Adult Film Industry (Maybe)

From the New York Times last week:

Health officials in Los Angeles said Friday that 22 actors in adult sex movies had contracted HIV since 2004, when a previous outbreak led to efforts to protect pornography industry employees.


Occupational health officials have long argued that failing to require that performers wear condoms during intercourse and other acts is a violation of safe-workplace regulations.

But Deborah Gold, a senior safety engineer with the California occupational health department, said violations in the pornography industry were so widespread that the state had a difficult time cracking down.

My first response on reading this was amazement that the number was so small — and, remarkably, that number turned out to be even smaller (1 case) when further details emerged in the LA Times:

Los Angeles County public health officials backtracked Tuesday on their statements last week that at least 16 unpublicized cases of HIV in adult film performers had been reported to them since 2004.

Despite their release of data to The Times describing the cases as “adult film performers,” the county’s top health official acknowledged that the agency does not know whether any of those people were actively working as porn performers at the time of their positive test.


The county lacks sufficient information to delve deeply into the cases and still has received no formal report on the most recent case.

“The system we have and the laws we have do not facilitate the kind of contact tracing and verification that we’d like to see,” [LA County Health Officer] Fielding said. “AIDS has been treated separately from other STDs.”

Bottom line here:  Aside from this well-researched cluster of cases reported in 2004 in the MMWR, we likely only have a vague idea how many cases of HIV are in, or linked, to this “industry” — which in addition to these semi-regulated companies undoubtedly has a huge underground as well.

And until we get rid of this bit of HIV exceptionalism cited above by Dr Fielding, appropriate contact tracing and partner notification are going to be very difficult indeed.

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HIV Information: Author Paul Sax, M.D.

Paul E. Sax, MD

Contributing Editor

NEJM Journal Watch
Infectious Diseases

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