Condom use and high-risk sexual acts in the adult film industry

Context: The heterosexual adult film industry routinely tests performers for HIV and other sexually transmitted diseases (STD). Despite this, an HIV outbreak occurred in the heterosexual industry in 2004. Cal/OSHA responded by fining two companies for not using personal protective equipment, in this case condoms.

Objective: To compare high-risk sexual acts and condom use between the heterosexual and homosexual industries after the 2004 HIV outbreak.

Design: 50 heterosexual and 50 male homosexual DVDs released in 2005 were randomly selected from the largest distributor for adult movies, representing 85% of the heterosexually released DVDs each year. One scene was randomly selected from each DVD for review. The main outcome was condom use in high-risk sexual acts and main independent predictor was whether the DVD was produced for a heterosexual or homosexual audience.

Results: Penile-vaginal intercourse was protected at a rate of 3% in the heterosexual industry. Though uncommon in the homosexual industry, penile-vaginal intercourse was protected 100% of the time. Penile-anal intercourse, common in both industries, is much more likely to be protected in the homosexual industry, 80% of the time compared to 10% in the heterosexual industry (p<0.05). Penile-oral intercourse, though common, is almost never protected, with rates of 0% in the heterosexual industry and 3% in the homosexual industry.

Conclusion: The heterosexual is less likely than the homosexual industry to utilize condoms. Cal/OSHA regulations, especially in the heterosexual industry, are not being enforced.