BODIES ON THE LINE

>> The following articles are organized alphabetically by last name (when available).

>> Feel free to submit articles, or research that you’d like to share!

TITLE: Prevention and Control of Sexually Transmitted Infections and HIV among Performers in the Adult Film Industry
AUTHOR(S): American Public Health Association
PUBLICATION INFO: Accessible online, at: http://www.apha.org/advocacy/policy/policysearch/default.htm?id=1396
ABSTRACT:
N/A

TITLE: HIV Transmission in the Adult Film Industry — Los Angeles, California, 2004.
AUTHOR(S): Centers for Disease Control and Prevention
PUBLICATION INFO: 2005  Morbidity and Mortality Weekly Report 54(37):923-6.
ABSTRACT:
In April 2004, the Los Angeles County Department of Health Services (LACDHS) received reports of work-related exposure to human immunodeficiency virus (HIV) in the heterosexual segment of the adult film industry in California. This report summarizes an investigation by LACDHS into four work-related HIV-transmission cases among adult film industry workers. The investigation was initiated April 20, 2004, and joined by the California Department of Industrial Relations, Division of Occupational Safety and Health (Cal/OSHA) on April 21, 2004, and by CDC on May 18, 2004. This investigation identified important and remediable gaps in the prevention of HIV and other sexually transmitted diseases (STDs) in the adult film industry.

TITLE: Sexual Health of Adults Working in Pornographic Films
AUTHOR(S): Coyne, KM with Banks A, Heggie C, Scott CJ, Grover D, Evans C, Mandalia S, McLean KA, Cohen CE
PUBLICATION INFO: 2009 International Journal of STD & AIDS. 20(7):508-9
ABSTRACT:
We report the frequency of sexually transmitted infections (STIs) diagnosed in performers in the adult pornographic film industry. Over a 13 month period, 445 STI screens were performed in 115 patients, 56 women and 59 men. All reported unprotected sex during filming. Seventy-five percent (86) had at least one sexual partner outside work, and 90% used condoms inconsistently with them. Women worked exclusively with women (23%), men only (38%) or both genders (39%). Almost all men (97%) worked exclusively heterosexually. Thirty-eight percent (44/115) were diagnosed with 77 STIs, including non-specific urethritis (51), gonorrhoea (10), chlamydia (6) and genital warts (6). Gonorrhoea was found exclusively at the pharynx in three heterosexual men. There were no cases of HIV, syphilis, hepatitis B or hepatitis C. Monthly screening and certification is a working requirement for this population but STIs are common in an industry where unprotected sex is the norm.

TITLE: Rxxx: Resolving the Problem of Performer Health and Safety in the Adult Film Industry
AUTHOR(S): de Cesare, Maria
PUBLICATION INFO: 2006 In Southern California Law Review (vol 79):667-710
ABSTRACT:
N/A

TITLE: High Chlamydia and Gonorrhea Incidence and Reinfection Among Performers in the Adult Film Industry
AUTHOR(S): Goldstein, Binh Y., Jane K. Steinberg, Getahun Aynalem, Peter R. Kerndt, Peter R.
PUBLICATION INFO: 2011 Sexually Transmitted Diseases 38(7):644-648
ABSTRACT:
Background: Adult film industry (AFI) performers engage in unprotected oral, vaginal, and anal sex with multiple partners, increasing the likelihood of acquisition and transmission of human immunodeficiency virus and other sexually transmitted diseases. Current industry practice does not require condom use; instead it relies upon limited testing. We sought to estimate the annual cumulative incidence of chlamydia (CT) and gonorrhea (GC) and assess the rate of reinfection among AFI performers.
Methods: We retrieved all CT and GC cases diagnosed among performers between 2004 and 2008 in Los Angeles, CA and reported to the health department surveillance registry. Using 2008 data, we estimated ranges for CT and GC annual cumulative incidences based on assumptions of the population size of performers. For cases reported between 2004 and 2007, we determined the CT and/or GC reinfection rate within 1 year.
Results: Lower bounds for the annual cumulative incidences of CT and GC among AFI performers were estimated to be 14.3% and 5.1%, respectively. The reinfection rate within 1 year was 26.1%. Female performers were 27% more likely to be reinfected as compared with male performers (prevalence ratio, 1.27; 95% confidence interval, 1.09–1.48).
Conclusion: CT and GC infections are common and recurrent among performers. Control strategies, including promotion of condom use, are needed to protect workers in this industry, as testing alone will not effectively prevent workplace acquisition and transmission. Additional legislation that places more responsibility on the production companies is needed to ensure the safety and health of performers.

