But that viewpoint can be somewhat narrow in terms of other health care concerns faced by the population of industry talent.
Greg Zeboray, owner of Zeboray Insurance Services in San Clemente, Calif., handles commercial and group health insurance for some of the industry's biggest players, including LFP/Hustler, Evil Angel, PurePlay Media, Titan Media and Shane's World, to name a few. His firm has been handling insurance for adult companies and performers for nearly 11 years.
While he has more than 100 performers on his books, he no longer actively solicits individual accounts, saying many who have applied for policies at his agency often stop paying premiums after a month or two.
"Regarding the health insurance," Zeboray explains, "we love the accounts, we appreciate the business. But we have just found that when it comes to talent, particularly this generation of talent, rather than us going out and soliciting them, they need to pick up the phone and call us, because it's not worth our time anymore."
Still, he encourages seriously interested performers to insure themselves. And since most are motivated by the financial rewards of the work they do, he points out the savings benefits of insurance.
"Everything you do is so much cheaper if you have insurance," he explains, using his own medical history as an example. "I have a couple of health problems, so I need to have a bunch of lab work for my physical every year.
"Quest Diagnostics billed $406.31. If I didn't have insurance, that's what I would have paid. Because Blue Cross forces them to write off $345.58 of it, I paid out of my pocket $24.29. Blue Cross paid $36.44.
At 23, Tiana Lynn is national sales manager at Elegant Angel and a former performer. She admits that early in her career, before acquiring health care insurance as a full-time employee for Elegant Angel, she spent more money on clothes and beauty products than on health care.
"I guess that you just get to the point where you're making so much money that if you need to go to the doctor, you just fork it out," Lynn says. "Even though you don't save a lot of money — I don't know what happens to you when you're making all that money; you just forget about buying insurance."
Like every working performer, Lynn accessed Adult Medical Healthcare Foundation, or AIM, for monthly HIV screenings. But for other issues, she saw Dr. Robert Rigg.
"To be honest," she says, "that's how my health care was taken care of — because it's fast, easy to get in. I could go in at eight in the morning, before AIM even opens up, and get everything done. Rigg works with so many industry people that he pretty much knows right off the bat what's going on with your body."
At Saticoy and Winnetka, in Canoga Park, Calif., Rigg opened West Oaks Urgent Care Center in 1985, not realizing his location would make him very convenient to industry clientele. Like AIM, Rigg's clinic is a comfort zone for patients who come in seeking discretion and familiarity they might feel are not available at other medical facilities.
In an email, Rigg writes: "Today, everyone insists on timely and appropriate treatment, advice and referrals... My reputation is built on proper and effective medical treatment, convenient hours, a clean and pleasant office, competent staff, reasonable prices and a location in the West Valley." And while no appointment is needed, the clinic does not accept medical insurance.
"We care for common STDs, with gonorrhea, chlaymydia, herpes simplex and genital warts being at the top of the list," Rigg says. "GYN illnesses include yeast vaginitis, bacterial vaginosis and urinary tract infections." Other clinic services include X-ray, laboratory, chiropractic, immunizations, pediatrics and generalized medicine.
The More You Know
Most of AIM nurse practitioner Patrick Hernandez-Kline's days are spent attending to the same STDs and GYN-related illnesses listed by Rigg, but a portion of what Hernandez-Kline does is educate and counsel on how to withstand the rigors of the business.
"Some peoples' focus here is to make as much money as they can in a short amount of time," he speculates, "so if that demands doing a double-anal for however much more, they'll continue to do that three or four times a week to get the money.
"Some [performers] have really good goals in mind, and some don't. At that point, when they come in, we sit and we talk about it. We're really talking about the long-term problems, the medical side of it. Like hemorrhoids, cuts, lacerations, fistulas; just a bunch of things that can happen from working the body a little too hard."
There also is some debate about whether the practice of over-medicating with antibiotics to ward off infections is actually doing more harm than good to the performer population.
"Because your first thought is, 'OK, I'm going to lose $6,000 worth of work. I need to get on the antibiotics before anything starts,'" Lynn says. "You can take some time off, but a lot of girls, due to their agents, feel very pressured to work. So when an agent already has so much work booked, and you just had an allergic reaction from a brand-new toy, and that agent has to call five different companies, a lot of them don't understand."
For Lynn, antibiotics combined with a stringent health regime, helped to improve her work performance and wellbeing. But performers must take great care to compensate for the damage antibiotics can do. For example, antibiotics are prescribed to kill harmful bacteria, but they also kill "friendly" bacteria, such as those used by the digestive and lymphatic systems to attack toxins in the body.
"Being on antibiotics, you have to replace your good bacteria as soon as possible," Lynn advises, "and cleanse your system out every day. You take your vitamins every day, and most importantly, just stay off drugs. That will keep you pretty much solid."
With increased potential for illnesses inherent to sex work, it seems almost self-destructive to put off enrolling in a health plan. At the very least, common sense would suggest every precaution available to lower risk: antibiotics (within reason), vitamins, detoxification, rest, healthy diet and exercise.
But strangely enough, there is an almost complete avoidance of the most obvious preventative measure of all — using a condom.