HIV prevention in adult film industry – testing alone ‘not sufficient’

An adult film actor has been infected with HIV during production in the USA, prompting the US Centers for Disease Control (CDC) to call on the industry to re-evaluate its approach to HIV prevention, as ‘testing alone is not sufficient to prevent occupational HIV transmission’.

Many adult film production houses in the USA, particularly those specialising in ‘bareback’ or condomless porn, use HIV testing as their primary means of preventing HIV among performers.

Currently, performers are required to have frequent HIV tests, with their data stored on a third-party database to protect their privacy. The production house consults the database, and is notified if an actor is cleared to work. 

The Mortality and Morbidity Weekly Report, released last week (Febuary 12), details the case of a 25-year old male performer (patient A). Patient A had an HIV-negative nucleic acid amplification test (NAAT), a highly sensitive test that can detect HIV from 10 to 15 days after infection.

22 days later he tested positive for HIV, after condomless sex with 12 adult film actors and five non-work-related partners. Two of the man’s partners, one actor, and one non-work partner were later diagnosed as HIV-positive.

The diagnoses have called into question whether HIV and STI testing protocol is sufficient in the adult film industry, and the CDC is calling for a variety of prevention initiatives to be used, including testing, condoms and the use of pre-exposure prophylaxis (PrEP).

The report said, “PrEP remains an important approach for preventing HIV infection among persons at high risk for HIV infection, including adult film industry performers who might be at risk in both their professional and personal lives.”

However, regulating the adult film industry is a challenge, with “the wide geographic distribution of adult performers, filming locations, and production companies”, says the report.

HIV prevention in the adult film industry is not a new issue. It is now illegal for condomless sex in adult productions to be filmed in Los Angeles – considered the epicentre of the adult film industry.