In what was perhaps the California legislature’s first ever in-depth look into the life and operations of the adult entertainment industry, Assemblymember Paul Koretz chaired a public meeting Friday on the health and safety issues pertinent to the adult industry, and the roll call of speakers assured that he’d get much of the information needed for the government to make an informed decision on how best to help adult performers avoid another HIV outbreak.
The hearing was divided into four sections – state and local healthcare professionals, industry experts and spokespersons, HIV specialists and legal perspectives – with room for public comment at the end, and just about everyone who wanted to have a say had one – including a couple who talked only to the news cameras.
The hearing had an importance far beyond the Los Angeles adult entertainment community, however, because as one speaker later noted, “If you scan the Internet, the salacious worldwide coverage on this outbreak is truly astounding. It rivals the coverage of AIDS in Africa, where there are 20 million people who are infected.”
In large part, the debate centered around three key questions: Is the possibility of becoming infected with STDs – sexually transmitted diseases, including the incurable human immunodeficiency virus, better known by its acronym HIV – an acceptable risk even for knowledgeable adult video performers? Should the California government require the use of condoms during sex scenes and/or HIV/STD testing for all performers, both straight and gay? And what would be the industry’s reaction if such requirements were put in place?
The First Panel: Government Health Officials Make Case for Regulation
Koretz, whose office has been tracking the adult industry for more than a year, set the stage for the discussion by noting, in his opening statement, that “The state must proceed thoughtfully upon this very complex issue.”
“Some argue, and I believe this,” he said, “that if we over-regulate, the industry would go underground or leave the state and the problem won’t be solved; in fact, it could be exacerbated.”
It was a thought that seemed to be in at least the back of every participant’s mind, though at least two of the government’s witnesses seemed convinced that the risks of unprotected sex outweighed the benefits.
“Just as we would not allow a construction worker to be on a work site without a hard hat,” intoned Dr. Jonathan Fielding, Director of Public Health for the Los Angeles County Department of Health Services, “we should not allow an adult film industry worker to have a high-risk sexual encounter as part of their work without a condom. We therefore endorse legislation for the adult film industry that would, number one, require condom use for all high-risk sexual encounters; two, have screening requirements for sexually transmitted diseases, with these set by the state, and the screening costs paid for by industry, and offering vaccinations for appropriate preventable conditions; three, mandate education and training for all adult film industry performers; and four, have high-quality monitoring to assure compliance and have this done by state and local health departments but paid for by the industry. Now, these measures would not only provide for reasonable worker protection, but would send an unmistakable message to the many millions viewing this material that sex between non-monogamous partners should always be safe sex.”
That last point raised the hackles of First Amendment advocates who would speak to the issue later., but it was supported by Dr. Fielding’s associate, Dr. Gail Bolan, the Chief of his department’s STD Control Branch.
“It is in the interests of health that if people choose to purchase and watch adult entertainment, it is best that safer sex behaviors that convey prevention messages be presented to viewing audiences,” Dr. Bolan argued. “Public health departments long ago have learned that cultural messages are carried effectively though the popular media, and that we in the health field cannot get our messages across only out of the journals.”
Also, Dr. Fielding never made clear exactly what he meant by “high-risk sexual encounters,” later admitting that he was unsure whether condoms should be required for oral sex.
But Dr. Fielding did testify at length about the factors that led him to his conclusion.
“One of the working conditions in the adult film industry currently involve a worker having prolonged and repeated sexual intercourse with multiple sexual partners over short periods of time,” Dr. Fielding noted. “These circumstances create unfortunately ideal conditions for effective transmission and acquisition of HIV and other sexually transmitted diseases.”