TITLE: Condom Use and High-Risk Sexual Acts in Adult Films: A Comparison of Heterosexual and Homosexual Films
AUTHOR(S): Grudzen, Corita R, M. Elliott, P. Kerndt, M. Schuster, R. Brook, and L. Gelberg
PUBLICATION INFO: 2009 American Journal of Public Health 99(1):152-156
ABSTRACT:
Objectives: We compared the prevalence of condom use during a variety of sexual acts portrayed in adult films produced for heterosexual and homosexual audiences to assess compliance with state Occupational Health and Safety Administration regulations.
Methods: We analyzed 50 heterosexual and 50 male homosexual films released between August 1, 2005, and July 31, 2006, randomly selected from the distributor of 85% of the heterosexual adult films released each year in the United States.
Results: Penile-vaginal intercourse was protected with condoms in 3% of heterosexual scenes. Penile-anal intercourse, common in both heterosexual (42%) and homosexual (80%) scenes, was much less likely to be protected with condoms in heterosexual than in homosexual scenes (10% vs 78%; P < .001). No penile-oral acts were protected with condoms in any of the selected films.
Conclusions: Heterosexual films were much less likely than were homosexual films to portray condom use, raising concerns about transmission of HIV and other sexually transmitted diseases, especially among performers in heterosexual adult films. In addition, the adult film industry, especially the heterosexual industry, is not adhering to state occupational safety regulations.

TITLE: Pathways to Health Risk Exposure in Adult Film Performers
AUTHOR(S): Grudzen, Corita R., G. Ryan, W. Margold, J. Torres, and L. Gelberg
PUBLICATION INFO: 2008 Journal of Urban Health 86(1):67-77
ABSTRACT:
Despite being part of a large and legal industry in Los Angeles, little is known about adult film performers’ exposure to health risks and when and how these risks might occur. The objective was to identify exposure to physical, mental and social health risks and the pathways to such risks among adult film performers. The objective was also to determine how risks differ between different types of performers, such as men and women. Semi-structured in-depth interviews were conducted with 18 female and ten male performers as well as two key informants from the industry. Performers and key informants were recruited through Protecting Adult Welfare, adult film venues and snowball sampling. Performers engaged in risky health behaviors that included high-risk sexual acts that are unprotected, substance abuse and body enhancement. They are exposed to physical trauma on the film set. Many entered and left the industry with financial insecurity and suffered from mental health problems. Women were more likely than men to be exposed to health risks. Adult film performers, especially women, are exposed to health risks that accumulate over time and that are not limited to sexually transmitted diseases.

TITLE: The Adult Film Industry: Time to Regulate?
AUTHOR(S): Grudzen, Corita R. and Peter R. Kerndt
PUBLICATION INFO: 2007 PLoS 4(6):993-996
ABSTRACT:
N/A

TITLE: Condom Use and Prevalence of Sexually Transmitted Infection Among Performers in the Adult Entertainment Industry
AUTHOR(S): Hill, SC, with G King, and A Scott
PUBLICATION INFO: 2009 International Journal of STD & AIDS 20(11)809-810
ABSTRACT:
The prevalence of bacterial sexually transmitted infections among clients of female sex workers (FSWs) was studied. A total of 156 condoms were collected from clients of 13 sex workers during three consecutive days. Condoms used by clients of FSWs were collected and DNA was extracted from the seminal fluid and used for the diagnosis of Neisseria gonorrhoeae, Chlamydia trachomatis and Trichomonas vaginalis by polymerase chain reaction. The prevalence of N. gonorrhoeae, C. trachomatis and T. vaginalis among clients of FSWs was 4.5% (7/156), 2.5% (4/156) and 7% (11/156), respectively.

