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July 28, 2011

LA County Continues to Lie About STDs in Adult Industry

LOS ANGELES—One might think that with the blockbuster dissection of the Los Angeles County Department of Public Health's (LADPH) pronouncements on sexually transmitted diseases (STDs) in the adult content industry by renown epidemiologist and biostatistician Dr. Lawrence S. Mayer of the Johns Hopkins University Bloomberg School of Public Health, that one of the primary subjects of that dissection—Dr. Peter Kerndt—wouldn't have the moxie to continue to spout his falsehoods to the public, much less the scientific community. But in a paper co-authored by Kerndt published this month in the journal Sexually Transmitted Diseases, that's exactly what they do—and needless to say, the AIDS Healthcare Foundation (AHF), which this week appealed its losing condom lawsuit against LADPH to the California Supreme Court, lauds them for it. The paper, "High Chlamydia and Gonorrhea Incidence and Reinfection Among Performers in the Adult Film Industry [AFI]," was also co-authored by LADPH epidemiologist Binh Y. Goldstein, Ph.D. and County Health employees Jane K. Steinberg, Ph.D. and Getahun Aynalem, M.D., and the misinformation begins in the article's first paragraph. "Since the legalization of adult (X-rated) ?lm production in the State of California in 1988 with the California Supreme Court’s ruling in People v. Freeman," the article begins, "the adult ?lm industry (AFI) has expanded tremendously and is estimated to have gross revenues nearly of $13 billion annually." The $13 billion figure was taken from a January, 2007 New York Times article, and since the actual gross revenue figure in 2011 is closer to half that amount, it's a good indicator of the level of scholarship and research which has gone into the paper, which was accepted for publication in December, 2010. But the misinformation keeps on coming! "The director of a clinic, which provides the majority of STD testing for performers, stated that 'an average popular male in the industry, through partner-to-partner-to-partner transmission, reaches approximately 198 people in 3 days'," the article claims. "Although the total population of performers at any one time may appear small, they have a very large sexual network and serve as a bridge population for STD transmission to and from the general population." Leaving aside the absurdity that one performer passing an STD to another during one shoot on one day could exponentially spread it to 198 performers in three days, the claim that the performer population has "a very large sexual network" that could transmit STDs to and from the Los Angeles population at large is ludicrous. While some performers have boyfriends/girlfriends or spouses outside the industry, the majority don't, and when performers "work private," the rule is that they use condoms because they don't want to bring any diseases from outside the industry in. After all, since the overwhelming majority of LA residents have never been tested for an STD, and have no idea whether they're infected with one or not, performers—who are tested monthly—know enough not to trust the odds with non-industry partners. And of course, the lack of STD testing in the general population was one of the main thrusts of Dr. Mayer's study. "[A]s Dr. Mayer analyzes the data provided by Drs. Kim-Farley and Kerndt," AVN previously noted, "the prevalence of STDs among the performer population 'appears to use all positive tests in the numerator, but does not take into account the number of tests the subjects received. AFI performers are tested every four weeks. Kim?Farley and Kerndt, lacking a denominator, used an estimate of number of AFI performers (2000 or 3000) when they should have used an estimate of the number of tests given to the performers. The two methodologies yield very different results.'" The article's authors also claim, citing testimony that AIM director Dr. Sharon Mitchell alleged gave to a California legislative committee, that "Between 1998 and 2008, 17 HIV cases were reported among performers," but aside from that being a misinterpretation of Mitchell's testimony, the time span used includes infections that took place before AIM was even formed, and when "regular testing" in the industry was more prayer than fact—and what testing there was, was the nearly-useless Eliza test, which can take months to show a positive result. The bulk of the journal article is then taken up with attempting to apply STD statistics reported to the LADPH STD Surveillance Registry between 2004 and 2008 of infections among (hetero) adult performers (since gay performers did not regularly test at AIM or similar clinics during that period) to the incidence of STD infections in the general population. However, Dr. Mayer exposed