Mandating Condoms In Porn Is Bad for Public Health

(Updated July 2, 2016)

A statewide ballot measure requiring that adult film actors wear condoms will appear on the 2016 ballot. While perhaps superficially appealing, this measure is terrible for public health, and we need to defeat it. It’s a gimmick measure that has no support in the HIV advocacy community other than from its sponsoring organization, the Los Angeles-based AIDS Healthcare Foundation, which also contradicted the entire HIV advocacy and public health communities (including the Centers for Disease Control and Prevention and World Health Organization) by opposing and advocating against pre-exposure prophylaxis (PrEP), perhaps the most powerful HIV preventative in existence.

(Photo credit: sodahead.com)

This ballot measure — which allows people to personally sue the actors who don’t wear condoms (yes, you read that right) — will not result in a single additional condom being used in adult films. Not one. Rather, it will simply drive the adult film industry underground or out of state — to underground, illegal, unregulated, unsafe studios or to states with less public health infrastructure than California. Indeed, since this same organization sponsored and passed a similar ballot measure in Los Angeles County a few years back, permits for adult film production there dropped by 90%. Those films, of course, are still being shot, but they’re being shot either without permits or in other states. Films shot underground lead to mistreatment of adult film actors and poor working conditions.

In other words, this measure will cost California jobs and tax revenue (tens of thousands of people are employed in the adult film industry) without any public health benefit whatsoever.

The adult film industry has stepped up and engaged in aggressive HIV and STD testing, and there hasn’t been an on-set HIV infection in more than a decade. Yet we continue to see this counter-productive effort. Indeed, the same organization that’s pushing this measure also unsuccessfully tried to get Cal-OSHA to adopt workplace safety standards for adult films that would require not just condoms but also goggles and dental dams for oral sex. Yes, you read that right — goggles. So much for public health policy linked to the real world. (I joined State Senator Mark Leno in writing a letter opposing the rule.)

One of the most dangerous aspects of this measure is that it proposes to freeze into law (since ballot measures can typically only be amended by going back to the ballot) a public policy that condoms are the *only* real protection from HIV. That is not true. While condoms continue to be an important prevention tool, they are not the only tool and are estimated to reduce risk by 70%, not 100%. Frequent testing — with modern HIV testing able to detect the virus within two weeks of infection — ensuring that people with the virus are on medication and thus virally suppressed (it’s extremely hard for virally suppressed people to transmit the virus), and use of PrEP are key tools as well. HIV prevention is about a mix of approaches, not fetishizing and codifying one imperfect approach over all others. To pass a law stating that it’s all about condoms, and nothing else, ignores modern science and public health approaches in an extremely irresponsible way.

We need to stop using moralism to guide public health policy and instead rely on scientific facts. Public health is about meeting people where they are, not where you want them to be. We learned long ago that denying women access to birth control or HPV vaccines doesn’t stop them from having sex. It just makes them less healthy. Similarly, mandating condoms in adult films isn’t going to change how these films are shot. Instead, such a mandate will simply drive the industry underground or out of state, with the actors having fewer health protections and support.

This ballot measure, of course, isn’t about public health, since it won’t have any public health benefit. Rather, it’s about a moralistic, ideological, non-science-based crusade by a zealot who doesn’t care about the facts — a crusade that will do great damage to this California industry and to the health of its employees. It needs to be defeated.

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