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Lessons on Coronavirus Testing From the Adult Film Industry

An industry that survived one health crisis could be a model for others looking to build 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.Credit...via Maitland Ward

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 adult film industry. It survived a different pandemic — an outbreak of H.I.V. 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,” said Perry N. Halkitis, dean of the School of Public Health at Rutgers University. “Thinking back to the H.I.V./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 nationwide program called PASS, for Performer Availability Screening Services, that requires performers to be tested every 14 days for H.I.V. and other sexually transmitted infections in order to be cleared for work. If a worker tests positive, he’s treated, and his partners are traced.

“We have to get over that this information is coming from the porn industry,” said 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.”

The suggestion of using the adult film industry as a model was reported by Stat News in May. Of course, the incubation period of the coronavirus means that it’s possible that people could have negative test results indicating it’s safe to travel but be contagious by the time they get on a plane.

“It’s not foolproof,” Dr. Jha said, but “we’re going to see more testing to make decisions in our lives.”

The adult film industry, which has been largely shut down since March 15, just 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 said. The coalition created a web page for Covid-19 resources for the adult film industry.

For H.I.V. tests, Mr. Stabile said, “we use a highly sensitive PCR-RNA test, which can detect the virus within seven to 10 days after infection.” He said 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 minimizes the risk of H.I.V.”

But because Covid-19 is transmitted by droplets via coughing or even breathing, rather than by sex, he said, “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.”

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.

Back in 1998, there was an H.I.V. outbreak in the adult film industry. Marc Wallice, an adult film actor, falsified his H.I.V. test certificate and infected a handful of actresses. H.I.V. tests, at the time, were printed out on paper and could be easily forged.

Sharon Mitchell, a former actress with a doctorate in human sexuality and training taking blood samples, formed the Adult Industry Medical health care foundation that year, formalizing the protocols that would eventually become PASS.

“While the acronyms and organizations have changed, and the testing improved, the general principles are the same,” Mr. Stabile said.

The system brought a major shutdown in 2004 and two shorter ones in 2013.

“I only perform on sets where the PASS system is in place,” said 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,” Ms. Ward said. 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 said.

“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.”

Dr. Jha agreed. He said he would like to see a database much like the PASS program 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 said. “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 don’t 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 Mr. Stabile, “People want to work and they want to work in a safe space, so they take the test.”

Dr. 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.

Dr. Jha believes most people would want to know that their work area, the restaurant they go to, or the airplane 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,” Dr. Jha said. “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 co-workers are safe builds confidence.”

Although he acknowledged 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 said he believed that most people would respond favorably.

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

Dr. Robert Gallo, a co-discoverer of H.I.V. in the 1980s and co-founder and director of the Institute of Human Virology at the University of Maryland School of Medicine, noted, “H.I.V. and the coronavirus are very different viruses. It’s like comparing a rabbit to a squirrel.”

Still, when it comes to fighting the coronavirus, he said, “Following the adult film industry example of testing is smart.”

Despite the stigma associated with adult films, Dr. Halkitis said, “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.”

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