White Coat Underground

Unsafe at any…er…

People in my profession are at increased risk for acquiring certain diseases: tuberculosis, HIV, hepatitis B and C, and some others. We vaccinate against the ones we can (primarily hepatitis B) and exercise universal precautions, which involves careful attention to bodily fluids and other infectious tissue. The basic rule is, “assume everyone has a blood-borne infection.” We don’t make the same assumptions for other illnesses such as tuberculosis as these usually have symptoms when they are infectious, as opposed to HIV and hepatitis. Even with these precautions, health care workers are frequently exposed to blood-borne infections.

Now imagine a job where you are intentionally exposed to infectious bodily fluids, perhaps containing HIV, hepatitis B or C, syphilis, or any combination of these.  There is an entire industry in Southern California where this happens on a daily basis.  The San Fernando Valley is home to America’s mutli-billion dollar pornography industry.  This industry has made attempts at regulating itself but these attempts are falling far short.

According to the New York Times, 22 pornography actors have contracted HIV in the last 4 years.  The details of these infections are unclear, and whether other infections such as syphilis or hepatitis are also spreading has not been reported. 

No industry should tolerate this level of preventable occupational injury.  None. But how do we encourage prevention?  Pornography is already a “grey market” industry, and if more tightly regulated, I’m sure most would slip back into the black market.  I don’t know what the solution is, especially among workers so prone to being exploited, but shining some light on the issue will hopefully help. 


  1. #1 The Blind Watchmaker
    June 13, 2009

    I don’t think mandating more precaution would help. This is a known risk inherent to this “profession”. If more safety is needed, it will have to come from within the industry. The real issue is who is going to pay for the treatments.

  2. #2 Dianne
    June 13, 2009

    Asking an industry to regulate itself practically never works. Why should it work for the porn industry? It’s time to start regulating it.

  3. #3 Joe B
    June 13, 2009

    For anyone wondering about how the porn industry works, at least from a performers view. There’s Christian’s year long blog (NSFW pictures and banners) of his life as a male performer in the porn industry.

    For the risk of exposure he made a living “working” about 4 hours a day (289 scenes over the year according to the blog), with the rest of the day spent working out, playing World of Warcraft and going out with his (HOT) co-workers.

    He also describes the testing situation for the industry in some entries.

  4. #4 Donna B.
    June 14, 2009

    As a conservative, I do not understand the allure of pornography. That is not to say that is does not have its place in society as a whole. I’m well aware of statistics that show that greater availability of pornography has resulted in fewer rapes.

    What worries me (as a conservative feminist) is that these statistics are skewed in some way… yet there is no evidence they are.

    Then we have Letterman making jokes about a female being “knocked up” in an extremely paternalistic and authoritative way — ie, females exist for male pleasure breeding.

    Where the hell did that attitude come from?

    I’m sure that I am missing the important part of your post, but why are attractive young women exploited when ugly, fat women like me are able to attract available men?

    I’m more than willing to admit that I don’t get it… but what is it that attracts people to become porn actors?

  5. #5 Chris
    June 14, 2009

    Donna B:

    I’m more than willing to admit that I don’t get it… but what is it that attracts people to become porn actors?

    Many decades ago when I was in college I was spending lots of time feeding cards into a card reader and getting a printout trying to do a novel way to digitally compute Navier-Stokes equations, along with several other sleep-deprived classmates in my department (in the end it didn’t work, but that was part of the learning experience :-/).

    One time a couple of us glanced into the auditorium sized classroom on the way to the evil class that was requiring our time in the computer center center… where we saw projected on the large screen several naked people. They were talking about their work in the porn industry.

    My classmate and I looked at each other and opined that we were majoring in the wrong field (engineering).

    It turned out it was for a class called “Abnormal Psychology.”

    And all this time we as engineering majors were considered abnormal by our friends because we did not freak at the notion of imaginary numbers. Who knew!?

  6. #6 DLC
    June 14, 2009

    I’m not sure it is gonna matter much. It’s not in a porn actor’s best interest to report his or her condition in an accurate and timely fashion.

