Not-so-safe Sex | Hacker News Reader

Not-so-safe Sex

forbes.com

85 pointsaraneae63 comments

Aside from the public watching people having unprotected sex (which isn't really unprotected - they are extensively tested and the chain of sexual partners is well documented in case there is an outbreak. Plus every female actor is on some form of birth control), what is the problem that they are trying to solve here?

Like he said, there was only one outbreak in that community, which is far better than your average college campus. Plus aren't these films intended for people 18+ who are supposed to be able to separate out fantasy from reality?

You are living in a fantasy land. If you actually had the time to talk to real porn stars who aren't being managed by a handler, they would tell you a completely different story. What you say may be true of the really big, "high brow" porn companies, but it is certainly not true for the bulk of the porn that is produced in the US.

Ask one of the doctors whose job it is to do this testing, not just for HIV, but for the whole range of STDs. I was told by one former porn star who has interviewed said doctors that somewhere around 65% of the porn stars he tests have Herpes.

I have also heard Audrey Hollander admit, in an interview, that if you have been in that industry for any amount of time, then you have herpes, period.

There is so much evil crap going on in this industry, but there is also a whole lot of denial among porn consumers who justify their habits by statements much like yours.

http://www.shelleylubben.com/porn-stars-speak-out-stds-drugs...

http://www.jupaman.com/2008/04/23/genital-herpes-and-pornogr...

Check the CDC site for info on herpes. Something like one in 5 people have it, that means if you're even moderately sexually active you probably do as well. The vast majority of the population is asymptomatic which is why there's such a stigma over the virus. In reality it's not a big deal at all. Freaking out over herpes is as silly as freaking out over HPV which is so common it might as well be a genetic marker for losing your virginity.

Not to mention that you can get herpes while using a condom.

Herpes may not kill like HIV does, but it likely makes one wish one were dead. You say it's fine to have herpes, when in reality it is not. At all. It affects your sexual life, hence it affects your personal life as well. A pregnant woman with an herpes outbreak is endangering her baby. There's a very good reason society's morals have evolved towards condemning promiscuity. The sex revolution only happened a few decades ago because of penicilin and antibiotics. Sure, many people carry the HSV without even knowing it, but that does not mean it's OK to have it. And, as you know, it is known that HPV causes cancer, so I don't think it's OK to carry it as well.

In the end, the only truly safe sex is masturbation, but that's not a life option I recommend to anyone. When teenagers are educated on sex via porn movies, promoting safe sex is the responsible thing to do. If the no-condom movies went underground, then one could ban them. Or rate them as akin to child porn, and hence, illegal.

In any case, if there are people willing to pay for no-condom porn, then the world is sicker than I imagined in my worst nightmares...

>In any case, if there are people willing to pay for no-condom porn, then the world is sicker than I imagined in my worst nightmares...

You wouldn't like to see the other things people are willing to pay for.

I'm sorry but can you tell me how asymptomatic Herpes has a negative effect on one's life? Most people who have Herpes don't know it. Frankly the scare over Herpes and HPV has a lot more to do with shaming people who are sexually active.

I don't think you realize exactly how common these "diseases" are. Roughly 50% of the population carries HPV, sure some strains are linked to cancer but it's quite insignificant compared to the number of people who actually carry the virus. As for Herpes, for it to cause a problem you must be symptomatic, which as I stated earlier the vast majority of the population is not. To use these relatively harmless viruses as a way to scare people away from sex is disingenuous and dishonest.

Whether or not it is OK to be promiscuous in the modern world is a moral discussion, it is perfectly possible to be healthy and have a lot of partners.

You have a point. I am not an expert on the topic, but it seems to me that an asymptomatic HSV carrier cannot infect anyone and, thus, there's no health problem, and no negative effect on one's life.

Yes, it's possible to have many sexual partners and be healthy. One only needs to compare the rates of HSV and other STD's in Sweden (where sex education is serious) to places like rural U.S. (where religion, not common sense, dominates).

Yes, there's a stigma associated with HSV and other similar virus. Epstein-Barr causes mononucleosis, but there's less stigma associated with it, perhaps because it's the "kiss disease", and kissing is apparently more innocent than fornication. On the other hand, I think stigmas are there for a reason. A legacy of a not so distant past where STD's where non-curable and non-treatable. Promiscuity is a moral issue, so I won't discuss it. I think one's sex life is better without any haunting STD's, and that's why I think it's not responsible to say that herpes is totally kosher. If one catches it, it's not the end of the world, but it's not a pleasant experience either.

"it seems to me that an asymptomatic HSV carrier cannot infect anyone"

Smacks forehead ... That is one of the big reason herpes is so wide spread. It gets pased on by people that aren't having, and may never have, an outbreak.

If such people never have an outbreak, how can they shed the virus? Is the virus present in the mucosae even in the absence of visible blisters?

yes

But not all the time.

I had shingles (a herpes zoster re-eruption) in 2000. Initially, I wasn't sure if it was shingles or a somehow widespread eruption of cold sores (herpes simplex), so I did some reading up on both. Neither is contagious except when they are presenting, ie when sores are present.

Your claim appears to be false -- genital HSV can be transmitted whenever the virus is being shed, which can happen in the absence of symptoms.

Wikipedia (http://en.wikipedia.org/wiki/Herpes_simplex_virus) disagrees at the end of the first paragraph, above the ToC. I'm at a major research university, so I was able to check their citation and confirm that it does in fact 1) appear to be a seminar/survey from a legitimate scientific journal (Lancet) and 2) say that viral shedding in the absence of sores is possible, citing what appear to be first-hand studies. I'll reproduce the citations here:

60 Lang A, Nikolich-Zugich J. Development and migration of protective CD8+ T cells into the nervous system following ocular herpes simplex virus-1 infection. J Immunol 2005; 174: 2919–25.

