Adult Film Performers Transmission Behavior & STI Prevalence

Pamina Gorbach
University of California, Los Angeles

Social and Behavioral Sciences

Los Angeles is the largest center for adult film production worldwide with an estimated 200 production companies employing up to 1,500 workers at any given point in time and producing and estimated 10,000 films per year. Throughout the course of their employment, adult film performers (AFPs) are routinely exposed to sexually transmitted infections (STIs) and are at high risk for acquiring and transmitting STIs including HIV as a result of high-risk work including multiple and concurrent sex partners over short time periods, high-risk sexual acts such as anal intercourse, and lack of condoms or other barrier methods. 

Outbreaks of STIs including HIV have been well documented in the adult film industry.  In 2004, three HIV infections were acquired during filming in Los Angeles, after a male performer infected three female performers.  There is additional data to indicate that as many as one in three performers have other STIs such as chlamydia and gonorrhea.  The STI prevalence among performers is extremely high and demonstrates that despite the industry's practice to routinely test performers for STIs, testing alone is not effective in preventing performers from being infected with STIs at endemic levels. Adult film performers are not an isolated community and performers may serve as a bridge population in passing STIs to and from the rest of the population.  Previous studies of AFPs show that the majority have at least one sexual partner outside of work and the prevalence of unprotected sex with these partners is high.   However, data on sexual networks, sexual risk behaviors, and the extent to which performers serve as a core transmitter group to the larger population is limited. 

The proposed study will examine the prevalence, risk behaviors, and sexual network characteristics of adult film performers in Los Angeles County, CA.  Specifically, we will conduct STI testing including Chlamydia, gonorrhea, syphilis, and HIV testing among a group of 340 AFPs.  The AFPs will be recruited from those seeking care at a health center serving many performers.  Those who agree to participate in the study will be asked to refer other performers as well as their sexual partners to be in this study.  This method of referral has been used with other sex workers and hard to reach populations and will allow us to extend our recruitment beyond those seeking care at the health center and get a better representation of the sexual network characteristics of AFPs.  Besides STI testing, we will also ask that all study participants complete a questionnaire about transmission behaviors practiced in their workplace and non-workplace activities. 

The findings from this study will be one of the first to describe the prevalence of STIs within AFPs as well as their sexual networks.  These data will not only help conceptualize the development of appropriate and effective prevention interventions aimed at reducing the acquisition of STIs/HIV among AFPs and transmission within their networks, but will also help inform overall screening guidelines among this group.