  7. #7 Alan
    June 14, 2009

    One of the issues here (for HIV at least) is that current tests have a substantial lag time between infection and detection (even the modern RT-PCR ones take 12 days or so). Thus a performer can be working for some time whilst infected before they test positive. I don’t see a way of restricting performers that gets around the lag time of antibody-based tests, they can be infected but test negative, or tested negative a number of months ago, but are now spreading the infection. Even if you were to test performers by RT-PCR every two weeks they could be infected for that two weeks. However, I guess if everyone in the industry was tested every two weeks then the circulating virus in “the herd” would be quickly identified. However, this regime would be hugely expensive. I am also not sure what the false-positive rate of these tests are, you would need to know this since you would be doing a huge number of tests and would get a few spurious results.

  8. #8 natural cynic
    June 14, 2009

    Google is your friend:
    The last HIV scare in the porn industry in 2004, there was a 60-day halt in production.
    The industry standard is is RT-PCR testing done once per month with some testing every 3 weeks.

    So, no, DLC, it is in their interest.

  9. #9 ebohlman
    June 14, 2009

    I see an unexamined assumption here, namely that all infections in porn performers are the result of occupational exposure. We have to consider the possibility that people who go into porn performance tend to be people who tend to engage in risky sexual behavior (whether by disposition or necessity) in general. The real question of interest here is not the raw incidence of infection, but the excess (if any) incidence compared to a properly-matched group outside the porn industry.

  10. #10 Joe B
    June 14, 2009


    what is it that attracts people to become porn actors?

    See #3

    he made a living “working” about 4 hours a day (289 scenes over the year according to the blog), with the rest of the day spent working out, playing World of Warcraft and going out with his (HOT) co-workers.

  11. #11 Art
    June 14, 2009

    Twenty-two in four years. Figure a bit less than six a year.

    I don’t know much about the size of the pornography industry but I think it is fair to assume several hundred thousand actors engaged in sexual performances in various roles every year. Say 200,000. So 6/200,000 or three per 100,000.

    Noting that it seems likely that a good proportion of those in this industry, I understand mostly those not making a career if it, are high-risk demographics, IV drug users, homeless, addicts that share needles and people engaged in prostitution and further that HIV may not show up on tests until some time after infection, meaning they may not have been infected during a performance, 3/100,000 doesn’t seem very high.

  12. #12 Isis the Scientist
    June 14, 2009

    But Pal, wearing a condom is just not sexy.

  13. #13 PalMD
    June 14, 2009

    Art, thanks for pulling the numbers out of your ass.

    In the US, HIV incidence per 100K is about 220 for whites, about 1700 for blacks.

    To make up the porn industry numbers is unhelpful. To the others as well, to point out that porn workers may be high risk in other parts of their lives is interesting…and irrelevant. They are intentionally exposed at work every day.

  14. #14 Jimbo Jones
    June 14, 2009

    Easy way to make the porn industry more regulated, and lift it from grey to white market status simultaneously:

    Get rid of ridiculous regulations, like Section 18 U.S.C. ยง2257; these are the kinds of laws holding the porn industry down in the grey market. At the same time, introduce laws requiring specific OH&S standards for sex work, due to the special dangers presented to sex workers.

    Those in the porn industry will see the new OH&S laws as a bargain for getting rid of 2257 and others meaning that, unlike ramping up regulation at other times, most of the porn industry will welcome the package.

    This is unlikely to happen though. The US is far too conservative on average to think of porn as an actual industry.

  15. #15 DLC
    June 15, 2009

    Sorry, Cynic, but industry-mandated testing is not self-reporting. It also doesn’t cover the more shady producers who don’t care about regulations or mandated testing, because they make a couple mil, go out of business and open up shop a few weeks later under a new name and in a new location. 22 people infected over the last four years isn’t a good number.

  16. #16 daedalus2u
    June 15, 2009

    “But Pal, wearing a condom is just not sexy.”

