Transmission Behaviors and Prevalence of Chlamydia and Gonorrhea Among Adult Film Performers.
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 (AFP) are limited.



From August 2012 to May 2013, AFPs in Los Angeles, CA, seeking care at 2 clinics that provide sexually transmitted infections (STIs) testing to performers were offered urogenital, pharyngeal, and rectal chlamydia/gonorrhea testing. Participants were 18 years or older and performed in at least 1 adult film scene within the past year. A Web-based survey was used to collect sexual behavior information.



A total of 360 AFPs were enrolled; 75% (n = 271) were women, and the median age was 25 years (interquartile range, 22-31 years). Most reported a main partner (73%), 23% reported non-film transactional partners, and only 6% reported always using condoms on-set. Overall, 24% (n = 86) tested positive for chlamydia or gonorrhea; 15% for chlamydia (n = 54) and 11% for gonorrhea (n = 41). Prevalence of chlamydia/gonorrhea varied by time as a performer (median, year 2 vs year 3; P = 0.06), and days of adult film-work in the past 30 days (median, 6 days vs 4 days; P = 0.02). In multivariable analyses, age (adjusted odds ratio, 0.90; 95% confidence interval, 0.85-0.96) and type of scene (adjusted odds ratio for double vaginal = 2.89; 95% confidence interval, 1.29-6.48) were associated with chlamydia/gonorrhea positivity.



Adult film performers had a high prevalence of STIs and reported low levels of condom use in the context of most sexual partnerships. Targeted intervention strategies-both in and outside the workplace-are needed to limit the spread of STIs.
From the *Department of Epidemiology, UCLA School of Public Health, Los Angeles; †West Oaks Urgent Care Center, Canoga Park; and ‡ Division of Infectious Disease, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Marjan
M
Javanbakht
M Claire
MC
Dillavou
Robert W
RW
Rigg
Peter R
PR
Kerndt
Pamina M
PM
Gorbach
D000328:Adult; D002690:Chlamydia Infections / Q000453:epidemiology* / Q000635:transmission*; D017280:Condoms / Q000706:statistics & numerical data; D004882:Erotica; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology* / Q000635:transmission*; D006801:Humans; D008297:Male; D009040:Motion Pictures; D015999:Multivariate Analysis; D009784:Occupational Diseases / Q000453:epidemiology* / Q000382:microbiology; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D011477:Sex Work / Q000706:statistics & numerical data*; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D013997:Time Factors; D055815:Young Adult