For the purposes of this supplementary information “Productions” refers to studios and content creators in their filming and content owning capacity. For the purposes of this pledge “Performers” refers to studio porn performers and adult content creators in their performance capacity. Adult content creators are often both Productions and Performers.
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Understanding HIV
No one knows everything about every subject. Have a look through the following for bits you've fallen behind with. It is an important topic to be up to speed with:
All Performers should be aware which status disclosure strategy Productions has them assigned to. Performers can always withdraw consent to work with someone for reasons they keep private or change which status disclosure strategy they consent to.
Performers show each other their most recent sexual health test results. In principle Performers are separated by HIV status (serostatus), only working with others of the same status. This method has flaws as HIV testing has ‘window periods’ when recently acquired HIV may not be found by the test; this means true separation by HIV status is currently impossible, no matter how frequent Performers test. Serosorting is commonly used in straight porn in USA and Europe.
Performers shows each other their most recent sexual health test results but Performers can work with Performers of another status as long as prevention strategies are used such as Performers living with HIV having an undetectable viral load and/or negative Performers using PrEP. Performers using this Status Disclosure method are usually completely public about their HIV status; this can be because they consider their HIV status may end up public knowledge eventually when Productions or other Performers know it. Non-disclosure agreements are hard to make enforceable, especially while also protecting the anonymity around Performers legal names. The Open Disclosure method happens in studio porn and increasingly in content creation around the world.
This strategy can protect Performers who want privacy or are in a situation where they are unable to work in Open Disclosure. A Performer may choose Status Privacy if they want to avoid the following scenario: two Performers fall out after filming together and one publicly discloses the other’s HIV status without permission. Ignorant public may then send hate mail or make life difficult for Performers or even to their family members.
Status Privacy means Performers know Performers they will work with may or may not tell them their HIV status, and they themselves are consenting to work with these Performers with the knowledge they either hold a recent HIV negative test result or the Performers have an Undetectable Viral Load and so are unable to pass HIV on.
Status Privacy began in gay porn in Europe because of personal medical data privacy laws. Many Performers taking PrEP have chosen this approach to support the privacy of those living with HIV. This approach supports the use of HIV prevention techniques such as PrEP and Undetectable = untransmittable over mandatory status disclosure.
Mandatory status disclosure can result in harm to people living with HIV via stigma. It also has poor efficiency as most people living with HIV acquired it from someone who didn’t know they had it, as new HIV transmissions can occur in the window period of a recent test. People also commonly acquire HIV from someone who has not tested recently so they do not know that they are living with it.
To minimise the chance of Productions being sued on discrimination grounds there is only one secure way of handling Status Disclosure. Although how this occurs varies between countries and states.
Living with HIV is considered a protected people characteristic, sometimes this is categorised as being disabled. As living with HIV (with an Undetectable Viral Load) is an invisible trait, not selecting these Performers due to them living with HIV cannot be considered a creative visual decision, but simply a discriminatory one. HIV can now be handled safely with treatment medication with extra options for Performers who work with them such as taking PrEP, using condom, femidoms/internal condoms etc. This means a decision to not work with Performers due to their HIV status (even if Undetectable) is not professional conduct for Productions.
Performers would have to personally take on legal risks for displaying HIV discrimination in who they work with. To do this, Productions would need to require that HIV PCR/RNA test results as their only form of test request for HIV status. Productions asking for more HIV tests than the PCR/RNA test (or enabling Performers to use more than that between each other) demonstrates Productions expect actions to occur based on those additional test results. All of these actions would suggest a form of HIV discrimination. After this suggestion it would then be the responsibility of Productions to prove they were not acting in a discriminatory fashion, this would be incredibly challenging if possible.
The use of HIV PCR/RNA tests enables Status Privacy as people who are living with HIV (with an Undetectable Viral Load) and people not living with HIV, will both yield a non-reactive test result. By passing on the legal risk to Performers if they want to discriminate against people living with HIV, then the Performers should be made aware of the legal risks if they want to know more than the PCR/RNA result from Performers they plan to work with.
In the UK the NHS does not fund the use of PCR/RNA tests at the 28 day testing frequency standard for the UK industry. As a result there are industry care groups fundraising to support this access for these specific times. These fundraising groups were established to support Performers living with HIV (with an Undetectable Viral Load) in the industry; they do support Performers with a range of HIV statuses however. Performers living with HIV could face stigma from the wider community if they did not meet standard testing frequency protocols to demonstrate they are still Undetectable for the time of the filming. This balances the HIV testing done by Performers who are not living with HIV.
Performers should contact their support network for adult professionals for more information about these industry care groups if needed. Performers wishing to purchase HIV PCR/RNA testing privately without these funding support groups can do so.
Other ways of reaching Status Privacy exist but may carry legal risks. The alternatives are below:
Apart from the HIV results, Performers may show each other their most recent sexual health test results. In addition to this, studios discreetly vet that Performers either have a recent HIV negative test result, or if they are living with HIV, that they have an Undetectable viral load result.
Another way to do this is to use HIV PCR/RNA tests, as an non-reactive result to them indicates either HIV negative or Undetectable. Whereas a reactive result indicates a detectable level of HIV is found.