the absurdity of attempting such comparisons. "It must be noted that his [LADPH's Dr. Robert Kim-Farley's] estimation of the prevalence is based on the false assumption that performers are never re?infected nor re?tested within any one year," Dr. Mayer analyzed. "He could have estimated the rates of re?infection and re?testing and adjusted for both although it would lead to a less startling, albeit more accurate, result. The oversight is particularly bothersome and misleading because the AFI performers are re?tested as many as 12 times a year or more. It would be rare indeed for randomly chosen member  of the public to be tested so often." Hence, without getting into more detail than necessary here, the figures reached by Drs. Goldstein et al in their journal article for chlamydia and gonorrhea infections among performers from 2004 to 2007—a total of 2633 cases—are simply unbelievable, as Dr. Mayer explained in great detail in his report, which is linked at the bottom of AVN's article. But in reliance on their faulty data, Drs. Goldstein et al nonetheless manage to come to the expected conclusions: "In summary, this analysis provides evidence that the burden of [chlamydia and gonorrhea] among AFI performers is unacceptably high and that testing alone is not suf?cient for controlling the spread of STDs within this industry...," the authors state. "The industry fears that use of condoms in ?lms will result in a loss of revenue. However, Wicked Pictures, one of the longest running and largest production companies, is condom-only, and Brazil, the world’s second largest AFI, has a condom usage rate of 80%, suggesting that use of condom in adult ?lms does not necessarily mean a decrease in pro?ts. Furthermore, ?esh tone-colored condoms or digital removal of condoms post-production can also be done to minimize their appearance. In addition to the use of barriers, the following strategies can be adopted by the industry to increase performer protection: (1) mandatory labeling of adult ?lms that state whether the ?lm was produced pursuant to OSHA requirements; (2) prohibit distribution and sales of adult ?lms produced in violation of OSHA requirements to hotels, cable television content providers, and others in commercial settings; and (3) more vigorous enforcement of OSHA occupational standards to reduce exposure to infectious diseases." Of course, Dr. Kerndt was present at the first CalOSHA subcommittee meeting where condoms in the industry were discussed, and undoubtedly heard Wicked Pictures Vice President Joy King tell the subcommittee that sales of its products had been enormously adversely affected by its condom-only policy, while as any industry insider knows, the market for Brazilian XXX product in the U.S. is vanishingly small. And considering the budgets of most adult movie productions, the suggestion that condoms could be digitally removed from the action, at a cost of thousands of dollars per second, is laughably ignorant. It remains to be seen whether CalOSHA will be able to implement the authors' suggestions that adult product be forced to carry labels regarding whether they're OSHA compliant, or whether the state can prevent hotels, cable providers or "others in commercial settings"—retailers and e-tailers???—from selling non-compliant material... and considering California's current operating budget, the likelihood that CalOSHA will be able to "vigorously enforce[]" its standards remains to be seen. Additionally, it is interesting that news of the Goldstein article's publication is being released now, within one day of the Los Angeles Times reporting that the Adult Performer Health Safety & Services performer database will soon be up and running—a report which includes a quote from AHF president Michael Weinstein that he "disagree[s] with" the reality that "testing is a safety net"—and within one day of AHF's announcement that it would petition the California Supreme Court to overturn the Court of Appeals' ruling that LADPH could not be forced to inspect every adult movie set to make sure condoms, dental dams, etc. were being used. And it's hardly a surprise that Weinstein and his group would unquestioningly accept the Goldstein, et al report, claiming in a press release, "Not only do these findings directly contradict claims by the adult film industry that STD rates are lower among performers than among the general population, it also destroys the industry’s argument that regular STD and HIV testing is a replacement for condoms. The only way to prevent such high infection and re-infection rates among porn performers is the enforcement of California worker safety laws that require condom use on set." Or as Sam Elliott's character remarked in the movie Roadhouse, "Different day, same story, eh, boss?"

 
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