FSC Report Blasts Health Officials, Says STD Findings Faulty

Jun 6, 2011 7:00 AM PST

LOS ANGELES A Free Speech Coalition report commissioned by Johns Hopkins epidemiologist Lawrence Mayer says presentations made by two Los Angeles public health officials targeting adult entertainment industry sexually transmitted disease screenings were faulty and misleading.

The FSC report also called out presentations by UCLA epidemiologist Dr. Robert Kim-Farley and by Dr. Peter Kerndt as inflammatory toward the risk of contracting an STD in the adult film industry.

The FSC plans to present their findings at Tuesday’s Cal/OSHA subcommittee meeting on the adult film industry. At the meeting, Cal/OSHA is gearing up to present a draft of proposed rules
strengthening workplace safety on porn shoots.

“Estimating this risk is a serious issue, it should have been given serious analysis,” Mayer said in his report.

“[M]ost of the analyses reported by Drs. Kim-Farley and Kerndt lack transparency,” Mayer said. “They do not document the methodology used to derive their estimates. In the absence of this detail, it is not possible to confirm the validity of their results.”

In Kim-Farley’s presentation, “STD/HIV Disease and Health Risks among Workers in the Adult Film Industry,” Mayer specifically points to several flaws in the doctors’ data collection, and specifically said that “poor science and inexcusable in epidemiology which can be characterized as the science of estimating risk from counts” when it came to Kim-Farley’s presentation titled.”

Mayer says that Kim-Farley had no explanation on how the data on adult performers were collected.

“Kim-Farley provides no information on turnover or longevity in this industry, the proportion of cases that were re-infections, or multiple testing of performers, so his statement that ‘one-fourth of all performers are diagnosed,’ is unfounded and misleading,” Mayer said. “This calculation is defective. The correspondence between the numerator and denominator are critical to the validity of an epidemiological analysis.

“Consequently the statements based on it are in error and misleading to those who are relying on the analysis.”

Mayer also said that Kim-Farley concludes, falsely, that the annual prevalence of chlamydia and gonorrhea among adult performers is 8.5-to-18 times greater than that in Los Angeles County residents 18-29 years old, and 34-to-60 times greater than that in all county residents, Mayer said.

“He provides estimates of annual prevalence [per 100,000] for chlamydia and gonorrhea among adult performers and the population of Los Angeles County," he said. “These data suggest that performers are 15.4 times as likely (based on 2000 performers) or 9.9 times as likely (based on 3000 performers) to be infected with chlamydia or gonorrhea as 18-29 year-olds in L.A. County. They are 59.7 times as likely (based on 2000 performers) or 38.5 times as likely (based on 3,000 performers) to be infected with chlamydia or gonorrhea compared to all residents of the county.

“In summary, Dr. Kim-Farley’s estimates of infection prevalence among [adult industry] performers and the comparison of these estimates to other populations are fatally flawed. He does not have accurate counts of the population exposed, and so uses counts of 2,000 and 3,000 performers to derive prevalence estimates.

"These counts are not justified in the presentation," he said. “Worse, he does not take into account re-infection rates and testing frequency.

“The comparisons to other groups of L.A. County residents are not valid. AFI performers, due to the nature of their work, may be at higher risk for sexually transmitted diseases than the average resident of the county.

“The general population of 18-to 29 year-olds [as well as all ages] in L.A. County comprise a mix of many subgroups, some of which may be at high risk and some of which certainly are not.

“In all likelihood, the vast majority of the persons in his comparison groups is not even tested within any given year for a sexually transmitted disease and may not be sexually active enough to risk re-infection, the two factors for which the counts of performers need to be adjusted.”

Mayer also took issue with Kerndt‘s presentation titled “Public Health Issues in the Adult Film Industry: Policy Implications of an Outbreak,” which reports the results of an 18-month pilot study among “straight” adult performers.

Kerndt reports that, during an 18-month period, STDs were 10-fold greater than among a similarly aged L.A. County population: 7 percent vs. 0.77 percent (chlamydia) and 27 percent vs. 0.27 percent (gonorrhea).

Mayer said that “it is clearly not appropriate to compare prevalence rates of adult performers to those of Los Angeles County residents using differing methodologies, as Drs. Kim-Farley and Kerndt have done.”

“Their methods do not take into account multiple tests and re-infections. Their comparison data, based on similarly aged subgroups and all ages do not take into account the fact that many people are not tested each year for sexually transmitted diseases.”

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