What the pornography industry could teach us about coronavirus testing

It survived the HIV crisis. So it could be a model for rebuilding confidence, experts say

Maitland Ward performs in adult films that rely on a health-screening system that some experts say could be a model for a coronavirus screening database. Photograph: Albert L Ortega/Getty

As more states open up and people return to work, companies are looking for guidance on how to keep workers safe from infection. Some experts suggest looking to what may seem an unlikely model: the United States’ adult-film industry. It survived a different pandemic – an outbreak of HIV infections in the late 1990s that almost shuttered the multibillion-dollar industry.

"We can actually learn a lot about safety guidelines by listening to producers of porn," says Perry Halkitis, dean of the school of public health at Rutgers University, in New Jersey. "Thinking back to the HIV/Aids crisis, the adult-film industry had to learn how to keep their workers safe."

He recommends following its lead by using what he calls the Four Ts: target, test, treat and trace. The adult-film industry uses a US-wide programme called Pass, for performer-availability screening services, that requires performers to be tested every 14 days for HIV and other sexually transmitted infections in order to be cleared for work. If a worker tests positive, he is treated, and his partners are traced.

We have to get over that this is coming from the porn industry. A major part of trying to get our economy back is building confidence for regular activities such as going to a restaurant, getting on a plane or going back to work

"We have to get over that this information is coming from the porn industry," says Dr Ashish Jha, director of the Harvard Global Health Institute. "If we're trying to get our economy back, a major component of that is building confidence for when we engage in regular activities such as going to a restaurant, getting on a plane or going back to work."

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Of course, the incubation period of the coronavirus means that it is possible that people could have negative test results indicating it is safe to travel but be contagious by the time they get on a plane. “It’s not foolproof,” Jha says, but “we’re going to see more testing to make decisions in our lives.”

The United States' adult-film industry, which has been largely shut down since mid-March, recently released guidelines on how to get back to work. Mike Stabile, communications director for the Free Speech Coalition, which is the adult-entertainment trade association, has been meeting with others in the industry over Zoom twice a week to discuss how to proceed once they get greenlighted to open back up. They consult with medical professionals regularly.

“We’ve looked at coronavirus testing, temperature checks, wearing masks on sets when not filming, and having couples who live together work together,” he says.

The coalition created a webpage for Covif-19 resources for the adult-film industry.

For HIV tests, Stabile says, “we use a highly sensitive PCR-RNA test, which can detect the virus within seven to 10 days after infection.” He says the frequent testing “and other controls used by performers, such as not having sex outside the tested-performer pool or using condoms when doing so, further minimises the risk of HIV.”

But because Covid-19 is transmitted by droplets via coughing or even breathing, rather than by sex, he says, “there are a million more exposures, from who did you work with on the set to who did you come into contact with before testing positive. Everyone’s happy to comply with testing, because no one wants to work on a set where they can get infected.”

The Aids Healthcare Foundation used a motorhome as a mobile HIV screening lab when California’s adult-film industry temporarily shut down after two porn stars tested positive for HIV, in 2004. Photograph: David McNew/Getty

If an infection were to occur, the production would shut down. Everyone on the set – those infected and those who tested negative – would be out of work. Most people in the adult film industry are independent contractors. If they’re not working they’re not getting paid, so the incentive to keep working is high.

“I only perform on sets where the Pass system is in place,” says Maitland Ward, an adult-film star with three Adult Video News Oscars and a former star on the sitcom Boy Meets World. “Professional porn follows very strict guidelines on a regular basis,” Ward says. When production resumes, in addition to the coronavirus testing, “extra precautions will be in place on sets, such as temperature checks and social distancing among crew members,” she says.

“Health screenings are the norm for us. I think the adult industry is far more prepared than mainstream” film sets or other businesses. “This is just one more thing we need to be cautious and vigilant about. Honestly, I think mainstream will be looking to how the adult industry handles this, because we are the standard-bearer when it comes to health and safety on sets.”

Jha agrees. He says he would like to see a database much like the Pass programme, where people can register online to show they were tested for the coronavirus. “It should be run by a nonprofit or private business, not the government,” he says. “I’m not opposed to the government doing it. It’s that a lot of people would not be comfortable with the government running it.”

In the adult-film industry, when people get tested and get a negative result, they get a green check next to their names. If they test positive or do not take the test, they get a red X.

Green checks show producers and others who do the hiring that performers are cleared to work. According to Stabile, “People want to work and they want to work in a safe space, so they take the test.”

Jha understands that if the model is adopted for coronavirus testing, not everyone will want to be tested and notes that testing should be voluntary, much as it is in the adult film industry.

If Delta or American Airlines said, 'You have to take this test to show us you don't have Covid,' you'd feel safer flying on that airline

Jha believes most people would want to know that their work area, the restaurant they go to or the plane they fly on is safe. “If Delta or American Airlines said, ‘You have to take this test to show us you don’t have Covid,’ you’d feel safer flying on that airline,” Jha says. “The airlines could purchase thousands of tests and charge their customers $5 or $10 to take it. Knowing everyone on that plane, everyone in that restaurant and all of your coworkers are safe builds confidence.”

Although he acknowledges that there could be false negatives and that Covid has an incubation period of five to seven days and can show up in as little as two, he believes that most people would respond favourably.

As possible models, he points to the private charter company Set Jet and Emirates Airline, which have experimented with rapid testing, with results in 10 minutes.

Dr Robert Gallo, one of the discoverers of HIV in the 1980s and cofounder and director of the institute of human virology at the University of Maryland school of medicine, notes that "HIV and the coronavirus are very different viruses. It's like comparing a rabbit to a squirrel." Still, when it comes to fighting coronavirus, he says, "Following the adult-film industry example of testing is smart."

Despite the stigma associated with adult films, Halkitis says, “We need to take any tools we have, even ones from the adult-film industry, and apply what worked to limit the spread of the coronavirus.” – New York Times