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sex, STDs

Why porn bums me out

I don’t like porn. While I find the story lines cheesy, the bodies fake, and the facial expressions that are supposed to represent the height of sexual satisfaction anything but sexy, it’s the idea that I’m watching people giving each other sexually transmitted diseases that, well, repulses me.

Between 1998 and 2008 there were 17 cases of HIV reported among adult film performers. To give you an idea of the impact of the number of contacts, one of the HIV index cases had 13 female partners during the month he was seroconverting from HIV negative to positive (he was complying with the monthly HIV test requirements). Three of those 13 partners, 23% of exposed women, contracted HIV from that one performer in that one month. And just this week the industry has largely halted production because sadly another performer has a positive HIV test (although according to most news sources the infection does not appear to have been confirmed with a second test).

In 2008, 14.3% of adult performers in California were positive for chlamydia and 5.1% had gonorrhea (Goldstein et al Sex Transm Dis July 2011). About 25% of adult performers with either gonorrhea or chlamydia are reinfected with one or the other (or both) within 12 months.

Adult performers have the highest incidence of chlamydia and gonorrhea when compared with other sexually active people, even those tested in STD and college clinics (source: California Department of Public Health surveillance data). So clearly porn sex is riskier than other sex, especially when considering gonorrhea. (I chose to compare adult performers with 20-24 year olds as I guessed that was the average age of an adult female performers).

Chlamydia and gonorrhea rates among adult performers and 20-24 year olds by testing site

Adult film performers get STD tested once a month, though it is voluntary (some film companies insist on it and others, I suspect, are more lax). The performers themselves have to pay for the testing and obviously there is an incubation period. You can test negative on day 1 on the month, get exposed on day 10 and have a good 15 days or so to pass the infection along before you are flagged by your next test on day 30. Now think about the sheer numbers. Apparently a “popular adult male performer” through partner-to-partner-to-partner transmission reaches 198 people in 3 days (Kerns M, Adult Video News, August 2003).

The testing is also less than ideal because it is only performed from the vagina/cervix for women and urethra (penis) for men. This is not adequate to identify rectal or oral infections with chlamydia or gonorrhea. Up to 33% of people can have infections in the mouth or anus that will be missed by conventional urine testing (Gunn et al Sex Transm Dis 2008).

There are ways to make porn safer for the performers. The first is condoms (i.e. making porn OSHA compliant). Some companies are able to turn a very good profit even with a 100% condom policy (and with post-production it would be easy to digitally remove condoms, if that is indeed necessary. Given the $13 billion a year of porn revenues, surely a few hundred thousands dollars could go to digitally cleaning up the penises).

Testing should also be paid for by the companies and condoms provided for free…my work pays for my TB testing and provides my exam gloves. Why should an adult film performer not be accorded the same workplace safety? Given condoms reduce the transmission of gonorrhea and chlamydia by almost 100% and HIV by 87%, we should see a lot fewer cases. A lot. And testing should involve the mouth and anus as well as the vagina/urethra.

So what do I see with porn? I see people giving and receiving sexually transmitted diseases. I see workers who have been neglected by OSHA. And you know, that just doesn’t do it for me.

What can you do? If you like porn, chose films from condom-only companies, like Wicked Pictures. Until there is an impact on profits nothing will change.

Discussion

8 thoughts on “Why porn bums me out

  1. Agree 100%.

    On a related note, the one time I got roped into watching Jersey Shore, all I could think about was that I was watching a group of people get paid to share their STDs. Eww.

    Posted by PGYx | August 31, 2011, 1:17 am
  2. Interesting. The abstract for Goldstein et al Sex Transm Dis July 2011 mentions “assumptions of the population size of performers”. Have you read the paper itself, and do you have any feel for what the assumptions are? Because as we exchanged on Twiter, this data is inconsistent with previous numbers. I’d love to know where those differences are coming from.

    Posted by Dan Lyke (@danlyke) | August 31, 2011, 2:26 pm
    • Dan, I have read the article. I would never source something without reading it and deciding if it was high quality evidence based medicine. BTW the Journal Sexually Transmitted Diseases is a high quality journal.

      When you have read the entire article, then perhaps we can discuss the finer epidemiological points.

      Posted by Dr. Jen Gunter | August 31, 2011, 2:59 pm
      • Thanks, I’ll have to hit a library to find a copy of it. I’ve found a couple of critiques of it which are pretty brutal about the methodology, both for the population size assumptions and for how the numbers for infection counts were derived from the numbers received from the testing (which I hadn’t put much thought into), but without having read the initial paper, of course, it’s all speculation on my part. I just find it fascinating that these numbers are so out of line with previous research on the topic.

        (Not that I have much of a horse in this race generally, I find most porn plastic and boring, I’m not in the industry, and I’m monogamous…)

        Posted by Dan Lyke (@danlyke) | August 31, 2011, 4:05 pm
  3. > condoms reduce the transmission of gonorrhea and chlamydia by almost 100% and HIV by 87%

    I didn’t realize the transmission rate on HIV with condoms was so high. Do you have a cite for that?

    Posted by Vik | August 31, 2011, 6:01 pm
  4. Sorry, ma’am, but those stats about STI rates among porn performers are cooked and absolute nonsense.

    They don’t take into account counts of multiple infections in a performer that are counted as separate infections.

    Worse of all, they ignore the basic fact that adult performers are tested far more often for STI’s than the general public at large, and even generally use condoms at a much greater rate than the general population.

    Also, this ignores the fundamental fact that since the 2004 “outbreak” where one performer was infected with HIV outside of his work and then accidentally infected three other performers, there has been NO case of any performer getting infected from HIV from performing on a porn set. The two infections that have taken place (2009 and 2010) each were outside of the porn set, and no one else was found to be infected.

    Most industry protocols already endorse and encourage voluntary condom usage; but it is a proven fact that porn consumers at large will NOT buy porn that is strictly condom only, outside from a small niche audience of “couples”-based consumers. Most companies that have attempted to go condom only have lost sales, to the point of having to return to a “condom-optional” policy. That in and of itself affects the livelihood of performers who might not want a condom shoved down their throat or who might have other ideas on how to protect themselves from STI’s.

    In addition, the proposed condom mandate would do away entirely with the regime of testing that has been mostly successful in screening out potential infections. In lieu of California anti-discrimination laws that forbid employers from asking an employee about his/her HIV status, that would actually increase the risks for performers for STI’s and HIV…especially given the average 85% success rate (and the nature of shooting sex scenes, which is fundamentally different than sex in real life).

    And then, there is the prospect of porn being outsourced out of California to places where less protection is offered, which further increases the risks.

    Finally, the $13 billion figure for the alleged profits of “the porn industry” are highly inflated…it is closer to $3 billion overall, and probably much less for the LA portion of the adult film/video industry.

    With all due respect, Dr. Gunther, you might want to read up on some facts, rather than merely regurgitate AIDS Healthcare Foundation talking points. And, even better, listen to the voices of actual performers like Nina Hartley who understand how best to protect themselves.

    Anthony Kennerson
    Lafayette, Louisiana

    Posted by Anthony Kennerson | September 6, 2011, 10:43 pm

Trackbacks/Pingbacks

  1. Pingback: How effective are condoms at preventing HIV. Really?! « Dr. Jen Gunter - September 2, 2011

  2. Pingback: How effective are condoms in preventing HIV | The 50 Something Man - September 5, 2011

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