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Volume 4, Number 3
January 13, 2003
In this edition:
California HIV Reporting Program a “Disaster”
Federal Funds Put at Risk
California’s HIV reporting system has been hobbled
in its first six months by the failure of some doctors and
clinics to provide the data required by law, county health
officials say. If the problems are not resolved, authorities
say, they won’t be able to track the epidemic’s
spread. And California risks coming up short as early as next
year, when the federal government begins linking its treatment
and service grants to the number of state HIV cases.
“It’s a disaster,” Dr. Steven Miles, a
physician at the UCLA Center for Clinical AIDS Research and
Education, said of the new reporting system. So far, the state
has been informed of only a fraction of the cases that officials
believe are out there: 9,155 through December 31 out of 80,000
projected by federal officials.
Moreover, the cases have been reported unevenly: Orange County,
with a population of nearly 3 million, submitted 829 HIV cases
while Los Angeles County, with almost 10 million residents,
reported just 1,064.
Los Angeles County officials say their figure will soon increase
by at least 700, after they process cases already submitted
by medical providers. Even so, officials still have to find
and track an estimated 20,000 HIV cases in the county.
The tracking system, set up under state rules that took effect
July 1, requires medical providers and laboratories to report
all new HIV infections. Each patient is given an alphanumeric
code to protect privacy. Doctors are required to provide additional
medical information, as well as data on race and risk factors.
The system was designed to help public health officials better
track the disease and target prevention and treatment dollars.
Previously, the state required reporting of AIDS cases only,
which meant that officials often learned of HIV infections
10 or more years after they had occurred. AIDS is the end
stage of HIV infection.
Although most laboratories are reporting their results to
local health departments, some doctors are balking, saying
the requirements are too burdensome. Others aren’t complying
because they aren’t versed in the new regulations.
“I’d like to help them, but I really don’t
have the time to do the paperwork that they’re asking
me, so I’m not doing it,” said Dr. Bisher Akil,
a Los Angeles physician who treats about 200 HIV and AIDS
patients.
Michael Montgomery, director of the Office of AIDS at the
California Department of Health Services, said growing pains
are to be expected in the first few years of a new tracking
system. “Nobody thought it was going to be easy,”
he said. All in all, Montgomery said, “it looks to me
that we’re escaping the problems that some of the other
states are experiencing.”
For instance, Montgomery said, most of the HIV case reports
contain information on patients’ risk factors-- such
as drug use and sexual orientation-- that other states have
struggled to compile.
The most daunting part of building an HIV reporting system
comes in the first months. Public health agencies must collect
information on all HIV cases, new and old, even those that
go back many years. The expectation is that, after a couple
of years, doctors will have reported all old cases, and tracking
new cases will be much more manageable.
But Los Angeles County officials said the first six months
have been more difficult than they had expected. Because of
incomplete or nonexistent information from medical providers,
the county reported fewer than 10 percent of the more than
7,000 potential cases identified by laboratory tests through
December. Before a case can be reported to the state, county
officials must receive data from a medical provider.
“If we don’t change, it’s going to take
us several years” to get existing cases reported, “and
we don’t have that much time,” said Gordon Bunch,
director of HIV epidemiology with the Department of Health
Services.
Officials in Ventura County say they have grown so frustrated
that they have threatened to fine several medical providers
who didn’t report their cases.
“This is an incredibly imperfect system that we’re
working with,” said Lynn Bartosh, a community service
coordinator with Ventura County Public Health. “This
is exactly what we were wanting to avoid.”
Some doctors and clinics say the use of codes hampers the
new system’s efficiency and usefulness. They note that
all other reportable diseases are tracked by patient name.
“It was a bad idea legislatively and it’s a
worse idea in practice,” said Michael Weinstein, president
of the AIDS Healthcare Foundation in Los Angeles, which had
advocated reporting of HIV by name.
Bunch concedes that the county would be a lot further along
if it used names in reporting HIV cases. But he said the code
system deserves an opportunity to prove itself. Six months
“would be far too premature to call it a failure.”
