Adult Entertainment and Sexually-Transmitted Diseases
- posted by Jim Leitzel @ 11:21 PM

Back in 2004, there was an HIV outbreak among performers in adult movies; eventually five performers were found to be infected. The virus's spread might have been much broader had it not been for the Adult Industry Medical HealthCare Foundation (AIM) and its founder, Sharon Mitchell. Among other things, AIM tests adult performers for STDs. Yesterday, Dr. Mitchell and AIM put out a warning about travel to Europe for adult workers, due to a syphilis outbreak within the adult industry on the continent. There can be significant lags between contracting an STD and positive test results, so unprotected sexual activity with someone who has just tested negative for an STD is not free of disease risk (and of course, even condom protection is less than perfect).

Dr. Mitchell is not a supporter of governmental mandates in the area of sex worker health; AIM works with performers and producers on a voluntary basis. (Some of their practices, such as informing other performers and producers of positive tests, are at odds with California health privacy rules.) But STD rates in the industry are still much higher than within the public at large -- this is not the case for workers at Nevada's legal brothels -- and some people are calling for state regulation. Dr. Mitchell has suggested a "seal of approval" system, one that is paralleled by a proposal in this article:

Short of legislation mandating performer protection, restricting distribution of adult movies to condom-only films may be the one way to have an impact on the industry. If there were organized and truly effective advocacy for performers, then large hotel chains, video retailers, and cable networks could be pressured to purchase adult films under a condom-only “seal of approval.”

I learned about AIM's alert on the syphilis outbreak from (not work safe) Adult Video News.com; I found the article discussing regulation through SWOP East Sex Workers Outreach Project.

Labels: HIV, pornography, testing

 
The Public Anti-Prostitution Oath
- posted by Jim Leitzel @ 10:21 AM

Back in May, when Vice Squad was more or less a going concern, we mentioned the policy of the US Agency for International Development (imposed by Congress) requiring grantees on anti-HIV projects to affirm their opposition to prostitution -- and Brazil's forfeit of $40 million from refusing to take the oath. Today's New York Times has more on the Brazilian situation. The basic story, familiar to readers of Vice Squad, is that Brazil has opted for a harm reduction approach that works closely with prostitutes to reduce AIDS incidence, while the US seems to want to insist on some lip service being paid to a zero-tolerance-for-prostitution policy. Why do we do this? Brazil has had tremendous success with its harm reduction. Many countries, including Britain, Canada, Germany, Switzerland, and so on, have legal prostitution -- oh yeah, we do too, in certain rural counties of Nevada. From the Times story:

"It's not as if you're choosing between two neutral policy programs," said Chris Beyrer of the Center for Public Health and Human Rights at the Johns Hopkins Bloomberg School of Public Health. "Brazil has good data to show that their approach works, and to ask them to change that, even if they get the additional money, to one for which there is no evidence, just because of moral squeamishness in the United States, is an extraordinary position to take."

A second story in today's Times, this one in the Magazine, tells a similar tale from Cambodia, where a group working to help improve the lives of sex workers lost US AID funding through unwillingness to take the pledge. This article also touches upon one of the perennially difficult issues with prostitution, namely, the extent to which decisions to become (or remain) a prostitute can reasonably be viewed as voluntary. A sample:

Rescue groups focus on prostitutes who are ''trafficked'': those who are under-age, have been tricked into sex work or are held captive by force or in debt bondage. But such cases are a minority. A 2002 U.S.A.I.D.-backed study found that 20 percent of the sex workers the researchers encountered directly were trafficked. But because of sample bias, the study's author, Thomas Steinfatt, says that he thinks the countrywide percentage is much lower. Another study of Vietnamese migrant sex workers, who make up about half of the prostitutes in Phnom Penh, found that 94 in 100 had sought out the work aware of the conditions they would be working in.