    But giving or getting HIV, or even risking giving or getting HIV is?

    No Isis, those of us who are the arbiters of what is “sexy” have to make it clear that unsafe sex isn’t sexy, not for themselves, not for anyone.

  17. #17 Dianne
    June 15, 2009

    But Pal, wearing a condom is just not sexy.

    Then the porn industry needs to figure out how to make it sexy. Condoms are a prop. I know that the directors and producers of porn aren’t necessarily the best and the brightest of the movie industry, but really if they can’t figure out how to use a simple prop then their movies are probably so bad that sex can’t save them anyway. I mean I can think of…maybe that sentence is best left uncompleted.

  18. #18 catgirl
    June 15, 2009

    I think we need to get past our “ick factor” and treat pornography like any other industry. I don’t really understand the point of Donna B.’s post, but she seems to be saying we, as a society, just shouldn’t have a pornography industry. Well, I don’t see how that attitude helps anyone at all. In fact, shaming these people puts them at greater risk for exploitation and work-related infection. Making it illegal would be a disaster. There are many reasons why people would work in the porn industry, and the biggest one is money. This is an industry which requires very few qualifications besides attractiveness. You don’t need a college degree or even a high school diploma to be a porn actor, and they pay is pretty good. Anyway, none of that matters. It doesn’t matter why they do it; it only matters that people do it and are not protected.

    I think that porn actors need less slut-shaming and more support from society as exploited workers. As a scientist, if I am exposed to hazardous chemicals at work, I can sue my company. If I’m even worried that I might be exposed because there aren’t adequate precautions, I can call various agencies to report it. We need workers in the porn industry to have the power and opportunity to do something about being forced to be exposed to diseases. If workers could sue an employer, with the expectation of winning, then the employers would care more about protecting their employees.

  19. #19 Kate
    June 15, 2009

    I think the sex industry as a whole needs to be brought out into the open and to have all the hell regulated out of it, simply for the safety and well being of the workers in those industries. That’s including porn, prostitution, escort services and other erotic services. If there’s more control and protections in place, there’ll be less rapes, less robberies, less gun-toting assholes trolling Craigslist…

  20. #20 Michael Simpson
    June 15, 2009

    Change isn’t going to happen unless pornography (and other sex-based industries such as prostitution) are legalized. I just don’t see where that’s going to happen.

    And the second driver of these attitudes in the porn industry is, pure and simple, profits. Big Porn. Pornography is a $10 billion industry with, I believe, 90% of it centered in the San Fernando Valley (Los Angeles). California and Los Angeles County health officials do their best to regulate the business, but it’s difficult given it’s not a “real” industry. Ironic isn’t it?

    A lot of porn is moving to eastern Europe because they don’t require the testing and regulations done in California. If that $9 billion in revenue leaves the San Fernando Valley, it’s going to hurt home prices, commercial property rentals, and other economic issues. So maybe, despite the lack of really effective regulation, the almighty dollar will cause the government and the porn industry to get moving in the right direction.

    One last thing. It’s amazing that with increased rates of hepatitis and other STD’s, the HIV rate appears low, with 22 out of 1500 regulars in the industry contracting HIV. And how many of those 22 contracted their disease from other behavior, such as IV drug use.

    @Donna B

    Then we have Letterman making jokes about a female being “knocked up” in an extremely paternalistic and authoritative way — ie, females exist for male pleasure breeding.

    Letterman is a comedian. He gets to be funny at the expense of hypocritical, uneducated, idiotic politicians like Sarah Palin. I guess it’s funny for the right-wing when those same comedians make fun of Bill Clinton. Liberals are in power, probably for a long time in the future. Get over it.

  21. #21 Phoenix Woman
    June 15, 2009

    Regulation is why our food supply is the safest in the world — and why average US life expectancy has zoomed upwards from under fifty years of age circa 1900 to nearly eighty today.

    End the shaming, bring the porn industry out into the light. The workers that all the moralizers claim to care about will be much better served if they aren’t shoved under the rug of taboo.

