I heard the news while driving home from work: a California porn star tested positive for HIV, resulting in a voluntary industry-wide shutdown. Here we go again, I thought as I waited for the radio announces to cry out for mandatory condom usage in adult films. It’s an issue that surfaces every other year or so after a news story about an HIV scare in the industry and a topic I have written about in the past, trying to explain why allowing government to get involved in individual’s choices about sex (albeit, sex work) is a very bad idea. To my surprise, the radio announcer made a comment that I think is the right aspect of this story to focus on.
“I’m surprised we don’t hear about porn actors testing positive for HIV more often," the radio DJ said.
He assumes, like many, that because of the frequency with which adult entertainers engage in sex acts and the variety of partners they generally enjoy that the rates of infection would be higher among porn actors than among the general population. After all, we aren't surprised when a firefighter gets burned or a shop teacher loses a finger; it sort of goes with the territory. However, upon investigating the numbers it seems that this assumption is incorrect and perhaps media attention on the few cases of infection that occur among porn actors every few years has skewed our perspectives on the risks. A porn star contracting HIV is perhaps a little something like a plane crash; the fatality rate of fliers is quite low compared with number of drivers who perish on our nation's highways every year, yet the media attention associated with each and every plane crash contributes to many people's feeling that flying is far riskier than driving.
While the risk of contracting a sexually transmitted infection (STI) is certainly greater for porn actors, it is part of the deal when they make the decision to go into the industry. So, does this increased risk actually result in increased incidences? According to the radio DJ and many observers outside of the porn industry, it seems intuitive that infection rates are higher. However, when we look at the numbers it seems that rates of HIV among adult film actors is not higher than the general population. Not by a long shot.
The rate of HIV infection among the general population from my unscientific analysis, is roughly comparable, if not greater -- than it is among the licensed adult film actors working in California. According to CDC data from 2009 (the most recent available) there were 48,100 new cases. If there are 305 million people living in the US, that means that about 0.0016 percent of the popoulation contracted HIV in 2009. While the numbers for adult film actors are tougher to nail down, we can use the data provided by the Adult Industry Medical Center (AIM), which serviced most of the licensed adult actors in the L.A. area and was required by law to report any positive cases of HIV to the to L.A. County Health Department within seven days.
According to AIM's reports, there have been only a handful of HIV infections in the adult entertainment community in the last decade. In the first five years AIM operated, there wasn't a single case of HIV infection among LA area porn actors until 2004 when porn actor Darren James contracted HIV and spread it to four other actors. It was six years until another incidence of HIV in the porn industry would become public -- one actor tested positive.
Add that to this latest case and there have only been around seven cases of porn actors contracting HIV in more than a decade; an average of less than one person a year. This means that the rate of HIV infection among the LA porn population is somewhere around 0.0007% of the population versus the general population’s 0.0016%.
How could this be? Well, my analysis is certainly not definitive and there could be a selection bias among the actors who sought care at AIM (all licensed actors are required to get monthly STI tests): it could simply be that, unlike the general population, adult film actors are extra careful about their sexual health. After all, it is their livelihood -- one day of carelessness could force them to hang up their handcuffs and fishnets for good.
Number-crunching aside, the point remains that a condom mandate will not prevent all cases of porn actors contracting HIV. On the other hand it does strip the right of actors and directors to make decisions about their health and welfare. As we can see by the numbers, condoms aren't the only way that porn actors mitigate the risk of contracting HIV. And as sex-tech and medical treatments advance it seems silly for government officials who have never (presumably) worked in the adult entertainment industry to mandate condom use. For example, some adult actors who have spoken out against the condom mandate claim that using condoms can be counter-productive to STI prevention. In a 2009 hearing on the issue, porn super-star Nina Hartley and her partner came out in defense of actors’ right to choose. They explained the dangers, particular for female actors, of such extended use of condoms, including broken condoms and friction abrasions which leave the actors more susceptible to contracting an STI.
The world is filled with risks that we all must weigh and decide on individually. While the average person is considering the best kind of car to drive or whether they want to drink skim or whole milk, adult film actors should have the right to weigh their risks and make their own choices. As the numbers show anyone having sex is taking a chance of contracting an STI and until science finds a cure for HIV it should be up to each individual who is sexually active person, how to deal with that risk.