Studies on Adult Film Performers
A cross-sectional structured online survey adapted from the California Women's Health Survey (CWHS) was self-administered to a convenience sample of 134 current female adult film performers via the Internet. Bivariate and multivariate analyses were used to compare data for these women with data for 1,773 women of similar ages who responded to the 2007 CWHS. Main outcome measures were self-reported mental health status.
In the past 12 months, 50% of the performers reported living in poverty and 34% reported experiencing domestic violence, compared with 36% and 6%, respectively, of CWHS respondents. As adults, 27% had experienced forced sex, compared with 9% of CWHS respondents.Conclusions: Female adult film performers have significantly worse mental health and higher rates of depression than other California women of similar ages.
Adult film performers engage in prolonged and repeated sexual acts with multiple sexual partners over short periods of time, creating ideal conditions for transmission of HIV and other sexually transmitted diseases (STDs). All the more concerning, high-risk practices are on the rise . These practices include sex acts that involve simultaneous double penetration (double-anal and vaginal–anal intercourse) and repeated facial ejaculations.
In 2004, only two of the 200 adult film companies required the use of condoms for all penile–anal and penile–vaginal penetration . Performers report that they are required to work without condoms to maintain employment. These practices lead to high transmission rates of STDs and occasionally HIV among performers.
Despite being part of a large and legal industry in Los Angeles, little is known about adult film performers' exposure to health risks and when and how these risks might occur. The objective was to identify exposure to physical, mental, and social health risks and the pathways to such risks among adult film performers and to determine how risks differ between different types of performers, such as men and women. Semi-structured in-depth interviews were conducted with 18 female and ten male performers as well as two key informants from the industry.
Performers engaged in risky health behaviors that included high-risk sexual acts that are unprotected, substance abuse, and body enhancement. They are exposed to physical trauma on the film set. Many entered and left the industry with financial insecurity and suffered from mental health problems. Women were more likely than men to be exposed to health risks. Adult film performers, especially women, are exposed to health risks that accumulate over time and that are not limited to sexually transmitted diseases.
The adult film industry nowadays represents a legal multi-billion dollar business. The main health risks of adult performers are well known. They mainly include the transmission of sexually transmitted diseases such as HIV, hepatitis, gonorrhoea, Chlamydia, herpes and papillomavirus. However, despite regular follow-up, the frequency of STD remains significant in this high-risk population since a large part of the industry continues to reject systematic use of condoms. Besides, performers are also exposed to other physical and mental health issues often not known to the public. This article provides a comprehensive review of what is known about STD and other risks among the community of performers in the adult film industry.
Undiagnosed sexually transmitted infections (STIs) may be common in the adult film industry because performers frequently engage in unprotected oral and anal intercourse, STIs are often asymptomatic, and the industry relies on urine-based testing.
During the 4-month study period, 168 participants were enrolled: 112 (67%) were female and 56 (33%) were male. Of the 47 (28%) who tested positive for Gonorrhea and/or Chlamydia, 11 (23%) cases would not have been detected through urogenital testing alone. Gonorrhea was the most common STI (42/168; 25%) and the oropharynx the most common site of infection (37/47; 79%). Thirty-five (95%) oropharyngeal and 21 (91%) rectal infections were asymptomatic.
Adult film industry performers had a high burden of STIs. Undiagnosed asymptomatic rectal and oropharyngeal STIs were common and are likely reservoirs for transmission to sexual partners inside and outside the workplace. Performers should be tested at all anatomical sites irrespective of symptoms, and condom use should be enforced to protect workers in this industry.
Adult film industry (AFI) performers engage in unprotected oral, vaginal, and anal sex with multiple partners, increasing the likelihood of acquisition and transmission of human immunodeficiency virus and other sexually transmitted diseases. Current industry practice does not require condom use; instead it relies upon limited testing. We sought to estimate the annual cumulative incidence of chlamydia (CT) and gonorrhea (GC) and assess the rate of reinfection among AFI performers. Lower bounds for the annual cumulative incidences of CT and GC among AFI performers were estimated to be 14.3% and 5.1%, respectively. The reinfection rate within 1 year was 26.1%.
CT and GC infections are common and recurrent among performers. Control strategies, including promotion of condom use, are needed to protect workers in this industry, as testing alone will not effectively prevent workplace acquisition and transmission. Additional legislation that places more responsibility on the production companies is needed to ensure the safety and health of performers.