“I think it’s critical to highlight that screening, while important, is not adequate alone to prevent HIV and other STD transmission,” he warned. “A performer who was infected with HIV a week ago can test negative today and transmit HIV to a sexual partner tomorrow. For HIV, the period immediately after infection, before the body’s immune response has been fully mobilized, and obviously before treatment has been applied, is the time when an individual can be highly infectious. STD screening of performers by AIM has found a monthly incidence of approximately 2 percent for chlamydia and gonorrhea, two other sexually transmitted diseases. Assuming between 700 and 1200 performers are screened per month, this translates into roughly 14 to 24 performers with active chlamydia infection and the same number with active gonorrhea infection per month.”
Dr. Fielding found those statistics to be unacceptable, noting further that “Infected workers can in turn transmit this to personal sexual partners in the general community,” and that “The adult industry should have the same fundamental obligations to worker health and safety as any other industry.”
“There is a fundamental question here,” he said, “and the question is, why should workers in the adult film industry be subjected to life-threatening incurable diseases as a condition of work when in fact those diseases are preventable?”
“What we need,” he concluded, “is a combination of what currently goes on in the gay adult film industry, which as I understand it is over 95% use of condoms, and the straight film industry that has a very good screening and testing program. These need to be married for both parts of the industry to have worker protection and also protect the community.”
Dr. Fielding’s associate, Dr. Peter Kerndt, later added another possibility to the discussion; one that had been discussed at a meeting which Dr. Kerndt had chaired in April, between health department officials and representatives of the gay adult video community.
“I think another area that we’ve explored and that I think is worthy of further effort on the part of the industry is the use of special effects,” Dr. Kerndt said. “Their concern is to maintain the market value of their product, and it may be possible through special effects, through using condoms that have flesh tones or other measures that can be taken – guiding the angle of the shot – that would protect the worker while maintaining some of the market value of the product. Of course, that would cost more.”
Dr. Fielding also spoke of the necessity of establishing a database of all filmed and videotaped sexual encounters in the industry.
“My understanding is that AIM has, in collaboration with a number of producers in the industry, established such a database,” he noted. “That is extremely important when you’re looking to try to contain the kind of outbreak that we have just experienced.”
AIM’s Dr. Sharon Mitchell later identified the database as the AdultDat system.
Vicky Heza, a Deputy Chief with the California Division of Occupational Safety and Health – better known as Cal OSHA – also spoke, and while she addressed many of the concerns later voiced by Dr. Fielding, she was unclear as to what her department’s role in the situation would be.
“As the name of our agency indicates, our work... is limited to that that takes place in the context of the employer/employee relationship,” she informed. “Where there is an employer/employee relationship, and in the context of that relationship employees are exposed to a hazard, Cal-OSHA has the authority and the obligation to take reasonable measures to enforce both protective measures mandated by law, to remove the hazard or otherwise protect employees from it.”
However, she later clarified that whether a specific incident involved an employer/employee relationship would have to be determined on a “case-by-case basis.”
She did say that if her agency did become involved, that there were already regulations in place to deal with an STD-infection situation.
“There are existing occupational and health requirements that apply to this situation,” Heza detailed. “The most important requirement is based on medical, public health and workplace health principles that are brought into question by the practices taking place in this industry. That requirement is to observe what are termed universal precautions in all cases where there is potential for contact with blood or potentially infectious body fluids. The universal precautions are defined in the blood-borne pathogen standard as follows. Universal precautions are on page 2, ‘infection control.’ ‘According to the concept of universal precautions, all human blood and certain human body fluids are treated as if known to be infectious for HIV, Hepatitis B and Hepatitis C and other blood-borne pathogens.’”
Heza also told Assm. Koretz that cooperation of performers would be essential to Cal/OSHA’s investigation if it did become involved.
“We worked with the LA County Department of Health Services to identify these employees who might be willing to come forward with information on the practices they have been taught in the adult film industry,” Heza said. “To be successful, our investigation will need some of these employees to come forward. We are required by law not to reveal the name of the complainant and we generally do not discuss the details of an investigation once it has been opened.”
[Ed. note: Due to the size of this article, it has been broken into sections. For the next section, click here.]