    Speaking of taboo: There’s a discussion of malpractice suits going on over at Oxdown right now. So far the lawyers are dominating, but some doctors are scheduled to appear, and soon. Even out the odds a little and let’s see what happens.

  22. #22 Donna B.
    June 15, 2009

    #18 – You read a lot into my comment that simply was not there. That I don’t get the allure of porn simply does not translate into a desire for it to illegal. In fact, I didn’t even say it was yucky.

    By comparing porn to Letterman, I wanted to point out that “comedians” who cross the line in portraying women as sex objects are worse than porn.

    #20 – Comedians should make fun of politicians, but they should leave the politicians’ families out of it regardless of party. This was true when Rush made fun of Chelsea (which was, btw, the last time I ever paid attention to anything he had to say) and it is true of Letterman and Palin’s children.

    Regardless which party is in power, I’m not about to “get over” cruelty trying to disguise itself as comedy.

  23. #23 Jimbo Jones
    June 16, 2009

    Wait, sane people still pay attention to Letterman?

  24. #24 Ranson
    June 16, 2009

    but they should leave the politicians’ families out of it regardless of party

    I can’t think of an instance in the last fifty years where the family of the President or other politicians haven’t been fair game. I’ve got old comedy routines recorded making jokes about Jackie Kennedy, LBJ’s daughters, Billy Carter, Ron Reagan Jr., etc.

    It’s especially funny when there’s actually some irony there, such as people who push abstinence-only education turning up with a pregnant teen, who then goes on to become a spokesperson for abstinence-only education. How is that not fodder for comedy?

  25. #25 PalMD
    June 16, 2009

    It is pure comedy gold. And no sane person would have thought that Letterman was talking about the younger kid. Anyone who says he was is either shamelessly captitalizing on the situation (irony), or a sicko (ew).

  26. #26 Terrie
    June 16, 2009

    I seem to remember that the Nevada brothels have an extremely low rate of STD transmission. So I don’t think it’s just about the sex industry. There have to be other factors contributing.

  27. #27 Donna B.
    June 16, 2009

    Compare the gentle humor of Vaughn Meader to David Letterman.

    Whichever daughter Letterman was talking about, it was needlessly demeaning of women and it was cruel. One has to consider Palin and her family as somewhat less than human to think it funny, therefore undeserving of any respect for human dignity.

    “Pure comedy gold” it was not as the best comedy skewers the comedian or large groups of people, not other individuals. It was fool’s gold, perhaps?

  28. #28 Ranson
    June 17, 2009

    George Carlin. Lenny Bruce. Rowan & Martin. Johnny Carson. Foul-mouthed, dirty-minded bastards, the lot of them (and if you don’t think Carson was, you never paid any real attention). Comic geniuses all, and I can guarantee you they would crack a similar joke in a heartbeat.

    As a matter of taste, you may not like that kind of humor. I think it’s hilarious, and would regardless of political persuasion (We’ve only “suffered” a decade and a half of “horny Bill Clinton cheating on his wife” jokes, y’know). That said, I find the bizzare, self-effacing one-liners of Mitch Hedberg and the storytelling of Eddie Izzard to be as funny or better.

    I leave you with a vicious, misogynist, angry joke that makes me laugh my ass off every time I hear it:

    [George Carlin On people who think rape isn’t funny]
    I say fuck you! I think it’s hillarious, how do you like that? I can PROVE to you that rape is funny! Picture Porky Pig raping Elmer Fudd!

    Or, to put it another way,

    Tragedy is when I cut my finger. Comedy is when you fall into an open sewer and die.

  29. #29 BaldApe
    June 23, 2009

    Pardon me for commenting on a dead thread, but as a matter of perspective, how many STDs are transmitted in the excitement arising over presumed adults with their IQs on their shirts playing a children’s game for a living?

  30. #30 LanceR, JSG
    June 23, 2009

    Ranson, you are a sick, evil, twisted person.

    That has got to be the worst GREAT joke I’ve ever heard.

    Now if I can just think of someone it would be safe to tell it to.

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