Acworth Asks: Is The Adult Industry a Model for HIV Prevention?

SAN FRANCISCO—About two weeks ago, AIDS Healthcare Foundation (AHF) announced that it would be placing ads in a variety of newspapers nationwide, taking the CDC to task for recognizing that the anti-HIV drug Truvada, if used correctly, is an excellent guard against HIV infection. Since his organization's charter is that it treats HIV-infected patients, AHF President Michael Weinstein—who famously described Truvada as a "party drug"—couldn't let anything as prosaic as an HIV preventative cut into AHF's business model. The ad, the text of which can be found here, focused on the CDC's discarding of the term "unprotected sex" in favor of "condomless sex," since those who took Truvada faithfully would not become HIV-positive from having sex without a condom. AHF's main argument was not that the drug didn't work, but that it doubted that people would take the required dose every day, and also that the drug had no effect on the various other sexually transmitted infections (STIs) to which even faithful Truvada users could be exposed during sex without a condom. But the fact is, Truvada isn't the only way HIV can be prevented from spreading among an otherwise at-risk population: There's also regular frequent STI testing, such as that used by the adult industry, which hasn't had an on-set HIV infection in over 10 years—and it's that fact that inspired a recent entry in Kink.com owner Peter Acworth's blog. After noting Weinstein's objection to the CDC's stance on Truvada, as set out in an "open letter" from Weinstein titled, "What If You Are Wrong About PrEP?" Acworth dared to ask, "As someone who has endured Mr. Weinstein’s morality crusades myself, I have to ask: Mr. Weinstein, what if you are wrong about the adult film industry? "For the past five years, attacking the adult film industry over HIV has been your near singular focus," Acworth continued. "You’ve railed against producers. You've called performers a threat to public health. You've run ballot measures, initiated boycotts, and wasted millions of dollars on failed legislation. You spend public money monitoring porn for condoms, and use your valuable resources shaming anyone who doesn't share your conservative morality. But what if you're wrong about us? What if, rather than being part of the problem, the adult film industry could be part of solution?" Acworth went on to note that it's been more than ten years since there was an on-set HIV transmission in the adult content production industry, "[d]espite shooting hundreds of thousands of scenes," and referred to the fact that all current performers receive a full panel of STI tests every two weeks—and that whenever "there's even a remote possibility that an STI like HIV or syphilis might pose a risk to the performer pool," the industry stops production until the reports are either verified—which then sparks an industry-wide testing regimen—or disproved, in which case production continues as usual. Acworth even referenced a New York Timesarticle from 2012 which deemed the adult industry "an unlikely model" for HIV prevention. "You see, sexual health is integral to our business," Acworth stated. "Performers know more about their bodies—and how to protect them from STI —than any other demographic on the planet. If a performer contracts an STI, they may not be able to work, sometimes for weeks. And in the case of production shutdown, the entire industry loses money. Even if we were the greedy profiteers you so often portray us as, we'd still have a vested financial interest in keeping the performer pool safe." Acworth goes on to say that it isn't all about money, describing those involved in production as "a small, tight-knit community" which "care[s] deeply about what happens to our fellow performers." Acworth wrote that it's this caring which has led him to support Truvada use among performers, "Because while we’ve been able to control performer safety on set, we can’t always control what happens off-set, with an untested population. ... In the past few years, several performers have attempted to return to work after contracting the virus off-set, and we’ve shut down production, initiated partner contacts and worked with doctors and public health officials to trace the genealogy of the virus (i.e., where it was contracted). A drug that protects performers off set as well as on set not only promises to keep our performers safer, it promises to keep our industry stronger." All in all, it's an excellent response to Weinstein's/AHF's position that only condoms can protect adult performers, and well worth reading in its entirety.