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Testing Porn Stars Isn't Stopping HIV

California will vote on whether adult film actors should have to use condoms.

The Centers for Disease Control has released a report into how an adult film actor in California infected two sexual partners with HIV in the weeks after he contracted the virus but before it was detected by lab tests. The report bolsters an already heated push for porn actors to wear condoms on set.

Within 22 days of receiving a negative test result in 2014, the 25-year-old male actor had sexual contact with 12 other men in two film productions without using condoms and at least five others outside work. Two of the man’s partners were later diagnosed with HIV, as he was. The actor was apparently infected by a partner outside of work six days before his negative lab results, according to a report by the CDC published Feb. 11. Tests may not be able detect HIV immediately after infection for as long as 10 days. "Adult film performers and production companies, medical providers, and all persons at risk for HIV should be aware that testing alone is not sufficient to prevent HIV transmission," according to the report, by California and federal officials.

The debate over whether to force porn actors to wear condoms is a controversial one that’s been playing out for years in California, home of the multibillion-dollar American porn industry. An HIV outbreak in 2004 spooked the industry and briefly shut down production.

Adult film productions may face greater pressure on two fronts in 2016. On Feb. 18, a state board appointed by California's governor to set standards for workplace safety will vote on proposed regulations to explicitly mandate condom use on sets. In November, new rules for the industry will also be put to Californians statewide on a ballot measure that would, among other things, require condom use and allow any state resident to sue to enforce the law. Both could extend restrictions now in place in Los Angeles throughout the state.

The AIDS Healthcare Foundation (AHF), a medical provider and nonprofit advocacy group, is leading the charge behind the ballot initiative and pressing California's Occupational Health and Safety Standards Board for stricter regulation of adult film productions. The group backed a similar ballot measure in Los Angeles County in 2012, which passed and has since been upheld by courts. “We felt that these performers were being treated as if they were expendable,” said Michael Weinstein, president of AHF. He also said making condoms the norm in on-screen sex has an important role in promoting safer practices more broadly. "Porn is the primary means of sex education that young people get, and it’s had a very negative impact on the promotion of safer sex."

The adult entertainment industry opposes the rules. The industry's own voluntary system requires performers to get biweekly HIV tests before working without condoms. Productions that adhere to those standards have not had an HIV transmission in more than a decade, says Eric Paul Leue, the recently hired executive director of the Free Speech Coalition, which represents adult film producers. (Leue was previously the director of sexual health and advocacy for fetish site Kink.com.) The CDC report would seem to contradict that. He characterized the incident as "a rogue out-of-state shoot."

"We’ve asked OHSA to vote down this regulation so we can sit down with them and build proper regulations,” Leue said. In particular, he sees a greater role for a drug called Truvada that HIV-negative men can use to dramatically reduce their risk of contracting the virus. The approach is known as preexposure prophylaxis, or PrEP. The AHF, controversially, has been critical of PrEP. Weinstein was criticized for calling it a “party drug” in 2014.

The CDC report notes that because PrEP needs to be taken daily, adult film producers can’t ensure that performers are adhering to the drug. “The high prevalence of [sexually transmitted infections] within this network of sexual partners, including performers, emphasizes the importance of consistent condom use,” the authors write. Still, the CDC notes that the industry should consider PrEP along with condoms and testing to prevent HIV transmission.

The broader issue is outside the adult film industry, which gets inordinate attention because of the controversy inherent in its business and the passion of the advocates that target it. About 50,000 Americans are newly infected with HIV each year, a number that shows no signs of declining. The burden disproportionately affects young gay men of color. The U.S. does a poor job of making sure the estimated 1.2 million HIV-positive Americans get the medical care needed both to control the virus and to prevent its transmission. It will take more than new rules on porn sets to solve that problem.