Investigation of HIV and Gonorrhea Transmission in the Adult Film Industry — Los Angeles, California, 2010

Background: The adult film industry (AFI) employs approximately 1,500 actors in Los Angeles. A case of human immunodeficiency virus (HIV) infection in an AFI actor who had worked in heterosexual and homosexual productions was reported to the Los Angeles County Department of Public Health in December 2010. The actor received a diagnosis of acute HIV infection, and pharyngeal gonorrhea in October. We conducted a multistate investigation to characterize the source and transmission of infections. Methods: We interviewed the actor regarding potential exposures and contacted production companies, talent agencies, and testing laboratories to obtain records to complete a contact investigation. We reviewed compliance of producers with occupational regulations during the actor's occupational exposures. Results: The actor identified 14 occupational and one nonoccupational sexual contacts, including 5 men and 10 women during the 8-week period preceding the October diagnosis. Occupational exposures involved 12 filming locations and 10 production companies. The actor reported having used condoms in productions involving anal exposure, but not during vaginal or oral exposures. Contact investigation was completed among 5/14 sexual contacts. One nonoccupational contact had pharyngeal gonorrhea; two occupational contacts were HIV-infected; three contacts were HIV-uninfected; and 9 have unknown status; investigation is ongoing. Occupational bloodborne pathogen standards were not followed during filming. Conclusions: Limited cooperation from many AFI companies restricted this contact investigation. AFI workers have a high occupational risk for acquiring and transmitting sexually transmitted infections. Many productions have not complied with current occupational health recommendations for bloodborne pathogen risk reduction which could prevent infection.