title: Sexually transmitted infection testing of adult film performers:  is disease being missed?
abstract: BACKGROUND
  Undiagnosed sexually transmitted infections (STIs) may be common in the adult film industry because performers frequently engage in unprotected oral and anal intercourse, STIs are often asymptomatic, and the industry relies on urine-based testing.
  
  
  METHODS
  Between mid-May and mid-September 2010, a consecutive sample of adult film industry performers recruited from a clinic in Los Angeles, California, that provides medical care to performers was offered oropharyngeal, rectal, and urogenital testing for Gonorrhea, and rectal and urogenital testing for Chlamydia.
  
  
  RESULTS
  During the 4-month study period, 168 participants were enrolled: 112 (67%) were female and 56 (33%) were male. Of the 47 (28%) who tested positive for Gonorrhea and/or Chlamydia, 11 (23%) cases would not have been detected through urogenital testing alone. Gonorrhea was the most common STI (42/168; 25%) and the oropharynx the most common site of infection (37/47; 79%). Thirty-five (95%) oropharyngeal and 21 (91%) rectal infections were asymptomatic. Few participants reported using condoms consistently while performing or with their personal sex partners.
  
  
  CONCLUSIONS
  Adult film industry performers had a high burden of STIs. Undiagnosed asymptomatic rectal and oropharyngeal STIs were common and are likely reservoirs for transmission to sexual partners inside and outside the workplace. Performers should be tested at all anatomical sites irrespective of symptoms, and condom use should be enforced to protect workers in this industry.
authors.affiliation: Sexually Transmitted Disease Program, Division of HIV and STD Program, Los Angeles County Department of Public Health, Los Angeles, CA 90007, USA. Cristina_Rodriguez-Hart@doh.state.fl.us
authors.forename: Cristina
authors.initials: C
authors.lastname: Rodriguez-Hart
authors.forename: Rohit A
authors.initials: RA
authors.lastname: Chitale
authors.forename: Robert
authors.initials: R
authors.lastname: Rigg
authors.forename: Binh Y
authors.initials: BY
authors.lastname: Goldstein
authors.forename: Peter R
authors.initials: PR
authors.lastname: Kerndt
authors.forename: Paula
authors.initials: P
authors.lastname: Tavrow
mesh_terms: D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000453:epidemiology* / Q000517:prevention & control; D003430:Cross-Sectional Studies; D004882:Erotica; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009040:Motion Pictures; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D017132:Workplace / Q000592:standards*