Montgomery said reluctant doctors need to realize that the
state’s ability to track HIV cases will be directly
correlated to federal funding for services.
Some health departments have had better luck with physician
reporting than others. “There was a lot of effort put
into helping people understand” how the new system works,
“and maybe that made a big difference for us,”
said Penny Weismuller, of the Orange County Health Care Agency.
San Francisco health authorities said they have been successful
largely because city workers go to physicians’ offices
to collect the necessary information themselves from patients’
medical records.
Providers are “really swamped,” said Dr. Sandra
Schwarcz, the city’s director of HIV/AIDS statistics.
“I’m sure they’re going to prioritize taking
care of a patient over sending in a case report form.”
Los Angeles County officials said they are starting to take
the same approach, and many clinics say they welcome the county’s
assistance. To add incentive, L.A. County officials plan to
make timely reporting a condition of grant funding.
Miles of UCLA said he finds it ironic that county health
workers are being allowed to peruse medical records, complete
with patient names, when the whole goal of code reporting
was to protect patients’ privacy.
But Dr. Douglas Frye, a medical epidemiologist with the Los
Angeles County HIV epidemiology program, said the names may
be seen but are not recorded. In any case, the stakes for
making the system work are high for the county and the state.
“Los Angeles County historically has reported 35 percent
of the cases in the state,” Bunch said. “If we
fail, the state fails.”
[Los Angeles Times, 1/11/03]
San Diego Extends Needle Exchange Program
A pilot needle exchange program meant to cut the spread of
HIV, hepatitis and other blood-borne diseases has been approved
for further evaluation by a majority of California’s
San Diego City Council. Since the program began in July, exchanging
needles one night a week from a camper parked on a downtown
side street, 18,500 dirty needles have been collected, Councilman
Michael Zucchet said. Handing out so many syringes to drug
addicts is “remarkable,” he said. By a 6-2 vote,
the council opted to continue the declaration of a public
health emergency as required by state law for the one-year
pilot program to operate. Mayor Dick Murphy and Councilman
Brian Maienschein voted against the emergency declaration.
Councilman Jim Madaffer, who has opposed the program, was
absent.
The program allows intravenous drug users to get one clean
needle for every dirty one they turn in, except on their first
visit, when they can get two clean needles without turning
in any dirty ones. So far, program operators said the number
of dirty needles turned in has exceeded the number of clean
needles dispensed. Not everyone turning in dirty needles requests
clean ones, they said.
At Murphy’s suggestion, the council’s Land Use
and Housing Committee will consider guidelines on establishing
permanent sites if the pilot program is continued after its
one-year test period. Murphy said people who live near proposed
sites should be notified, and formal council approval should
be required for each site. Deputy City Attorney Lisa Foster
said no such requirement currently exists.
Murphy has opposed the program because he said he feared
it would draw addicts to neighborhoods with exchange sites
and cause an increase in crime.
[San Diego Union-Tribune, 1/8/03]
New Jersey AIDS Panel Pushes Condoms for School
Children and Needles for Drug Addicts
New Jersey should provide clean needles to drug addicts and
condoms to public school students, the Governor’s Advisory
Council on AIDS says in a report to Governor James E. McGreevey.
McGreevey has already proposed a pilot needle-exchange program,
which former Governor Christie Whitman strongly opposed. That
has encouraged many AIDS-prevention workers to think the governor
might also embrace the idea of allowing teens to get condoms
at school.
A McGreevey spokeswoman said that the Democratic governor,
like Republican Whitman before him, has preferred to leave
it up to local schools boards to decide about condom distribution.
None have adopted the idea.
But the spokesman, Ellen Mellody, added that McGreevey has
yet to review the council’s report and is keeping an
open mind. “While the governor supports comprehensive
age-appropriate sex education in public schools, including
information regarding contraception, abstinence, STDs and
HIV prevention, he feels that it should be a local decision,”
Mellody said.