Labels: Brazil, Cambodia, HIV, prostitution

 
Brazilian Officials Won't Condemn Prostitution
- posted by Jim Leitzel @ 2:50 PM

Brazil is proud of its anti-AIDS efforts among sex workers. To protect these efforts, the Brazilians turned down $40 million from the US Agency for International Development to combat AIDS, because receipt of the US money would require Brazilian officials to take a public stand expressing their opposition to prostitution. Voice of America has the story.

Labels: Brazil, HIV, prostitution

 
Porn Production in the Wake of the HIV Outbreak
- posted by Jim Leitzel @ 7:40 PM

Five adult movie actors tested positive for HIV in March and April, leading to a two-month filming moratorium in much of the industry. (Previous Vice Squad coverage includes posts on April 16 and on May 11.) What has been the longer-term effect of the outbreak? Well, there hasn't been much of long-term effect, according to the cover story (link perhaps not work-safe) in the August edition of Adult Video News. A few performers are sticking with safer practices, but there seems to be substantial financial incentive to forego condom use and to perform higher-risk activities: "Nearly every person interviewed for this article agreed that life in the industry is virtually no different today than it was before the crisis broke in mid-March. A few performers dropped out, a few companies tightened their testing policies, some sexual acts were on hold for some producers, but, largely, looking back, it seemed the crisis never happened."

Labels: HIV, pornography

 
Testing Porn Actors
- posted by Jim Leitzel @ 3:45 PM

Yesterday's Times also had a story (registration required) about Sharon Mitchell, the founder of the Adult Industry Medical Health Care Foundation. That's the place that runs the clinic that has been performing the HIV (and other STD) tests on sex industry workers (1200 tests per month), and uncovered the five positive tests in the past few weeks. The initial positive tests led to a (partial) moratorium on filming that probably prevented a much wider outbreak of HIV.

Dr. Mitchell has an unusual biography, having starred in adult films before earning her doctorate in human sexuality and opening the clinic. On May 2, she wrote an op-ed for the Times on how it might be possible to make condom use a more regular part of the adult film landscape. The key is to pressure the producers, directors, and distributors. According to her op-ed, "Two of the largest film companies, Vivid and Wicked Pictures, regularly use condoms and the other companies will if the actors insist on it." Dr. Mitchell does not think that a regulatory response to the current crisis by the state will help, as it will drive filming (back) underground.

As an alternative, she suggests a "seal of approval" be developed and awarded to films that are made using safe workplace and health practices. Mainstream hotel chains and cable companies could then be persuaded to show only films with the seal of approval, providing the financial incentive to filmmakers to employ the safe procedures. Sounds like a worthy proposal to me.

Labels: HIV, pornography

 
Sex Workers' Rights Conference in Hong Kong
- posted by Jim Leitzel @ 2:58 PM

Reuters reports on the proceedings at yesterday's Hong Kong conference on prostitute rights. Here's the beginning of the linked article: "The world's oldest profession should be decriminalised and treated like any other business, international activists at a Hong Kong conference on prostitution said on Sunday.

Prostitutes are abused by policemen who demand free sex and then arrest them for soliciting and they are victimised by politicians who launch crackdowns to woo voters, speakers at the conference said.

Activists also demanded better health support for prostitutes to prevent the spread of diseases including HIV/AIDS, especially in less developed parts of the world."

UPDATE, May 4: Here's an article covering the conference that offers a good deal of international background and presents many of the issues that arise in the regulation of prostitution. An excerpt...

"In Germany, where prostitution has been legalized a new study has found that many sex workers still remain reluctant to register with authorities as they continue to experience discrimination. The study also discovered that women are often put in unnecessarily dangerous situations as a result of arbitrary rules that dictate exactly where they are allowed to tout for business. These are often dark and dead industrial areas, where the women are far more vulnerable to violence. One of the problems with the new prostitution law is that it does nothing to help foreign prostitutes, who constitute almost half of Germany sex workers, who don't have a legal work permit. Without it, they can't report ill treatment or exploitation to the police unless they want to run the high risk of subsequent deportation. The sad reality of prostitution in Germany is that despite the new law, most prostitutes still work under very poor conditions. The majority of the money they earn is taken away from them by pimps and landlords and, for those who are trying to work by the book, from the tax office as well."