As often no studio equivalent can act as a 3rd party in content creation, there are two ways to create Status Privacy.
Out of two performing content creators, if only one wants Status Privacy and the other is happy to enable this; then this latter content creator may explain they are living with HIV (with an Undetectable Viral Load), or they show they are effectively taking a PrEP routine. When they do this, they may accept Status Privacy for the other performing content creator, whatever HIV status they have. They would then only check non-HIV sexual health tests for each other.
In larger groups the One-Off works best if only one performing content creator wishes Status Privacy. This is because when two or more use it then transmission may happen between those using this Status Privacy. As multiple people have unchecked HIV status. Performers should be aware that HIV has multiple strains and acquiring additional strains may alter which treatment regimens available to them. Due to the casual nature of this approach it is used by few studios. This approach also increases opportunities for performing content creators who are having hard time achieving an Undetectable Viral Load.
Performing content creators can access Status Privacy by allowing an appropriate mutually trusted 3rd party to vet each performing content creator’s HIV results. Checking that they are either HIV negative or they have a result showing they have an Undetectable Viral Load.
Productions have different protocols, and different tests are used around the world. Performers should be made aware which testing approach Productions have. To learn more about the types of HIV test used see the table named ‘Types of HIV test’.
In the USA Performers test results can be directly uploaded into large databases; the aim is to avoid tampered results. In Europe medical data privacy laws prevented these databases being developed.
Porn Productions have tried owning testing companies, but potential bias and conflicts of interest has meant impartial testing was seen to be safer. Some Productions contribute to the cost of Performers being tested, others do not. Some Performers access testing through national health services where they are available. Some clinics will charge a fee when a Performer says they need the test result as a certificate for them to work. On the certificate there should be an indication that the medical staff saw the performer’s legal photo ID, so Performers can use their ID to show the certificate is real when needed.
This is limited to HIV tests but was usually fingerpick instant self-testing or other rapid testing as it is quick and requires little training. However, this testing has a longer window period where results may not show a recent HIV acquisition. See the section on window periods below to explain this further.
Some Productions are requiring Performers to test every 14 days and show the 3 most recent tests in order to film. However, many publicly funded healthcare services like the NHS in the UK don’t find offering this viable. The NHS finds testing every 28 days works well alongside a focus on prevention tools such as PrEP, condoms, and people who are living with HIV getting treatment to have an undetectable viral load (as this prevents HIV passing on).
Some Productions have a formal position saying Performers sexual health is in their own hands. They do not require recent sexual health tests, but this almost only occurs for scenes where condoms are used. These Productions should still make an effort to educate Performers about condom failures and STIs transmitted via oral sex where condoms are less frequently used.
Each type of HIV test has a different ‘window period’ so it is important to know what HIV test is used and when it happened. With an HIV finger-prick instant result test there is a 3-month period following exposure where the test may not identify that you have acquired HIV.
E.g. If you acquired HIV in January, it may not give a positive result on this finger-prick test until April. There is a graphic below for people finding a visual explanation helpful.
To work in porn, traditionally Performers require a porn certificate by a medical professional. The certificate comes from a 4th generation HIV test and/or PCR/RNA HIV test, depending on where in the world you are. Performers should keep ‘window periods’ in mind when considering test results for other Performers and should still consider prevention options like condoms and/or PrEP as there is no way to have test results without potential risks from a window period.
There are many names for HIV test like ‘Elisa’, ‘Combination’ or ‘Western Blot’ and it can be confusing. Those names describe components within a number of the standard test-groups listed in the infographic below. These test-groups are sorted by the window period to be aware of. If in doubt about a test, then treat it as having a three-month window period. Ask the clinic staff what type of HIV test you are having if you are unsure.
In the three timelines in the image above, the orange duration is each test-group's window period. The second timeline is for the '4th generation HIV test', this is the test-group largely used for porn in the UK. In USA, and in some parts of Europe the test-group used is the ‘PCR/RNA test’, or requiring both the second and the third test groups together.
The ‘production hold’ scheme is well established in the USA and is becoming more common in the UK and Europe. Under this scheme when Performers test positive for HIV or Syphilis the clinic can inform Productions collectively that a recent positive result was issued to one or more of the Performers. This is done with anonymity and with the Performers consent. The scheme was established to diagnose Performers who do not know they are living with HIV. However when only PCR/RNA HIV tests are required for work, then the scheme can also be used to include Performers who are living with HIV (with an Undetectable Viral Load). This is because this test will not react to them, and can provide assurance that Performers are virally suppressed and so they cannot pass HIV on.
Notification that Performers have been diagnosed with HIV or Syphilis triggers a ‘production hold’ meaning: all Performers go to get a new test and certificate, then wait a further 45 days without sex with someone else, and then test again to receive another certificate. If any new cases of HIV or Syphilis are found, then this process resets.
In October 2020 the BASHH and BHIVA updated the UK's guidelines for the 4th generation HIV test-group updating the window period to 45 days from 30, so along with this, the ‘production hold’ duration before retesting extended to match it.