Terrence P. Zealand, the council’s acting chairman,
said he hoped school districts would voluntarily adopt condom-distribution
policies. Zealand, director of the AIDS Resource Foundation
for Children in Newark, said he envisioned making condoms
available at school-based clinics or through school nurses,
who would meet confidentially with students.
The council’s report, which has yet to be released
publicly, is its first since 1996.
New Jersey ranks fifth in the nation in AIDS cases, with
43,824 as of the end of 2001, according to the state Department
of Health and Senior Services. School-age children represent
a small portion of those infected: There have been 196 reported
infections among New Jersey residents ages 13 to 19 in the
last decade.
Public health care workers say the state needs to draw more
attention to methods of prevention among young people. Dangerous
rates of needle sharing, increases in other sexually transmitted
diseases and signs of “prevention fatigue” among
at-risk populations are all reasons for worry, said George
DiFerdinando, the Department of Health and Senior Services’
deputy commissioner for public health services. “We’re
concerned about signs of behavior that are increasing the
risk,” DiFerdinando said.
At McGreevey’s orders, the department is developing
a pilot clean-needle exchange for intravenous drug users.
The council first took a position in favor of needle exchange
in 1993, but it was not adopted by Governor Jim Florio or
his successors. Whitman was particularly adamant, saying giving
addicts clean syringes would condone illegal drug use and
send a harmful message to children.
No New Jersey school district has taken up the council’s
past recommendations to distribute condoms.
[Newark Star-Ledger, 1/9/03]
Syphilis on the Rise in Texas County
Syphilis cases in Tarrant County, Texas almost doubled in
2002 after steadily declining for nearly a decade, county
health department officials said in a special report to Commissioners
Court.
“It has not reached a health alert level yet, but
we must reduce these numbers,” Scott Hanlan, the health
department’s assistant director of operations, told
commissioners. In Tarrant County, the increase has been seen
mostly in the heterosexual community, particularly among prostitutes
and those who trade drugs for sex or sex for drugs, he said.
The cases are clustered in Fort Worth and Arlington, Hanlan
said. Most of the cases were reported this past summer, he
said.
“This is not something to be taken lightly,”
said Commissioner Marti VanRavenswaay, who represents the
Arlington area. “It is a significant health risk.”
The rate of syphilis infection in Tarrant County climbed
from 6.9 cases per 100,000 people in 2001 to 14.2 cases per
100,000 in 2002, Hanlan said. The rate in Dallas County also
nearly doubled in 2002, he said.
There was not a similar increase in the rate of infection
for gonorrhea and chlamydia, two other sexually transmitted
diseases, and there was not a comparable increase in syphilis
in the state’s other large metropolitan areas of Harris
County and Bexar County, Hanlan said.
“There is great concern locally and nationally about
the rate of syphilis,” said Dr. George Wendel, an obstetrician/gynecologist
at the University of Texas Southwestern Medical Center in
Dallas who specializes in sexually transmitted diseases.
If the trend continues, it has implications for gays, heterosexuals
and pregnant women, who can pass the disease to their fetus.
“There is a strong correlation between co-infection
of syphilis and HIV infection,” Wendel said. “This
is important information in an era when we are trying to eliminate
both diseases.”
Syphilis has been curable with penicillin since 1947. The
infection is caused by a bacterium that can damage tissues
in many organs of the body, producing a wide range of problems.
The initial symptoms-- a painless sore, followed by a rash--
often go unnoticed and disappear without treatment, but the
bacterium can persist in the body for many years. Untreated,
the infection can invade all parts of the body, causing pain
and eventually leading to blindness, general paralysis and
death.
New cases of syphilis reported in the United States fell
during 1996 to the lowest rate in 40 years, a decline that
health officials then said could make it possible to eliminate
the sexually transmitted disease from the country in the near
future.
But a November 2002 study by the federal Centers for Disease
Control and Prevention found the syphilis rate rising nationally
for the first time since 1990, especially among homosexual
men. The study also found significant increases in the 2001
syphilis rate in San Francisco, Atlanta, Chicago and other
cities.
