Nina Hartley Discusses Myths, Rumors Over HIV in Porn
WEST HOLLYWOOD, Calif. — Longtime performer and industry advocate Nina Hartley has posted a statement discussing myths and rumors about HIV in porn after the latest STI scare to affect the adult entertainment business.
In her statement on Fetlife.com's board, Hartley — who has filmed for three decades in the biz, is a former registered nurse and is a founder of the now-defunct AIM Medical Services — gives a candid discussion about porn stars, condoms and finger-pointing.
Hartley discusses myths and rumors about HIV in porn here:
Cameron Bay has acquitted herself bravely and ethically and the terrible things that some have said about her remind us, sadly, of how badly stigmatized sex work still is. I can't even bring myself to address some of the cruel and stupid attacks that have been made on her, so I won't. I do think that she's being a bit hard on herself in characterizing what happened to her as a result of irresponsible behavior. It was human behavior which is unpredictable and not always wise, but that doesn't make it irresponsible.
It is a fact, and hardly a new one, that HIV has been with us a long time. New research suggests it existed in isolated pockets here and there forty years ago. Unless and until a vaccine is developed (and BTW, AIDS Healthcare Foundation, the outfit largely responsible for creating not only the current controversy surrounding porn industry STD safeguards but also the more complex and error-prone system of safeguards we have now than existed before they made porn their favorite target, resolutely opposes funding for HIV vaccine research "because it will divert funds from treatment for existing cases," which are the source of AHF's $200 million per year income) that HIV is here to stay. It exists in the general population and no matter what safeguards are used, there will be occasional cases in the porn talent pool. There is no 100 percent fail-safe protection against HIV transmission, condoms included (read the label on the condom box if you don't believe me because the manufacturers recognize the impossibility of making foolproof barriers), and porn performers possess no special immunity.
All evidence so far, including Cameron's own courageous testimony, suggests that she contracted the virus through a personal contact not related to her work in the industry. All her professional partners since her last clean test in late July have tested negative and there is no reason to believe that new infections related to hers will appear in the porn talent pool. Medically speaking, female to male transmission of HIV, though not unknown, is rare, as the virus is mainly passed through blood and serum products (like semen) and present in only trace amounts in saliva and vaginal fluid. It would have been unlikely for Cameron to have infected any of her onscreen partners even during the window period between her last clear test and her first positive. Fortunately, she wasn't working much at the time and her contacts were few. They're out of the woods already and the industry has gone back to work.
I would question the assertion that newer, younger players are engaged in more irresponsible behavior than their predecessors. If anything, the events of the past couple of years have brought the issue of STD transmission very much to the front of all our minds and while there will always be those who behave recklessly, I still shoot scenes a couple of times a week and have close relations with many partners of differing ages. My impression is that, as a group, they're far more risk-aware than their "civilian" counterparts. Whatever gets said on social media is not to be confused with fact, which depends on evidence rather than endless repetition to attain credibility.
I'm not quite sure what you mean when you refer to "risky behavior" when no sexual behavior can ever be risk-free. I've always disliked the term "safe sex" because physical intimacy with any other human being is not without risk and can never be truly safe in all ways. A jealous partner bursting in on a clandestine assignation and shooting the participants is a risk with a certain percentage of probability, fortunately not the highest but not negligible as risks go. There are various precautions that can be taken against the transmission of STDs but none are 100 percent effective. I'll try and break that down in greater detail as we move on here, but the indisputable truth is that sex is not a risk-free activity; never has been and never will be.
As a sex educator, my initial response won't come as much of a surprise. I think what's needed is accurate and complete information for every sexually active person. The systematic destruction of comprehensive sex education in our public school systems by the relentless attacks of right-wing religious fanatics has endangered all young people and needs to be reversed. We need to teach all young people what the physical and psychological risks of sexual activity are in a science-based curriculum through public education. Equip them with the information they need to decide what level of risk they find acceptable and what methods of protection of the many out there suit their individual situations best.
