Monday, June 6, 2011

Porn Panic 2011 Update: New Report Debunks AHF/LACDPH/Cal-OSHA Cooked -Up Stats On Performer STI Transmission Rates..But Will Even THAT Be Enough? (Updated)

Updated...scroll to bottom.

Well....the Cal-OSHA hearings on the condom mandate proposals is tomorrow, and I'm sure that there will be plenty of industry heavyweights out there to make the case against imposing the condom mandate.

Today, they got a nice new weapon at their disposal....in the form of a report that debunks the presentation of officials at Cal-OSHA, the LA County Department of Public Health, and the AIDS Healthcare Foundation (AHF) regarding  the rates of transmission of sexually transmitted infections (STI's) among performers.

The report's author, Dr. Lawrence S. Mayer, was asked to review a presentation done by LADPH clinicians Peter Kerndt and Robert Kim-Fairley, which contained detailed statistics on the STI transmission rates amongst porn performers as compared to rates amongst the general population.

One of the fundamental foundations for pushing the condom mandate is that porn performers are infected far more often than the general population is, and without the need for "barrier protections" such as condoms (and dental dams, and the use of personal protection equipment) during sex scenes, performers are literally risking their lives everytime they do a shoot "unprotected".

As Mark Kernes reports at AVN.com in analyzing Dr. Mayer's newly published report, such claims are, to say the least, severely overhyped and distorted...and outright cooked out of thin air.



Perhaps Dr. Mayer's most important finding is that the numbers put forth by the health department doctors for chlamydia and gonnorhea infections in both the adult performer population and the public at large are statistically invalid, and therefore their conclusions are, according to Dr. Mayer, "without basis in science," and that their "conclusions, analysis and advice in these three presentations should be discarded."

That's an incredibly important finding for the adult industry, since one of the main reasons put forth for requiring performers to use condoms, dental dams, rubber gloves, goggles and face shields for all forms of sexual (and even some non-sexual) contact in adult movies is that adult performers have higher infection rates of STDs than, say, the average Joe or Jane at the local nightclub.
The idea that adult performers are more sexually active and must bear the brunt of such "protection" in order to "mentor" the general population on "safer sex" is a key talking point of groups like AHF...never mind that it restates the current right-wing trope about how porn is an incubator for "disease" and merely carries it via porn to general society. And, never mind the fact that people are just as capable of being safe and sexually active and conscious of their own risks and safety all by themselves, without the need for PPE or LADPH jamming condoms and dental dams down their throats.

It is those cooked stats that Dr. Mayer basically refutes...mostly, by attacking the methodology of how performer infections are counted in LADPH's "research". I have added bolded emphasis to particular points.


Dr. Mayer begins his report by analyzing Dr. Kim-Farley's presentation at the first advisory committee meeting, STD/HIV Disease and Health Risks among Workers in the Adult Film Industry, where Dr. Kim-Farley estimated that there were between 2,000 and 3,000 performers involved in the industry between 2004 and 2008, the years which he used in his calculations, and that 3228 sexually-transmitted infections (STIs) of chlamydia or gonorrhea were reported to the LA County Public Health Department during that period. Dr. Mayer points out that Dr. Kim-Farley provides no basis for either his estimate of the size of the performer population, nor does he provide any explanation of how the data on the alleged number of infections was collected.
"This is poor science," Dr. Mayer concluded, "and inexcusable in epidemiology which can be characterized as the science of estimating risk from counts."

Among the flaws that Dr. Mayer found in Dr. Kim-Farley's presentation were that he provided "no information on turnover or longevity in this industry, the proportion of cases that were re‐infections, or multiple testing of performers," thereby calling Dr. Kim-Farley's claim that "one-fourth of all performers are diagnosed" with either or both of those diseases "unfounded and misleading."

Part of the problem in estimating infection rates is that it requires the statistician to divide the number of persons infected with the diseases (the "numerator") by the total number of people in the population under consideration (the "denominator"), and if either of those numbers is inaccurate, the result will also be inaccurate.

"It must be noted that his estimation of the prevalence is based on the false assumption that performers are never re‐infected nor re‐tested within any one year," Dr. Mayer states, regarding the figures provided in Slide 17 of Dr. Kim-Farley's Powerpoint presentation. "He could have estimated the rates of re‐infection and re‐testing and adjusted for both although it would lead to a less startling, albeit more accurate, result.  The oversight is particularly bothersome and misleading because the AFI performers are re‐tested as many as 12 times a year or more. It would be rare indeed for [a] randomly chosen member of the public to be tested so often."

In other words, Dr. Mayer says that Dr. Kim-Farley's statistics apparently don't take into account the fact that an infected performer may have been retested once or even twice before the infection has cleared his/her system, thus jacking up the statistics for that disease, and also that the vast majority of performers are tested on a monthly basis, whereas the overwhelming majority of Los Angeles residents aren't even tested once per year—in fact, many have never been tested—so that comparing the infection rates of those two populations is statistically invalid.
Or, to put it in layman's terms:

Porn performers are required to be tested once a month, and many others test even more than that, as a requirement of future employment, and because many who happen to get infected are retested to insure the STI is cleared before they resume shooting, that will artificially inflate the rates of infection for performers.