TITLE: Interventions in the Commercial Sex Industry During the Rise in Syphilis Rates Among Men Who Have Sex With Men (MSM)
AUTHOR(S): Taylor, Melanie; Montoya, Jorge A.; Cantrell, Russell; Mitchell, Samuel J.; Williams, Mark; Jordahl, Lori; Freeman, Millicent; Brown, James; Broussard, Dawn; Roland, Eric
PUBLICATION INFO: 2005 Sexually Transmitted Diseases 32(10): S53–S59
ABSTRACT:
Objective: Describe sexually transmitted disease/human immuno-deficiency virus prevention interventions targeting men who have sex with men (MSM) in commercial sex venues (CSV).
Study: Compilation of descriptive and evaluation data from the CDC 8-city MSM Syphilis Response on interventions conducted in bathhouses/sex clubs, circuit parties, the Internet, male sex workers, and the adult film industry.
Results: Interventions in the commercial sex industry (CSI) often involved multiple collaborative efforts between public health departments (PHD), community-based organizations (CBO), and CSV owners and managers. Education and condoms were provided at multiple venues, including circuit parties, bathhouses, and sex clubs. CBO staff reported one-on-one street and CSV outreach to engage MSM at risk. Evaluation data demonstrate that MSM exposed to media campaigns were more aware of syphilis and more likely to have been tested for syphilis than MSM who did not see the campaigns.
Conclusions: PHD and CBO are using multiple means of reaching MSM in the CSI. Evaluations are needed to determine which of these efforts decreases syphilis transmission.

TITLE: Epidemiologic Investigation of a Cluster of Workplace HIV Infections in the Adult Film Industry: Los Angeles, California, 2004
AUTHOR(S): Taylor, Melanie M., Harlan Rotblatt, John T. Brooks, Jorge Montoya, Getahun Aynalem, Lisa Smith, Kerry Kenney, Lori Laubacher, Tony Bustamante, Robert Kim-Farley, Jonathan Fielding, Bruce Bernard, Eric Daar, and Peter R. Kerndt
PUBLICATION INFO: 2006 Clinical Infectious Disease 44(2):301-305
ABSTRACT:
Background. Adult film production is a legal, multibillion dollar industry in California. In response to reports of human immunodeficiency virus (HIV) transmission by an adult film worker, we sought to determine the extent of HIV infection among exposed workers and to identify means of improving worker safety.
Methods. The Los Angeles County Department of Health Services initiated an outbreak investigation that included interviews of infected workers to elicit information about recent sex partners, review of the testing agency’s medical records and laboratory results, molecular analysis of HIV isolates from the 4 infected workers, and a risk assessment of HIV transmission in the adult film industry.
Results. Many adult film workers participate in a monthly program of screening for HIV infection by means of polymerase chain reaction-based technology to detect HIV DNA in blood. A male performer tested negative for HIV on 12 February 2004 and 17 March 2004, then tested positive for HIV on 9 April 2004. During the period between the negative test results, he experienced a flulike illness after performing unprotected vaginal and anal intercourse for an adult film produced outside the United States by a US company. After returning to California, he performed unprotected sex acts for adult films with 13 female partners who had all tested negative for HIV in the preceding 30 days; 3 subsequently tested positive for HIV (a 23% attack rate). Contact tracing identified no reasonable sources of infection other than the male index patient.
Conclusion. Although current testing methods may shorten the window period to diagnosis of new HIV infection, they fail to prevent occupational acquisition of HIV in this setting. A California Occupational Safety and Health Administration-approved written health and safety program that emphasizes primary prevention is needed for this industry.

TITLE: Public Health Advocates Push for Safer Sex in Pornographic Film Industry
AUTHOR(S): Vogel, Lauren
PUBLICATION INFO: 2009 Canadian Medical Association Journal 183(5): E261–E262
ABSTRACT:
N/A