That the industry is "taking a black eye on this" has nothing to do with the industry's own practices, which are extremely meticulous when it comes to STDs, but rather because political groups with self-serving agendas keep punching us in the face for things that are simply untrue, as the punchers well know.
The fact in this case, as was true in the big "syphilis scare" of a few weeks ago and last summer's "HIV scare" (which turned out to be yet another example of a personal situation that had no connection to the porn industry beyond the fact that one of those involved worked in it briefly) and even true in the two documented cases of on-set HIV transmission back in 2004, which were the only such cases in het porn since we began comprehensive testing in 1998, is that our hazard mitigation system worked brilliantly, exactly as it was designed to.
STD testing does not prevent STDs. That's not its purpose. It serves as an early warning system to exclude from the talent pool those trying to get in who are already infected with some contagious condition and alert us as quickly as possible if anyone who passes the initial screening later contracts such a condition. Because we test for not only HIV, but also gonorrhea, Chlamydia, syphilis and hepatitis A and B at least once a month (the industry standard will soon go to twice a month to narrow infection window periods even further) contact tracing when a positive test for any of the above turns up is quick and effective. Performers agree to participate in an industry-wide database that other performers, producers and directors can access by computer to establish that any performer's test data is clear and up to date. If the tests come up otherwise, the testing facilities contact the performer to come in and re-test immediately, provide contact information and begin treatment and counseling immediately.
There have been all kinds of false rumors spread about this system, but it has proven itself amazingly powerful for over a decade. During that time, the L.A. based het porn industry has turned up a total of two work-related infections in our entire talent pool. To put that in perspective, Los Angeles County, according to its own health department, has recorded nearly 30,000 new HIV infections during that same period. Considering the age and demographic of porn performers, despite disingenuous claims about the danger we pose to the general public, it would appear that they pose a greater danger to us. Indeed, in the current case, it would appear that the virus was transmitted from the outside in, as the statistics would suggest.
Those who judge Cameron for doing what millions of others do, no matter what they may claim to the contrary, which appears to have been exposing herself to risk with a personal partner she trusted, are contemptible and I feel nothing but compassion for the additional burden she bears of absorbing all that hostility from people who should know better. She appears guilty of doing something human and will pay the highest price of anyone involved for having done so.
In terms of what the industry can do to make itself safer, no system is beyond improvement and improvements are being made. For many years, since Sharon Mitchell, Ernest and Dr. Steven York first established AIM, the community based, performer operated testing and treatment clinic back in 1998, and we relied on the PCR-DNA test for HIV proteins, which was absolutely the state of the art throughout that period. There's been a lot of loose and downright dishonest talk about how this test works and how it's distinguished from the "free" tests offered by various walk-in clinics.
The oldest and most common test, the ELISA, searches for HIV antibodies in the blood. It's the gold standard in one respect. It never throws a false positive. If you have HIV anti-bodies in your system, you're infected and your body has begun fighting back. However, you can be infected and contagious for up to six months before anti-body production begins. New infections are the most dangerous, as the body's defenses haven't mobilized against them yet, and viral loads for new cases can exceed 100,000 before ARV treatment is begun. That's why it's imperative we catch new cases sooner.
The PCR-DNA test looks for viral proteins in the blood, which show up no later than two weeks after infection. Two weeks vs. six months is clearly a superior standard. But we haven't just accepted it as the best there is. Recently, we've moved on to the Aptima test, which is based on PCR-RNA analysis and is even more reactive sooner than its predecessor. The Aptima is now the only test whose results are accepted in the PASS database, where a clean result is required to certify a performer as available for work. Does everyone cooperate with this protocol? You bet. Any director or producer who puts a performer to work without that clearance is inviting major liability and performers as a matter of on-set etiquette show their test results to anyone they're going to work with before doing so.
So one thing we've done is to upgrade the quality of the HIV test. We've also added some new tests to the panel we do. Hepatitis A and B, as well as syphilis and trichomoniasis are now standard along with the other conditions for which we had previously tested. We are also testing now for HPV, the virus that causes genital warts, and vaccinating those who test negative with Gardisil to make sure they stay that way.
