TP 97 Adult Film Performers Transmission Behaviors and STI Prevalence

Tuesday, June 10, 2014
Exhibit Hall
Marjan Javanbakht, PhD1, Pamina Gorbach, DrPH1, M. Claire Dillavou, MPH1, Robert Riggs, MD2, Sixto Pacheco, CCRC3 and Peter R. Kerndt, MD, MPH4, 1Fielding School of Public Health, Department of Epidemiology, UCLA, Los Angeles, CA, 2West Oaks, Canoga Park, CA, 3BioCollections, Miami, FL, 4Keck School of Medicine, Dept of Medicine, Div of Infectious Disease, University of Southern California, Los Angeles, CA

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 (AFPs) are limited. 

Methods: From August 2012-May 2013, AFPs in Los Angeles, CA seeking care at two clinics that provide STD testing to performers were offered urogenital, pharyngeal and rectal Chlamydia/gonorrhea NAAT testing.  A web-based survey was used to collect demographics, type of sexual practices on-set and off-set, substance use, and sexual network characteristics.  Participants were at least 18 years of age and performed in at least one adult film within the past year.

Results: A total of 366 AFPs were enrolled; 75% (n=274) were female, 62% (n=219) were white and the median age was 25 years (IQR: 22-31 years).  Most reported a main partner (74%), 23% reported non-film transactional partners, and 26% reported sex with an AFP off–set;  only 6% reported always using condoms on-set and 13% off-set.  Overall, 24% (n=86) tested positive for Chlamydia (15%, n=54) or gonorrhea (11%, n=41).  The most common site of infection for Chlamydia was urogenital (43/54) and pharyngeal for gonorrhea (33/41).  Prevalence of Chlamydia/gonorrhea varied by age (median 23 vs. 26 years; p-value<.01), time as a performer (median years 2 vs. 3; p-value=0.06), and days of adult film-work in the past 30 days (median 6 vs. 4 days; p-value=0.02). In multivariable analyses, age (adjusted odds ratio [AOR]=0.90; 95% confidence interval [CI] 0.85-0.96) and type of scene (AOR for double vaginal=2.89; 95% CI 1.29-6.48) were associated with Chlamydia/gonorrhea.

Conclusions: AFPs had a high burden of STIs at all anatomic sites and reported inconsistent condom use within the context of any occupational or other sexual partnerships. Targeted intervention strategies - both in and outside the workplace - are needed to limit the spread of STIs.