Epidemiologic investigation of a cluster of workplace HIV infections in the adult film industry: Los Angeles, California, 2004.
BACKGROUND
Adult film production is a legal, multibillion dollar industry in California. In response to reports of human immunodeficiency virus (HIV) transmission by an adult film worker, we sought to determine the extent of HIV infection among exposed workers and to identify means of improving worker safety.


METHODS
The Los Angeles County Department of Health Services initiated an outbreak investigation that included interviews of infected workers to elicit information about recent sex partners, review of the testing agency's medical records and laboratory results, molecular analysis of HIV isolates from the 4 infected workers, and a risk assessment of HIV transmission in the adult film industry.


RESULTS
Many adult film workers participate in a monthly program of screening for HIV infection by means of polymerase chain reaction-based technology to detect HIV DNA in blood. A male performer tested negative for HIV on 12 February 2004 and 17 March 2004, then tested positive for HIV on 9 April 2004. During the period between the negative test results, he experienced a flulike illness after performing unprotected vaginal and anal intercourse for an adult film produced outside the United States by a US company. After returning to California, he performed unprotected sex acts for adult films with 13 female partners who had all tested negative for HIV in the preceding 30 days; 3 subsequently tested positive for HIV (a 23% attack rate). Contact tracing identified no reasonable sources of infection other than the male index patient.


CONCLUSIONS
Although current testing methods may shorten the window period to diagnosis of new HIV infection, they fail to prevent occupational acquisition of HIV in this setting. A California Occupational Safety and Health Administration-approved written health and safety program that emphasizes primary prevention is needed for this industry.
Taylor
Melanie M
MM
Division of STD Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA. taylorm@azdhs.gov
Rotblatt
Harlan
H
Brooks
John T
JT
Montoya
Jorge
J
Aynalem
Getahun
G
Smith
Lisa
L
Kenney
Kerry
K
Laubacher
Lori
L
Bustamante
Tony
T
Kim-Farley
Robert
R
Fielding
Jonathan
J
Bernard
Bruce
B
Daar
Eric
E
Kerndt
Peter R
PR
D000328:Adult; D004882:Erotica; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D009040:Motion Pictures; D016273:Occupational Exposure