NEW YORK — Investigators at the Los Angeles County Department of Health Services recently became aware of four cases of HIV infection related to work in the adult film industry. The infections occurred despite a widely adopted voluntary program of HIV and STD testing in the industry.

As reported in the Morbidity and Mortality Weekly Report, the first identified case was a 40-year-old man who tested HIV-negative on February 12 and March 17, 2004, but tested positive on April 9.

Dr. H. Rotblatt, with the Los Angeles Department of Public Health, and colleagues report that, on April 20, the LA County Department of Health Services started an investigation to identify HIV transmission from this case.

During the time between his two negative tests, the patient had engaged in unprotected sex while producing a film in Brazil. After returning to California he engaged in unprotected sex with 13 female partners, three of whom tested HIV-positive in April and May after negative tests results were obtained one month previously.

HIV strains obtained from the four patients and sequenced by the CDC showed that they were all identical, supporting the conclusion that the male patient was the source of the HIV infection.

In September, the California Department of industrial Relations, Division of Occupational Safety and Health, cited employers of the workers for failing to comply with the state’s bloodborne disease standard, failing to report a serious work-related illness, and failing to prepare and follow a written occupational injury and illness prevention program.

MMWR editors comment that in Los Angeles County there are approximately 200 production companies employing 1200 workers who engage in direct work-related sexual contact, which is often prolonged and performed without condom use.

"In addition to the testing program being inadequate as the sole source of protection from HIV transmission, the costs of testing are typically borne by the workers themselves," the authors note. "The cost burden of health services could cause some workers to reduce the range and frequency of HIV and STD screening or to avoid or delay pursuing vaccination for hepatitis B virus."

They conclude that "workers in this industry need to be made aware of the risks associated with participation in various acts, to be able to participate in decision-making about their health and safety at work, and to benefit from prevention practices."

SOURCE: Morbidity and Mortality Weekly Report, September 23, 2005.

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