Dr. Tim Coleridge, chairman of the family medicine department
at the University of North Texas Health Science Center in
Fort Worth believes syphilis is on the rise because “unprotected
sex is becoming more commonplace.” He said “if
people don’t think they can get syphilis from oral intercourse
they are wrong.”
Beginning in April, Tarrant County health officials have
developed an action plan and a syphilis response team, Hanlan
said. The team is increasing disease surveillance, awareness
and education, and is expanding its effort to target groups
most likely at risk.
The county health department is also working in conjunction
with the Texas Department of Health, Fort Worth’s health
department, the Dallas regional Syphilis Elimination Team,
local medical providers and community organizations.
[Forth Worth Star-Telegram, 1/8/03]
FBI Investigating DC HIV/AIDS Official
An official with the District of Columbia HIV/AIDS Administration
is under investigation by the FBI for allegedly receiving
as much as $120,000 from the Washington Teacher’s Union
as part of a scheme in which former WTU leaders are suspected
of diverting more than $2 million in union funds for their
personal use. According to an FBI affidavit filed in federal
court, Michael Martin, a supervisory program analyst at HAA,
and his business partner, Errol Alderman, received more than
$100,000 in questionable payments from the WTU through a company
they operate called Expressions Unlimited.
The FBI affidavit says Martin received an additional $20,000
from the WTU through direct, personal payments. Investigators
suspect he and his company did not provide legitimate services
or products to justify any of the payments, the affidavit
says.
Martin is the son-in-law of Gwendolyn Hemphill, the WTU’s
former assistant to the president and legislative representative,
who also is under investigation for alleged misappropriation
of WTU funds. She resigned from her union post in September
after being targeted in the FBI investigation. Hemphill worked
directly under Barbara Bullock, the WTU president who resigned
that same month when investigators identified her as the ringleader
in the alleged scheme to divert WTU funds for her and her
alleged co-conspirators’ personal use. In addition to
her union job, Hemphill served as co-chair of D.C. Mayor Anthony
Williams’s election campaign before resigning at the
time the FBI opened its investigation into WTU. Hemphill also
resigned from her post as executive director of the D.C. Democratic
State Committee.
The FBI used the 31-page affidavit to obtain warrants to
search the homes and offices of Martin and the others implicated
in the probe. Separate documents released by the United States
Attorneys office show that FBI agents confiscated hundreds
of items and documents during the searches, including the
computer Martin used at his HAA office.
No charges have been filed against Bullock, Hemphill, Martin,
or any of the others implicated in the investigation. A spokesperson
for D.C. Mayor Anthony Williams said the mayor’s office
and the Department of Health, which has jurisdiction over
HAA, are monitoring the situation, but officials there don’t
believe there is sufficient grounds for taking personnel action
against Martin at the present time.
Although the FBI affidavit says Martin used a HAA fax machine
in October to send invoices to investigators seeking information
for the WTU probe, nothing in the FBI document suggests that
Martin engaged in illegal actions at HAA.
Members of the D.C. Gay and Lesbian Activists Alliance and
the local AIDS protest group ACT UP/D.C. said Martin’s
involvement in the embezzlement investigation associated with
the WTU highlights their longstanding concern about HAA’s
handling of federal and D.C. AIDS funds. Officials with the
two groups said HAA has not responded to separate Freedom
of Information Act requests the groups have made seeking information
about HAA’s programs and employees.
Bob Summersgill, GLAA’s former president, said HAA
has been more than three months late in responding to the
group’s request for the names, job titles, and salaries
of all HAA employees.
“Trying to get any information out of HAA is like
trying to get information from the Kremlin,” said Wayne
Turner, ACT UP’s lead organizer said.
HAA official Ivan Torres said the GLAA request was approved
in November but was never sent to GLAA due to a mix-up by
an HAA staff member. Torres said he made arrangements for
the HAA staff to fax the information to GLAA on Wednesday,
January 8. Torres said his records show that HAA had sent
Turner several weeks ago the information ACT UP requested.
