Refined Protocols Reduce STI Risks for Performers

Refined Protocols Reduce STI Risks for Performers

Every so often, I hear from a producer or performer who feels that the 14-day testing protocol is too much work, or too much money, or not necessary. Why can’t we return to the days of monthly testing?

For those new to the discussion, monthly testing was the industry standard from 1998 to 2013. And it was very successful at preventing HIV and other STIs. However, performer health and safety is not a static goal. Just as the tests we use evolve, and what we test for improves, so does the testing regimen.

Science has shown that once a person contracts HIV, the virus multiplies quite rapidly.

The adult industry first began testing in earnest in 1998, when an outbreak of HIV among adult performers traced to a forged HIV test led to the creation of AIM, the Adult Industry Medical clinic.

For years, the testing “system” was a scattershot mix of paper tests, slow detection times, and, to some extent, an honor system among performers and producers. There was no real way to track performers and scene partners, to notify the exposed, or enforce a production halt.

We’ve come a long way since then. Thanks to our protocols, we haven’t had an HIV transmission on a regulated set since 2004.

Our protocols today require testing for HIV, hepatitis C, hepatitis B, syphilis, gonorrhea, chlamydia and trichomoniasis. HIV is not only the most serious of those, it’s also the only one that cannot be cured, or prevented through vaccination. And the reason why we test every 14 days is deeply connected to HIV.

Science has shown that once a person contracts HIV, the virus multiplies quite rapidly. At first, there aren’t enough copies of the virus to allow it to be effectively transmitted to another person. After 14 days, however, the viral load begins to reach levels that dramatically increase the chance that the virus could be passed to another person.

This is why the medical advisors on the PASS board have instituted the 14-day standard.

While it’s true that the monthly testing protocol previously used effectively prevented on-set HIV in the years between 2004 and 2013, better science and better tests now allow us to further reduce the risk to performers.

No system is ever perfect, however our testing protocols are meant to significantly minimize the risk of an infection occurring, for example by preventing someone who is infectious from entering a set.

The test we use looks for the genetic building block of HIV, RNA — the earliest sign of an infection. The test allows us to detect the virus early, often even before the person becomes infectious to others. (Because of the turnaround time with testing, working performers often end up testing more frequently than 14 days.)

That’s also why, on that 15th day after a negative test, performers are automatically removed from availability in PASS. PASS also eliminates the use of paper tests, which can often be forged or modified, and provides producers with an online database that allows foolproof compliance. Since PASS automatically calculates the expiration date of the test, we’re also able to guard against mathematical errors.

These PASS protocols aren’t arbitrary rules decided by the Free Speech Coalition. They were established (and are periodically reviewed) by a panel of medical doctors, infectious disease specialists and performer advocates.

The PASS protocols allow us to look at transmission risks in a level-headed, dispassionate fashion that is based in science rather than rumor or stigma. To us, it doesn’t matter who you sleep with, what your gender is, or what you do when you’re not at work. All that is noise: what matters is when you last tested.

We know that as the business has shifted away from the big-studio productions, and to performer-based products like content trades, custom clips and webcams, the temptation to shoot outside the protocols grow. We know that testing presents a cost to your business, which is why we’ve worked with companies such as MindGeek to develop a subsidy fund to help bring those costs down further.

Our tests are meant to significantly reduce the risk on set, and have been incredibly effective. But when we take precautions in addition to testing — such as vaccines and PrEP — the protection for the entire community increases exponentially.

I am a longtime AIDS/HIV activist and advocate. The virus flourishes when stigma, assumptions and rumor take the place of science and rationality. That’s why we’ve engineered a system based in the latter to protect us from the former. We can always work to increase the accuracy, lower the costs and limit the disruptions, but we will never do so at the expense of safety.

Make sure you’re tested every 14 days, and insist on it from your partners. Not only does PASS demand it — your health, and the health of your partners depends on it.

Eric Paul Leue is the executive director of the Free Speech Coalition.