title: Epidemiologic investigation of a cluster of workplace HIV infections in the adult film industry: Los Angeles, California, 2004.
abstract: 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.
authors.affiliation: Division of STD Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA. taylorm@azdhs.gov
authors.forename: Melanie M
authors.initials: MM
authors.lastname: Taylor
authors.forename: Harlan
authors.initials: H
authors.lastname: Rotblatt
authors.forename: John T
authors.initials: JT
authors.lastname: Brooks
authors.forename: Jorge
authors.initials: J
authors.lastname: Montoya
authors.forename: Getahun
authors.initials: G
authors.lastname: Aynalem
authors.forename: Lisa
authors.initials: L
authors.lastname: Smith
authors.forename: Kerry
authors.initials: K
authors.lastname: Kenney
authors.forename: Lori
authors.initials: L
authors.lastname: Laubacher
authors.forename: Tony
authors.initials: T
authors.lastname: Bustamante
authors.forename: Robert
authors.initials: R
authors.lastname: Kim-Farley
authors.forename: Jonathan
authors.initials: J
authors.lastname: Fielding
authors.forename: Bruce
authors.initials: B
authors.lastname: Bernard
authors.forename: Eric
authors.initials: E
authors.lastname: Daar
authors.forename: Peter R
authors.initials: PR
authors.lastname: Kerndt
mesh_terms: 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