For the general public, though, testing is mostly voluntary, based on fear of infection, and most people who ultimately get infected don't even get tested at all, thusly undercounting the rates in the general population.

Whether that's a flaw in the methodology or a deliberate cooking of the books is something I will leave to you to decide.

Regarding the rates of particular STI;s such as chlamydia and gonnorhea amongst porn performers, Kernes reads Mayer's study thusly:


Dr. Mayer deals with the issue of the prevalence of STD infections in the AFI [adult film industry] population later in the report, noting that the CDC recommends calculating chlamydia positivity by "dividing the number of women testing positive for chlamydia (numerator) by the total number of women tested for chlamydia (denominator includes those with valid test results only and excludes unsatisfactory and indeterminate tests) and is expressed as a percentage. The denominator may contain multiple tests from the same individual if that person was tested more than once during the period for which screening data are reported. The numerator may also contain multiple positive test results from the same individual if that person tested positive more than once during the period for which screening data are reported." [Emphasis in original]

However, as Dr. Mayer analyzes the data provided by Drs. Kim-Farley and Kerndt, the prevalence of STDs among the performer population "appears to use all positive tests in the numerator, but does not take into account the number of tests the subjects received. AFI performers are tested every four weeks. Kim‐Farley and Kerndt, lacking a denominator, used an estimate of number of AFI performers (2000 or 3000) when they should have used an estimate of the number of tests given to the performers. The two methodologies yield very different results."

At the end of his report, Dr. Mayer attempts that exact calculation, finding that for the years where data exists to make the calculations, the chlamydia and gonorrhea infection rates within the adult industry are statistically close to those which Drs. Kerndt and Kim-Farley found within the general Los Angeles population.
In other words, there is really no pandemic of STI's within the LA porn industry...at least, not greater than STI's in the general population.

Far more enlightening, though, is the way that Mayer reveals how LACDPH (through AHF and Cal-OSHA) deliberately distorted data they got from the former testing group AIM Medical Foundation to buttress their case for the condom mandate and other "protections". It seems that in the process, they couldn't even synch their stats to match each other.


Inbetween, Dr. Mayer tackles the report of Dr. Kerndt's 18-month "pilot study" (June, 2000-December, 2002) of "straight" performers, Public Health Issues in the Adult Film Industry: Policy Implications of an Outbreak, and finds that to be fatally flawed as well.

While Dr. Kerndt that according to that study, there were approximately three times as many chlamydia infections among straight female performers as among similarly-aged LA County females, and five times as many gonorrhea infections, Dr. Kerndt also failed to provide any data regarding the testing frequency of the "LA County female" population that formed the "denominator" count of his equation. But perhaps more troubling is his note that, "Not all individuals tested and reported by AIM are necessarily AFI performers."

In other words, not only do Dr. Kerndt's statistics attempt to compare apples (tested performers) with oranges (generally untested population at large); he doesn't even know who his "apples" are! They could just as easily be prostitutes or other at-risk women who have never even come close to making an adult movie!

Or as Dr. Mayer puts it: "Again, epidemiology is about counts, not policy. To treat counts so casually cuts against the basic grain of epidemiological reasoning. If the goal was to put numbers on the table to justify changes in policy then why not fabricate the entire analysis?"

Let us remember that AIM not only served industry performers, but also offered testing to private individuals as well...so not controlling for either the prevalency of multiple testing of infected performers or non-industry infections discovered by AIM certainly distorts the data in favor of higher STI rates amongst performers. Again, I'll leave it up to you to judge whether or not this was a slip in analysis or a deliberate con job.

Of course, the condom mandate proponents will probably dismiss Dr. Mayer as a paid stooge of the porn industry, and scream about the recent HIV/AIDS scares (restating the usual libel about how 24 performers have contracted HIV from sex during shoots, and probably using the likes of Ministress Shelley Lubben and Derrick Burts to shed crocidile tears over how "the inddustry failed and destroyed them" in the name of their scheme to impose condoms (and profit immensely from the government and the condom companies).

If they are the only voices heard, of course.

All the more reason why performers who actually care about their rights and livelihood absolutely must pack this meeting tomorrow and stand up and be counted and heard. This isn't about "protection"; this is more about a false choice between paternalism dressed up as "protecting performers" and running porn out of California entirely.

Unless, of course, you like your porn made in sweatshops in Lafvia.


Update:

XBiz.com just posted an article on the Mayer Report that gives further details on its genesis.

It was funded and initiated by the Free Speech Coalition, which has become the key organization that has been resistiing the condom mandate from the beginning, and who recently developed their own, performer-friendly, and far less intrusive, testing/treatment regimen to replace the one maintained by AIM-ORG before they were run out of business by the efforts of Cal-OSHA, LACDPH, and AHF.

Also...the report in its entirity is now available as a PDF file from XBiz, it can be read here.


Update #2:

The FSC just posted a blog entry synopticizing the Mayer Report over at their blog; and it also includes a link to the full report.

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