We have not added either hep C or herpes and there’s a lot of talk about that. The thing is that neither is a reportable STD. Hep C is transmitted blood-to-blood primarily through needle sharing among IV drug users, who are extremely rare in our community. The CDC does not classify it as an STD and clinics aren’t required to report it to health authorities as such. It’s a nasty, often fatal, disease, but it’s not a risk for single-contact sex performances and the hysteria drummed up around it by the Usual Suspects is medically indefensible.
As for herpes, it’s transmitted skin-to-skin and can be passed by contact at any part of the body. Condoms do little to reduce the risk (as is also the case with bacterial bugs like Chlamydia and surface viruses like HPV) and barriers won’t stop it. Indeed, since 70 percent of the adult population would test positive for either Herpes A or Herpes B according to the CDC, the harm reduction from testing would be minimal.
Remember what I said about it being impossible to create an entirely safe system. An error rate of zero is impossible, so you enter this business with some assumption of risk. We minimize it very effectively but we can’t promise to eliminate all risk.
That is true of any job. According to The Bureau of Labor Statistics, the ten most dangerous jobs in America are:
3. Aircraft piloting
4. Refuse and recyclable material collection
6. Structural iron and steel work
9. Truck driving
There are clinical deaths in significant numbers associated with every one of these trades.
Since porn was legalized in the U.S. 40 years ago there hasn’t been a single job-related fatality on any porn set. Even mainstream film loses half a dozen stunt players a year. Is porn completely safe? No. Is it dangerous in the way any of the jobs listed above are? Hardly.
But why wouldn’t mandatory condoms make it even safer?
It’s a logical question but the answer is counterintuitive. Porn sex is a performance. It’s not like the sex most people have at home. Depressingly, Masters and Johnson found in their groundbreaking studies a few decades ago that the average American couple typically completes an act of sexual intercourse in about eleven minutes from foreplay to orgasm. That’s a sad thing and the subject for a post all its own, but it tells you nothing about what sex on a porn set is like.
Typically, because we shoot multiple angles on multiple positions, in addition to shooting stills, wrangling lights and cameras and other gear and dealing with technical problems of all sorts. It takes about two hours to shoot a good hardcore scene. Condoms were never intended for that kind of industrial use. Hard-ons come and go. Condoms roll down, come off, dry out, split and otherwise fail on sets about 30 percent of the time. I know this because I work mainly for Adam&Eve, one of the companies most supportive of performer choice when it comes to condom use, and Ernest and I have shot miles of condom footage. We’re left with little confidence regarding the efficacy of condoms for this application.
And speaking personally, I can tell you that they have, for many female performers, a serious drawback. I’ve taken a lot of crap for saying this in other places, but facts just refuse to conform to PC ideas of how things should work. Condoms, no matter how lubricated and how designed, create more internal friction on a woman’s intimate anatomy than human skin, with which it’s evolved to tolerate contact. All-condom players, and I’ve known many of them tend to turn up at clinics with raw internal tissues and multiple surface infections. This we call “condom rash” and it’s more than an annoyance. Intact tissues are the first line of defense against infection. If your insides are compromised by friction burns and low-grade bugs of whatever sort, you’re that much more vulnerable to whatever might be turned loose should a condom fail.
Those who have never worked as performers love to dismiss this as bullshit urban legend. Those who do that have zero experience with the realities of shooting a hardcore scene. Condoms make everything take longer. They make everything less comfortable for male and female players. They can’t be trusted to operate as intended. They create conditions conducive to contagion. These circumstances are unique to porn and I wouldn’t suggest the general population abandon using condoms, though I do think testing for non-sex-workers is still an excellent idea and recommend it highly, if only for your own peace of mind.
The safest sex you can have, on or off camera, remains sex with an uninfected partner, and this is where things get dicey. I ask those who favor mandatory condoms in porn this question: If you knew you were HIV-, would you knowingly have intercourse with someone who is HIV+, condom or no? Anyone who honestly answers yes to that question has a very different notion of safe behavior from mine. I prefer to know that anyone I have sex with has been tested with the best available methods and carries no communicable disease. In fact, I accept no less for either work or play. I see a current test or intercourse doesn’t happen.
