Transmission Behaviors and Prevalence of Chlamydia and Gonorrhea Among Adult Film Performers.

BACKGROUND

Adult film work involves multiple sex partners, unprotected intercourse and frequent oral/rectal contact. Data on sexual networks and sexual behaviors of adult film performers (AFP) are limited.

METHODS

From August 2012 to May 2013, AFPs in Los Angeles, CA, seeking care at 2 clinics that provide sexually transmitted infections (STIs) testing to performers were offered urogenital, pharyngeal, and rectal chlamydia/gonorrhea testing. Participants were 18 years or older and performed in at least 1 adult film scene within the past year. A Web-based survey was used to collect sexual behavior information.

RESULTS

A total of 360 AFPs were enrolled; 75% (n = 271) were women, and the median age was 25 years (interquartile range, 22-31 years). Most reported a main partner (73%), 23% reported non-film transactional partners, and only 6% reported always using condoms on-set. Overall, 24% (n = 86) tested positive for chlamydia or gonorrhea; 15% for chlamydia (n = 54) and 11% for gonorrhea (n = 41). Prevalence of chlamydia/gonorrhea varied by time as a performer (median, year 2 vs year 3; P = 0.06), and days of adult film-work in the past 30 days (median, 6 days vs 4 days; P = 0.02). In multivariable analyses, age (adjusted odds ratio, 0.90; 95% confidence interval, 0.85-0.96) and type of scene (adjusted odds ratio for double vaginal = 2.89; 95% confidence interval, 1.29-6.48) were associated with chlamydia/gonorrhea positivity.

CONCLUSIONS

Adult film performers had a high prevalence of STIs and reported low levels of condom use in the context of most sexual partnerships. Targeted intervention strategies-both in and outside the workplace-are needed to limit the spread of STIs.