Turner said January 8, that he had yet to receive the documents
he requested from HAA and was puzzled over Torres’s
statement. Summersgill said the HAA staff had not faxed the
information to GLAA.
The investigation into Martin’s ties to the alleged
embezzlement scheme at the WTU also comes at a time when the
U.S. Department of Health & Human Services is poised to
begin an audit of HAA’s use of millions of dollars in
federal funds under the Ryan White CARE Act.
Judy Holtz, an HHS spokesperson, said HHS Inspector General
Janet Rehnquist would begin the audit in the next four to
six weeks as part of a series of audits of AIDS offices in
a number of cities, including D.C., New York, Miami, San Francisco,
and Los Angeles. Holtz said the audits are being conducted
at the request of the Senate Committee on Finance, which wants
HHS to more closely examine the expenditure of federal AIDS
funds. Vera Jackson, a spokesperson for the D.C. Department
of Health, said department official Ron Lewis told her HHS
has not informed HAA of an impending audit. She said Lewis
noted that federal agencies conduct periodic audits of D.C.
government agencies receiving federal funds and that such
audits are ongoing and expected.
Lewis, a deputy director of the Department of Health who
is in charge of HAA, did not respond to a press call seeking
comment on GLAA and ACT UP’s concerns about difficulties
in obtaining information from the AIDS agency.
In the past, Lewis has disputed assertions by GLAA and ACT
UP that HAA has withheld information about how it spends AIDS
funds. Lewis has said HAA’s expenditures are outlined
in its annual budget submitted to the D.C. Council. He has
said HAA has provided GLAA with detailed financial information
in response to previous Freedom of Information Act requests.
GLAA officials have said the information provided by HAA in
the past has been incomplete.
The FBI affidavit pertaining to the teacher’s union
probe states that Gwendolyn Hemphill, Martin’s mother-in-law
and the former WTU official, prepared union vouchers that
accompanied many of the WTU payments to Martin and his company,
Expressions Unlimited. The affidavit says the vouchers only
stated the amounts of the payments to Expressions Unlimited
or to Martin but made no mention of services rendered that
would indicate the purpose of the payments.
A D.C. Department of Health spokesperson said department
officials don’t believe sufficient evidence exists to
justify removing Martin from is job at HAA.
[The Washington Blade, 1/10/03]
In California’s Unregulated Porn Film
Industry, an Alarming Number of Performers Infected with HIV,
STDs
During production of the 1997 movie “Mimic,”
American Humane Association representatives wandered through
the Los Angeles set, ensuring that a herd of cockroaches was
well taken care of. Licensed animal handlers were to follow
state and federal anti-cruelty laws designed to protect the
insects, which had been trained to swirl around actress Mira
Sorvino’s feet. The roaches had to be fed at a certain
time. They could only work a few hours each day. They could
not be harmed.
At the same time, in studios in the San Fernando Valley,
scores of other actors and actresses were working long hours
and were exposed to a host of infectious, and sometimes fatal,
diseases. These performers were making heterosexual adult
films for an industry that in California is entirely legal,
and utterly unregulated. Its producers take in several billion
dollars annually from cable television programming, videos
and Internet sites. These actors and actresses are discouraged
from wearing prophylactics during filming because porn producers
believe the public wants to see ‘unprotected’
sex. So adult porn stars commonly engage in sexual acts with
scores of partners, and then return each evening to their
private lives-- dating or having relationships with people
across Southern California.
In the words of former U.S. Surgeon General Joycelyn Elders,
when told about the lack of oversight of the adult film industry:
“These folks are a reservoir. They don’t just
have sex with one another. They have sex with regular people
outside their business-- doctors, lawyers, teachers, your
next-door neighbor.”
But California regulators and political officials don’t
believe the public is worried about protecting the porn stars
themselves-- despite the enormous popularity of the films
they produce. As David Gurley, staff attorney for the California
Labor Commissioner’s office, says: “Porn stars--
people think they’re not worth the time. The public
sees these people as disposable.”