Labels: HIV, policing, prostitution, taxes

 
Porn Production and HIV
- posted by Jim Leitzel @ 5:02 PM

Two pornography performers have tested positive for HIV. As a result, the largest producer of adult movies is suspending all filming for 60 days. Not all porn producers intend to follow suit, however. This LA Times (via Yahoo news) story provides details.

To my mind, this sad story nevertheless reflects the benefits of a legal (and regulated, though largely self-regulated) vice relative to one that is criminalized. Actors working in mainstream porn typically take regular tests for HIV. When the positive tests in today's news were revealed, mitigating actions (such as publicizing the test results and "quarantining" those who had performed with the HIV-positive actors since their last negative test) immediately began to be implemented. Alternatively, where prostitution is illegal, there typically is no system of regularized STD testing, and HIV positive prostitutes might work for many months without even knowing of their condition.

Labels: HIV, pornography, prostitution

 
Foreign Vice Developments: Moscow (gambling), India (alcohol), Malawi (prostitution)
- posted by Jim Leitzel @ 2:41 PM

Three unrelated but somewhat exotic stories, at least given their locales....

(1) "Moscow has been transformed over the last two years as gambling businesses have flooded the city's streets, shops and metros, enticing passersby with chances to win or lose their money....

There are now 53 casinos in Moscow, 35,000 slot machines and 2,000 igroviye zaly, or slot machine arcades in the city..." London, similar in population to Moscow (13,945,000 in the London metropolitan area, 11.2 million in Moscow), has 29 casinos, according to the linked Moscow Times article. Moscow also now sports its first Gamblers Anonymous group.

(2) The Indian state of Gujarat has prohibited alcohol since 1960. The son of one of the state ministers has had more than 750 crates of alcohol confiscated from his house, which neighbors on his father's home. The father's portfolio in the cabinet is not one you would find everywhere: he is Minister for Religious Places and Cow Protection.

(3) The lame-duck president of Malawi has been issuing a spate of decrees as elections approach. Following a long tradition of scapegoating women for sexually transmitted diseases, he recently ordered that women out at night be arrested, as a precaution against the spread of AIDS. Four law students challenged the decree, and the High Court granted an injunction that has caused the implementation of the decree to be postponed.

Labels: alcohol, gambling, HIV, India, Russia, slot machine

 
Russia Does Not Believe in Reducing Harms
- posted by Jim Leitzel @ 6:36 PM

Back in his halcyon early-November days as a guest blogger at Crescat Sententia, Vice Squad noted the negative reaction of members of the Moscow City Duma to US-sponsored harm-reduction measures that promoted the use of condoms to combat AIDS. The Moscow legislators thought that the condom information and distribution promoted prostitution along with condoms. Now it looks as if hostility towards harm reduction in Russia has taken another step forward, according to this RFE/RL report (scroll down to the third article for January 8) sent along by friend of Vice Squad Bridget Bukevich. This time, it is needle-exchange programs that have earned the ire of Russia policymakers, and it looks like participants in such programs who do not cease and desist could face jail. Here's a paragraph from the RFE/RL (Radio Free Europe/Radio Liberty) report:

"Aleksandr Mikhailov, deputy chair of State Narcotics Control, sent a letter dated 19 November 2003 to the chiefs of his agency's territorial offices, expressing concern about various organizations "actively imposing on public opinion the idea of implementing so-called 'harm-reduction' programs," involving distribution of disposable needles for drug addicts to combat AIDS infection through the practice of sharing needles, asi.org.ru reported on 16 December 2003. "The leadership of State Narcotics Control views this idea as nothing other than the open propaganda of drugs," wrote Mikhailov. He added that passing out fresh syringes or cleansing packets would be construed legally as providing the means for the use of drugs under 1998 Supreme Court Resolution No. 9 on narcotics, banning "any deliberate actions aimed at causing another person to wish to use drugs (persuasion, offering, provision of advice, and so on)." Under other drug laws, only narcotics prescribed by a doctor may be legally used, and appliances such as syringes can be confiscated."