Given all this, why is there such a huge battle being fought over this issue here in Los Angeles?
The answer is political. Epidemiology, as any doctor will tell you, is a highly political form of medicine. There are always those willing to use the threat of epidemic to push some other kind of political agenda having nothing to do with health.
In this case, AIDS Healthcare Foundation, the largest HIV service organization in the world (and a stakeholder in the world’s largest condom manufacturer, BTW) has taken it upon itself to come after the porn business in order to force condom use on performers who overwhelmingly prefer to make their own choices of protection methods and bitterly oppose the idea of having government agencies tell them how to do their scenes and protect their own health. This has been a big generator of publicity for AHF, which not only hauls in $200 million a year but pays its director, Michael Weinstein whose face has become so familiar from this controversy, over $600,000 a year to act as its front man. It’s a huge enterprise that claims non-profit status but is currently under investigation by Los Angeles County for Medicaid fraud.
Mr. Weinstein et al think that Porn, by showing barrier-free intercourse acts as, in his words: “commercials for unsafe sex.” He and his supporters in the UCLA working group and at Cal/OSHA think that porn should be compelled by law to make safe sex commercials. Sorry, but this thing called The First Amendment not only prohibits censorship, it also prohibits compelled speech. If AHF wants to make porn with condoms to push its own ideas about sex, it has more than enough money to do so. What Measure B and all of AHF’s other machinations cannot do is force pornographers to include content in their products that they don’t want there.
Yes, money is a factor for both sides of this dispute. The porn buying public overall doesn’t want condoms visible in the picture because it detracts from the fantasy of perfect, carefree sex they pay to indulge. The one company in het porn that requires condoms is uncompetitive in DVD sales by its own admission and makes most of its money off cable softcore, in which condoms aren’t an issue. No company that has attempted to market all-condom products to het audiences has managed to stay in business.
Likewise, AHF also has a dog in the fight. Not only do they manufacture and sell condoms, for which they would force us to make commercials, but they also make no secret of their willingness to “consult” for a hefty fee in instituting an all-condom protocol in the porn industry. AHF has sued its way into lucrative consulting jobs like this before. When Pfizer first introduced Viagra, AHF “offered” to consult with the company so that Viagra users would be properly advised of the risks of unprotected sex with this new product. AHF wanted $5 million for that service. Pfizer declined. AHF sued them for $50 million alleging unsafe marketing practices. Pfizer caved on the consulting deal. The lawsuit mysteriously faded away. Now Viagra commercials carry teeny-tiny little disclaimers warning consumers that it doesn’t protect them from HIV or other STDS. That’s what Pfizer got from AHF for its $5 million, along with immunity from litigation.
See, we know all about AHF’s litigation practices first hand. Internal emails between Weinstein and AHF’s chief counsel Bryan Chase (this has all been posted online if you care to check it out) decided early on that the effectiveness of our existing system as administered by AIM was the Number One obstacle to AHF’s political ambitions and had to be destroyed if AHF’s claim that performers worked without protection was to be made credible. Toward that end, AHF used tax-free funding to hire AIM’s lab messenger as a spy to dig through AIM’s operations in search of dirt that could be used against it. AHF and Cal/OSHA initiated a series of nuisance litigations against AIM, a tiny non-profit NGO that tested at cost and often barely had money to keep the lights on at the clinic, leading to AIM’s ultimate bankruptcy. AHF did its best to create the threat, not previously there, upon which they built the Measure B campaign that’s raised millions in funding and made them constantly visible in the media at the expense of increasing my risk.
The Free Speech Coalition, the industry’s trade organization, which answers mainly to producers, stepped in to help create a new database to replace AIM’s, which has been very helpful in the Cameron Bay case to be sure, still does not operate a full-service, centralized clinic of its own. It depends for reporting of test results on the cooperation of private clinics that don’t all have the same methods of testing and reporting, which leaves us with a less effective means of monitoring the entire talent pool simultaneously and opens the door to possible test report fraud because of lack of uniformity in the reporting forms used. This opens the door to new dangers that have already been hinted at in recent months by confusion over confirmatory tests for suspected STD cases conducted at different facilities.
