As an industry, adult entertainment is adept at circling the wagons.
Historically, any porn-related health-care crisis has performers, studios, agents and trade organizations reading from the same script: expressing sadness that someone has contracted an illness but quickly following up with a rundown of the industry's safety protocols and a notation that the condition was almost certainly contracted off the set.
Last year was rough for porn in terms of health, though. After four confirmed cases of HIV and three moratoriums that pretty much shut down the industry, both performers and studios say the system might not be as strong as the industry portrays it.
"I've never seen so many positive HIV diagnoses in all of the time I've been in the business," said Scott Taylor, president of the adult film studio New Sensations. "The more bullets you shoot at a target, the more you're likely to hit it. The more this continues to happen, the more I'm concerned this will spread in the industry."
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The Free Speech Coalition, the trade group for the adult entertainment industry, counters that last year's revelations prove the effectiveness of its program. Adult stars are tested every two weeks for HIV and a number of other sexually transmitted diseases.
"What we found and know is the four performers who tested positive were infected outside of the industry," said Diane Duke, executive director of the coalition. "We have the most rigorous testing panel you will find anywhere. Our performers test every two weeks. ... Performers, in their private lives, may contract HIV ... but when it happens in our industry, it gets a lot more attention."
As a result of safety concerns, though, more stars—especially in porn's upper echelon—are taking matters into their own hands. None is more public about it than Lisa Ann, a 23-year industry veteran.
Last summer, Lisa Ann announced via a series of tweets that she had been booked to work with someone who she discovered had not been cleared to work by the industry's self-regulated health-screening service. She did not name the performer but accused him of attempting to work with hepatitis C.
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"This is to protect myself and my peers," she wrote. "This is also to remind the evil doings of 'Breaking the Trust' they will be called out. Come on people, I love this business, I will always fight for it, But it is scarier than ever with the lack of trust. Putting others' health [at] risk to make a bit of money is unacceptable."
At the 2014 Adult Entertainment Expo, Lisa Ann said that while the performer in question was pursuing legal action against her, she has otherwise received nothing but positive feedback from the adult community.
She did not directly identify the actor in the tweets but later acknowledged she was referring to Alex Gonz.
Replying to the allegations in October on a conference call set up by his agent, Gonz said he does have trace levels of hep C in his blood but that medical experts had told him those were so low that he has never been infectious.
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During that same call, he announced that he would no longer be a performer in adult films.
"I've had it since I was born," Gonz said. "I've never put anyone's life at risk by doing anything harmful or dangerous. ... I never lied on or tampered with any test result, nor have I ever concealed or deceived the industry with any test result that could negatively impact the thousands of talented performers I am proud to call my colleagues. I have consistently been cleared to perform by all of the testing facilities I have ever been tested at, and never been given any reason to believe otherwise,"
Chanel Preston, another prominent performer, believes the safety system works as well as it can without mandating condoms, but that actors and actresses are concerned and yet feel powerless.
"It's hard, because we're putting a lot of our faith in the Free Speech Coalition," she said. "As performers, we want some rights and some say in what's happening. ... People say we do because we are the ones who make the scenes, but it's really hard to have a voice in this industry."
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Some stars say they're taking extra steps to ensure their safety these days. Lisa Ann pays for a fresh round of tests for her co-stars to ensure they're clean. And performer Bonnie Rotten says she limits the number of male performers she's willing to work with.
"I like when they have girlfriends or wives because they go home at night and there's less to worry about with their behavior," she said.
There has been talk of performers' launching an association or a union to safeguard their interests, but few think that idea has much of a chance. For one thing, porn is a transient business, with some performers lasting just 30 to 60 days. And a formal workers group could drive up production costs.
Though the Free Speech Coalition maintains that its strict testing protocols have prevented most major diseases (including HIV and hep C) from being spread in productions, other STDs, including herpes, gonorrhea and chlamydia, have been known to be contracted on the set.
Substance use is also on the rise, according to Lisa Ann.
"This industry is cyclical," she said. "Today, it's like the late 1970s again, and some people are doing a lot of drugs."
Another risk factor is the waves of new performers who are not educated about the unwritten rules and ramifications, much less about risks.
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"I think a lot of performers didn't even know hep C existed," Preston said. "A lot of people aren't savvy about their health and what the risks are. The best way to deal with that is to get more education for those getting into the industry."
At the adult expo, a DVD featuring advice from many of today's top performers was available for people considering a job in porn.
Duke at the coalition noted that the industry's screening has prevented HIV-positive performers from entering the industry.
"We've had cases of people who ... didn't know they were HIV until they went through the testing," she said. "Not only are we stopping it at the door, but we're providing vital information that they need to know for themselves and to protect loved ones. ... Easily, 10 people tried to come in the industry [in 2013] who were HIV-positive."
Screening and education don't completely eliminate the current risk, though, and no one is quite sure how to deal with the problem.
"It's very concerning," said Taylor at New Sensations. "I'm not sure what we should do or how to react to it all, but it's definitely not all wine and roses. I'm concerned about how this affects the future [of the industry]."
—By Chris Morris
This story has been updated to correct the reference to Lisa Ann's time in the adult industry.