...and later in the same report: "With the official number of HIV cases registered at 235,000, and estimates ranging from 700,000-1.5 million, and diagnoses almost doubling annually since 1998 according to UNAIDS, there is an urgent need to try anything that might stem the infection, which unlike other parts of the world, mainly comes from drug injection." But, to repeat my uncharitable encapsulation from the previous Russian harm-reduction post, the authorities apparently believe that deterring the use of drugs is so important that they must threaten drug injectors with the death penalty (via AIDS), even though that approach has not been very effective so far -- and those who disagree and attempt to distribute needles (or perhaps even to inform addicts of the importance of using clean needles and not sharing) must face prison for their impudence.

Labels: Crescat, harm reduction, HIV, Russia, sex

 
More on Condoms and Harm Reduction
- posted by Jim Leitzel @ 11:46 AM

Yesterday Vice Squad mentioned some Somalis who were not
taking well to anti-AIDS harm reduction measures. Today's
Chicago Tribune has a story (registration required) about the
opposite approach being taken by the city government of Washington,
DC. The Bush administration, which emphasizes abstinence over harm
reduction, is not "actively opposing" the program. Here are three
paragraphs with some details:

"In an effort to curb the nation's highest incidence of AIDS, the D.C. Department of Health has begun installing free condom dispensers in bars... and in government buildings across the city. It's believed to be the first program of its kind in the nation.

'They're going to be as common as water fountains,' said Ivan Torres, interim director of the city government's HIV/AIDS Administration, when he introduced the program Dec. 1, World AIDS Day.

In 2004, city officials hope to hand out about 550,000 male condoms, 30,000 female condoms and 45,000 dental dams (used during oral sex) to places such as the D.C. Housing Authority and the Department of Motor Vehicles, as well as to beauty salons, bars and barber shops."

This earlier Vice Squad post discussed harm reduction around teen
drug use.

Labels: harm reduction, HIV, sex

 
Taking Opposition to Harm Reduction to an Extreme
- posted by Jim Leitzel @ 6:57 PM

Harm reduction policies look to minimize the cost of vicious behavior, as
opposed to limiting the amount of vice itself. (The goals are frequently
incompatible, in that efforts to reduce the incidence of vice often result
in more harm per incident.) Prototypical harm reduction policies aimed
at heroin addicts are methadone maintenance and free needle
exchange. In some sense, these policies "subsidize" heroin addiction,
while attempting to ameliorate harms. The onset of the AIDS pandemic
greatly strengthened the case for needle exchange, as AIDS represented
a huge new harm that could be substantially reduced through such
exchanges.

AIDS also greatly strengthened the case for some forms of harm
reduction with respect to sexual "vices." In particular, increasing the
availability of condoms and information about their use became more
attractive policies when AIDS raised the stakes for unprotected sex.

Friend of Vice Squad Beth Plocharczyk sends along this report that a
UN-sponsored AIDS awareness campaign (that includes information
on condoms, apparently) in Somalia is meeting with some resistance
from Islamic leaders: "The umbrella Somali Ulema Council has said it
will use Sharia (Islamic) Law, including flogging, to punish those selling
or using condoms." This Council is asking those who don't share or heed
its views about sexual relations to pay a high price -- not just the
potential flogging, but the death sentence meted out to those who do
not use a condom and subsequently contract AIDS. This would be bad
enough if they actually understood the risks, but it is even worse given
the actual state of knowledge about AIDS in Somalia: "Due to the
fighting, there has been little research into the prevalence of Aids in
Somalia but the UN Aids agency says some 70% of young Somali girls
have not heard about the disease."

Labels: harm reduction, heroin, HIV, sex