Told of those remarks, and similar ones by other California
officials, former Surgeon General C. Everett Koop said: “That’s
ridiculous. That’s the same thing we heard about the
gay community back in the early days of AIDS.”
Koop and others note that in Nevada, legal brothels are subject
to stringent state oversight--and the spread of sexually transmitted
disease in that industry has been reduced to trace amounts.
In California, the adult film business, which has expanded
to include the most risque forms of sex widely referred to
as Triple X, is remarkably similar in scope to Nevada’s
legalized prostitution in terms of the number of people employed
and the nature of the job.
Yet the only monitoring in Triple X is a form of modest self-regulation
by some companies that request health tests before performers
go on camera.
But even that practice is neither widespread nor tightly
monitored. “The fact that no one’s watching this
industry is shocking,” Koop says. “How many people
have to be infected with an STD before someone does something?”
Anne Marie Ballowe is a former porn star who flourished in
the burgeoning business. Ballowe became famous, paid thousands
of dollars to grin for the camera, prance beneath the hot
lights--and have sex with strangers. For years she enjoyed
the perks of her job, shuttling around town in limousines,
attending hot Hollywood parties, dating famous athletes and
rock ‘n’ roll gods. During her seven years in
the business, she starred in scores of Triple-X films.
Legal and medical records show she walked away from the business
in 1998 with chlamydia, which could make her sterile; cytomegalovirus,
which could eventually make her blind; hepatitis C, which
has damaged her liver; and HIV, which causes AIDS and will
probably kill her. According to medical records, her liver
is too damaged-- in part because of the hepatitis--to allow
her to take the anti-viral drugs that could delay the onset
of AIDS.
Along the way, she also became a drug addict, and she has
exhibited symptoms of schizophrenia. Today the 29-year-old
former actress lives in Honolulu. There, sitting inside an
AIDS clinic for homeless patients, waiting for medication,
she hides her past behind an engaging smile. “I know
people hate what we do,” she says. “But porn stars
make a lot of money for other people. If farm workers have
rights, so should we. The laws need to change.”
Hours later, staring at the TV screen inside a friend’s
apartment, Ballowe watches a clip from a 1998 video she made
for Hard Core Television and K-Beech Video Inc. It is the
film in which Ballowe has alleged she was infected with HIV
by an actor named Marc S. Goldberg. She was paid $10,000 for
her work, but records show the check bounced just days after
she learned that she was HIV positive.
Ballowe’s rise and fall in the business is not unusual,
but her reaction is. She filed a lawsuit with the California
Workers’ Compensation Appeal Board against Hard Core
Television, the producer of the video, and K-Beech, the distributor.
Ballowe alleges that Goldberg faked a test showing he was
HIV negative. Included in the lawsuit is a copy of an HIV
test supposedly taken by Goldberg on March 21, 1997, nearly
a year before the two actors worked together. The result is
negative.
The document says the test was conducted by the Medical Science
Institute in Burbank-- a laboratory that filed for bankruptcy
in 1995, and whose assets were purchased by Physicians Clinical
Laboratory Inc. in February 1997. The document also shows
that Goldberg’s blood sample was taken at Northeast
Valley Health Corp.’s Pacoima offices, by a physician
identified only as “Martinez.”
Officials from Northeast Valley said that no doctor by that
name worked at their facilities during this time. “We
had a doctor named Martinez, but he left and moved out of
the area back in 1985,” says Kimberly Wyard, chief executive
officer.
Goldberg could not be reached for comment despite nearly
two dozen attempts to contact him by phone and in person at
his home and at the video company where he works. No response
from Goldberg to Ballowe’s lawsuit is on file with the
state. Hard Core Television and K-Beech have filed papers
denying responsibility.
