Sexually transmitted infections in the adult film industry

Adult film performers engage in prolonged and repeated sexual acts with multiple sexual partners over short periods of time that often leads to rectal and/or vaginal mucosa trauma resulting in exposure to semen, seminal and vaginal fluids, and blood. These occupational exposures create ideal conditions for transmission of HIV and other STIs. Measures that would protect workers and that Cal/OSHA determined are required under the bloodborne pathogen standard such as worker education, medical monitoring, and condom use are generally considered by most adult film production companies to be “voluntary”.

In this analysis we reviewed cases of chlamydia (CT) and gonorrhea (GC) reported to the Los Angeles County Department of Public Health STI disease registry between April 2004 and December 2007 from sites that were known to provide performer testing services. During this period, 1,804 performers were diagnosed with 2,723 STIs (52% with CT only, 32% with GC only, and 8% co-infected with CT and GC); of these infections, 72% (1960) occurred in female performers. Among the 1,804 performers, 24% (432) had a repeat infection with an STI, either the same or another STI, and 4% (66) were infected with an STI four or more times. Female performers were 34% more likely to be repeatedly infected than male performers (OR=1.34, 95% CI=1.08-1.65).

The STI burden among workers in this industry is likely to be underestimated due to underreporting and lack of industry compliance with medical monitoring. Despite Cal/OSHA requirements the risk and burden of STIs in this industry is unacceptably high.