Thanks, Mr. Weinstein, for your demonstrations of concern for all of our wellbeing. That you enjoy virtually no support among actively working performers should tell you something. But no, absent all tangible evidence to support it, AHF has now filed a complaint with Cal/OSHA against Kink.com simply because that was the last place where Cameron Bay shot a scene, even though at the time she shot it her tests were still all negative.
Should Measure B remain on the books, much less be extended to the entire state of California as AHF would like, the result will be an erosion of the testing system. The great advantage porn in California enjoys over other forms of sex work in other places is its legality. We can call 911 if we have an accident or an altercation on set (not that these are common occurrences by any means) and not get arrested for doing so. If we are named as contacts in a potential contagion pool, we can be asked to confirm that we were or were not contacts without admitting to violating the law because we didn’t use condoms, and in admitting this, subject our employers to potential legal consequences that would put them out of business.
The result of this is already obvious. We used to pull permits from L.A. County so we could get production insurance and shoot legally in a state where doing so is not prohibited. We used to tweet from sets talking up the projects we were working on.
Now we’re back to shooting in secret without permits and asked to keep our cell phones off because we know that the gang from AHF is monitoring some of our feeds and using that information to try and organize set inspections.
This is all going to be sorted out at great expense in court eventually. Last week in the first round of FSC’s challenge to Measure B, the judge chose not to take up the constitutional issue of compelled speech, but stripped Measure B of most of its enforcement powers on the grounds that they would require what amounted to a blanket search warrant of all sexually explicit shoots without a warrant, which the judge viewed as trampling all over the Fourth Amendment. Both sides have already appealed.
Meanwhile, this battle rages in the media on sites like this one to the detriment of people like me. I like being in a legal business. I like being able to shoot on nice locations in the open without fear of arrest. I don’t care to go back to clandestine operations for a perfectly legal business. And I don’t trust those trying to push their program on me to protect my health as well as I can and my fellow performers will if left to do so as they have been for the last dozen years.
Do I think the industry bears no blame in all of this? Hardly. Contrary to accusations certain people loooove hurling at me that I’m an enormously wealthy shill for the producers (yeah, right, so where’s my check, boys?); I have my share of gripes with them. Ernest and I warned the leadership of the FSC six months before AIM was put out of business that this would happen if those who could afford to resist AHF’s malicious lawsuits failed to do so. They failed to do so and AIM closed. We also warned them they’d face political challenges from AHF for which they were unprepared. They paid no heed and ran a truly inept campaign against Measure B, which was qualified for the ballot with questionable petitions that should have been challenged but weren’t. Instead, showing a complete ignorance of L.A. politics, the FSC campaigned against Measure B in a Democratic, pro-labor, pro-regulation stronghold with arguments about lost revenues, lost jobs and lost tax money that would have gone over much better in Orange County than in bright blue Los Angeles. And instead of letting performers speak for themselves, which they do most articulately and from the most immediate personal concerns, they let the producers do the talking to the media. Swell idea. Everyone loves porn producers, right?
This is and has always been about our health and safety as performers and frankly I don’t think anyone else has much standing to address it. Between them, our friends and our enemies have managed to make us less safe and less able to earn our livings and there’s no good outcome in sight. AHF will never back off for as long as they can get airtime with their crusade. We will never effectively push them back until we let performers and doctors take the lead for us and stop whining about lost revenues when lives are at stake.
And until this issue is resolved, you’re going to see every isolated case like that of the unfortunate Ms. Bay turned into a political football by people who don’t care a bit about her, me or any of us.
It’s a long post, and I thank those who took the time to read it. When next you’re confronted with all the usual lies, half-truths and distortions that have been spun around the real issue of performer safety, feel free to quote Nina Hartley, former AIM board member, RN and sex-worker advocate when you let the hot air out of their dishonest and cynical propaganda.
There are lives at stake here, including mine. Nobody should be playing politics with them.