Ballowe’s suit says that during several days of filming
in Chatsworth in February 1998, the actress had sex with about
25 men-- a mix of actors established in the business, would-be
stars trying to get a break in the industry and adult-film
fans who had been recruited at adult video stores. Most of
the men showed up at the set with paperwork that declared
they were HIV-negative. Some wore condoms. Others, like Goldberg,
did not.
“I had known Marc for years, so I didn’t make
him wear one,” Ballowe says in an interview. “I
was going on good faith” that he was not infected. In
her lawsuit, Ballowe says that K-Beech and Hard Core failed
to provide a safe work environment, as required by state law.
Specifically, she claims the businesses failed to “verify
the health certificates provided . . . to ensure their accuracy
and reliability.” She also claims the companies failed
“to furnish and use safety devices and safeguards for
the benefit of the employee . . . with knowledge that serious
injury to applicant would be a probable result.”
Ballowe’s lawsuit has become the leading example cited
by all those who argue for regulation of the industry. It
was filed in 1998, at a time when, one by one, porn actresses
were testing positive for HIV. Among industry veterans, those
years are now known as “the dark times.” In January
of that year, actress Tricia Devereaux tested positive. She
was followed by Ballowe in March; a Hungarian performer, who
used only the stage name Caroline, in April; and Kimberly
Jade in May.
“I could have given this to my boyfriend,” Jade
says. “Any of us could have and not known because we
were getting tested only once a month, for HIV. The only thing
we all have in common is Marc. But we had no idea how to prove
that he did it.”
Some companies, such as Vivid Video Inc. in Van Nuys and
VCA Pictures in Chatsworth, insist performers bring a recent
HIV test to the set and use condoms when they perform. But
dozens of Triple-X filmmakers have no such requirements. Even
at those that do, the rules can be easily overlooked, according
to interviews with more than three dozen actresses working
for various Triple-X companies.
Gay pornographers abide by a different set of rules: No condom,
no HIV test, no audience. Nearly all gay Triple-X production
studios throughout the industry demand condom use. The decision
is rooted in financial concerns. While there is a niche audience
for films that depict ‘unprotected’ sex, few retail
and Internet outlets will carry such movies for fear of drawing
public criticism.
“They all wear condoms,” says Roger Tansey,
former executive director of Aid For AIDS, a West Hollywood-based
nonprofit that provides financial assistance for people with
HIV. “Gay actors and gay viewers don’t see unprotected
sex as a fantasy. They see it as watching death on the screen.”
Though the porn industry is huge when measured in dollars,
it has relatively few employees. Talent agents say there are
typically 500 Triple-X actors and actresses working at any
given time in Southern California. But because the average
career lasts just 18 months, the number of people who have
worked on Triple-X sets over time is actually far higher,
exceeding thousands per decade.
The extent of infection among those performers is unknown
because no government or regulatory medical agency has ever
tracked the industry consistently. The limited data that does
exist is alarming. The Adult Industry Medical HealthCare Foundation
(AIM), an industry-backed clinic in Sherman Oaks, administered
voluntary tests to a group consisting primarily of adult film
workers. Of 483 people tested between October 2001 and March
2002, about 40 percent had at least one disease. Nearly 17
percent tested positive for chlamydia, 13 percent for gonorrhea
and 10 percent for hepatitis B and C, according to Sharon
Mitchell, a former adult actress who founded AIM. None of
the tests came up positive for HIV, Mitchell said. The testing
was funded in part by the Los Angeles County Health Department.
The industry agreed to start AIM under pressure from Mitchell
and others, after Ballowe and several other actresses contracted
HIV. “We don’t test everyone in the business,”
Mitchell said. “People come into this business, and
they leave this business. We can follow many of them, but
not all.” For every positive test, the clinic contacted
the performers’ partners and tested them as well. On
average, said Mitchell, one positive STD test for a porn star
led to the discovery of four other infections.
The figures obtained by AIM are “clearly an indication
of what’s happening,” says Dr. Peter Kerndt, the
county health department’s STD control director. “We
support AIM’s effort, but we can’t help them very
much financially. Our budgets are tight, and there’s
no public outcry over this. But even we wonder why we don’t
have the same legal requirements in California that they have
with legalized prostitutes in Nevada.”
