HIV Risk and Health Status in Female Adult Film Performers

Corita Grudzen, University of California, Los Angeles
Social and Behavioral

Though an over $11 billion industry in Los Angeles County, adult film performers enjoy little to none of the mandated protection of workers in other legal industries and are entitled to no royalties from their movies. With the rapid growth of the adult film industry, more and more women are exposed to what appears to be a quick and easy way out of poverty. The majority are forced to work without barrier protection and are exposed to sexually transmitted diseases (STDs) that include HIV, hepatitis B, HPV, Chlamydia, Gonorrhea and their many complications.

This project is the third phase of an ongoing investigation into the health and safety of female performers. Our media review (Phase 1) showed that the heterosexual is less likely than the homosexual industry to utilize condoms. Penile-vaginal intercourse was protected only 3% of the time in the heterosexual industry. Though uncommon in the homosexual industry, penile- vaginal intercourse was protected 100% of the time. Penile-anal intercourse, common in both industries, is much more likely to be protected in the homosexual industry, 80% of the time compared to 10% in the heterosexual industry. In the qualitative phase of our prior work (Phase II), we performed twenty-two interviews with adult film performers who identified mental health, alcohol and drug abuse, STDs, and body manipulation (plastic surgery and use of performance- enhancing drugs) as problems in the AFI.

In this specific project, we will determine HIV risk behaviors and health-related quality of life (HRQOL) and its potential associated factors in female adult film performers as compared to females in the traditional modeling industry. To achieve this aim, we will conduct a structured web-based survey by recruiting participants from an Internet site used by traditional and adult film performers seeking employment. We will select a random sample of approximately 200 models, half of whom are interested in adult film, from the largest modeling website, One Model Place. Subjects will be sent an email and asked to complete a 45-minute structured web questionnaire to assess HIV risk behaviors, HRQOL, and potential associated factors. They will be reimbursed $50 for participation in the study. The survey will also address family and childhood characteristics, demographics including income, education, social support, mental health history, substance use, and sexual history. HIV risk behaviors, HRQOL and potential associated factors will be compared among adult film performers and traditional models. Surveys questions regarding HIV risk behaviors will be based on the sexual behavior module designed by the Centers for Disease Control and questions about HRQOL on the Medical Outcomes Study SF-36 Short Form.

The survey will provide the basis for the future design of a program to decrease HIV risk and address the mental and physical health of adult film performers. Data from this pilot project will be used by the principal investigator to apply for an NIH Career Development Award from the National Institute of Allergy and Infectious Diseases (NIAID). The project was designed in collaboration with the community partner, Bill Margold of Protecting Adult Welfare, a nonprofit started to provide counseling and financial assistance to adult film performers.