“If California is the only state where it’s
legal to be paid for having sex in front of a camera, it’s
going to be up to the state of California and the local agencies
to do something about regulating it,” says Frederick
S. Lane III, an attorney and author of “Obscene Profits:
The Entrepreneurs of Pornography in the Cyber Age.”
Whose job is it to track the San Fernando Valley pornography
industry?
There are two leading candidates. One is the L.A. County
Health Department. It relies heavily on state and federal
money, but the federal funds are to end in 2004-2005. “Of
course there’s concern,” says Kerndt, the county’s
STD control director. “We know that if a disease enters
this population, it could rapidly spread.” Health department
officials say they don’t have enough staff or money
to monitor the industry and point to a budget deficit that,
by 2005, is on track to hit between $350 million and $400
million annually.
The other candidate for oversight is the California Division
of Occupational Safety and Health, whose monitoring effort
includes oversight of Hollywood stunt work but not the porn
industry. It is “too fragmented, too hard to track,”
says Dean Fryer, a Cal-OSHA spokesman. “We rely heavily
on employees to give us tips about unsafe working conditions.”
Before Ballowe filed her lawsuit, she and Jade reached out
to law enforcement and other government agencies, asking that
they investigate working conditions in the industry. The first
stop, in 1998, was Cal-OSHA. “They told us they didn’t
track our business,” Ballowe says, and sent her to the
state health department.” The California Department
of Health Services, however, doesn’t track their industry.
“It’s a local issue controlled by the local county
health department,” Ballowe says she was told. The Los
Angeles County Department of Health Services said the case
was a criminal matter, not a public health issue.
So they went to the Van Nuys office of the Los Angeles Police
Department, where they met with Det. David Escoto, then with
the department’s Crimes Against Persons unit. “I
told them there was no way we could prove who did what,”
recalls Escoto, now in the department’s Foothill office.
“I don’t know how the industry works. And I don’t
think there’s a way to prove they all got HIV from the
same person. No one would believe them anyway.”
“That’s utter rubbish,” counters Dr. Michael
Gottlieb, the former UCLA medical researcher who identified
the earliest AIDS cases. “There is a way to track that
information. It just takes money.”
Gottlieb pointed to the case of Dr. David Acer, a Florida
dentist who was found to have infected six of his patients
with HIV. Federal epidemiologists used molecular sequencing
studies of the viral strains of the patients to see if there
were any similarities in the virus carried by the seven people.
The results showed that the patients’ strain was similar
to that of the dentist--and vastly different from other HIV
strains collected elsewhere in the community.
But there was an important difference with the case of the
dentist. “People cared what happened to those patients,”
Gottlieb says. “They were seen as innocent. No one sees
porn stars as victims.”
Almost no one. Somewhere in Los Angeles is one office worker
who does care. In the words of an adult-film actress: “I
picked up chlamydia on an Extreme set. I gave it to my boyfriend
by accident. I had no idea that I had it. I didn’t have
any symptoms.” She learned that she was infected nearly
a year later, long after she and the boyfriend had broken
up. By then, he was in another relationship and had unknowingly
infected his new girlfriend. “She had it, too,”
says the actress, who agreed to speak only if not identified.
“The girlfriend worked at some insurance company. She’s
a secretary.”
[Los Angeles Times, 1/12/03]
The HIV Update is a weekly report of articles, studies and
other information related to HIV/AIDS, sexually transmitted
diseases and related risk behaviors compiled from various
news sources by the Children’s AIDS Fund.
The Children’s AIDS Fund is a non-profit, non-partisan
organization dedicated to helping limit the suffering of HIV-impacted
children through direct assistance and resources, as well
as through technical assistance for their parents and care-givers.
For additional information, call (703) 471-7350.
Previous editions of the HIV Update are available on-line
at http://www.childrensaidsfund.org/news.asp.
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