62 Wald A, Zeh J, Selke S, Ashley RL, Corey L. Virologic characteristics of subclinical and symptomatic genital herpes infections. N Engl J Med 1995; 333: 770–75.

I was able to locate a (I think) public copy of the second study, by Wald et al.: http://depts.washington.edu/herpes/php_uploads/publications/...

The abstract of the paper reports that "Among women with genital HSV-2 infection, subclinical shedding occurred on a mean of 2 percent of the days." Subclinical shedding is defined in the body of the paper, specifically under the "Statistical Analysis" heading on the first page, as "the isolation of HSV from the cervix, vulva, or rectum in the absence of genital or perianal lesions noted by the subjects or the clinicians."

In summary, at least one study has proven that herpes shedding is possible without the presence of sores. I apologize for going to so much trouble to prove you wrong, but it's dangerous for people to be wrong about the possibility of transmission of STDs.

To be entirely precise, there's no such thing as genital HSV. There's HSV1 and HSV2. If I remember correctly, HSV1 is usually what is referred to as "lip herpes", while HSV2 is usually called "genital herpes". However, one can have sores in other parts of the body.

You can indeed shed the virus without having a visible outbreak. All that is necessary for infection is having sex with an infected partner when they are shedding. Unless you have lab equipment at your disposal, you would never know.

I'm with you that HPV is generally overhyped, and for bad reasons, but as far as I know, the strains that raise cancer risk are not much (if any) less common than the "low-risk" strains that don't. I can't find any reference for this, so please correct me if I'm wrong.

Some handy notes from the CDC fact sheet:

Genital herpes can cause recurrent painful genital sores in many adults

People diagnosed with a first episode of genital herpes can expect to have several (typically four or five) outbreaks (symptomatic recurrences) within a year.

Regardless of severity of symptoms, genital herpes frequently causes psychological distress in people who know they are infected -- maybe because of the frightening prospect of giving someone you like, or at least do not hate, "recurrent painful genital sores." And because you have to disclose to every person you sleep with, before sleeping with them, that sleeping with you may cause recurrent painful genital sores.

How in the world is that not a big deal? People who are infected with herpes are sexually cut off from the majority of people who are not. There are dating sites just for people with herpes, because they get tired of meeting someone, getting to know and like them, disclosing their herpes status, and then finding out that their new friend does not want to roll the dice on getting recurrent painful genital sores.

Did I mention that herpes causes recurrent painful genital sores in many people who become infected? You know, that might have something to do with the "stigma."

Check the CDC site for info on herpes. Something like one in 5 people have it, that means if you're even moderately sexually active you probably do as well.

Ahhh, NO. Let's not confuse the population as a whole with the people who have a clue and give a damn. From the people I know, about in five seems roughly right, or maybe a bit low -- for sexually active people around the age of thirty. But then again, I tend to hang out with enlightened sex-positive yuppie types who get tested and disclose their herpes status to potential sex partners. We don't look down on people who are infected -- we just don't have sex across the infected/not infected line. (People who lie about that kind of thing are gaped at with uncomprehending horror.) It isn't a perfect system, but it works a hell of a lot better at preventing recurrent painful genital sores than deciding that we all probably have it so why bother caring?

Interesting note on HPV: apparently if a woman has had more than five partners, there's no real benefit to her getting Gardasil at that point because she's probably developed an immunity against most strains of HPV already. Source: a woman I know who went to the doctor asking about Gardasil.

"only one outbreak in that community, which is far better than your average college campus"

So the average college campus has much more than one outbreak of HIV? Somehow I doubt that...

Since 1998? I'd say that's accurate...

He said there was "only one major outbreak." I don't know what they consider major or minor, but that does not mean there have not been other minor outbreaks and I am scared to think how many people are going to die because of that "only one major outbreak." I think when you are talking about AIDS, "only one major outbreak" is a rather dubious safety record.

I think that is better than any college campus. I have no been aware of any major AIDS outbreaks in college campuses in the last 10 years.

Marginal Revolution (my favorite economics blog) has an entry on this:

http://www.marginalrevolution.com/marginalrevolution/2009/12...

This is a great post. Points out two things:

1. That this really isn't about the safety of the performers, but more about the fact that people watching the films are exposed to people having unprotected sex, which influences their own action. The anti-AIDS lobby is trying to increase condom use by the public, not decrease AIDS infection in adult performers.

2. The law is worded such as to include the performers under Cal/OSHA. It could probably be reworked and let them have their cake and eat it too.

A commenter there also pointed out that if the performers do become employees under Cal/OSHA, the mandatory HIV testing they undergo will become illegal.

Overall I think he's right, but it also reminds me of arguments in the 1960s and 70s against seat belts and air bags: that by adding a new safeguard, people would come to depend on it and neglect other more effective precautions like driving carefully. There is indeed a "risk homeostasis" effect, but history suggests that extra precautions do reduce overall risk.

The most important take-aways from that article are that the actors will have to become employees which: (1) makes mandatory HIV testing illegal and (2) makes discriminating against HIV-infected actors illegal. How could either of these things be considered a good for the industry or the employees?

Is it really impossible to create a law that makes it illegal to show unprotected sex in a film? I can't see any way in which such a law would require any particular employment regime. Sounds like posturing/obstruction to me.

By whom? Apparently the law is worded so that they have to be employees. This seems like it's part of the "this is for the protection of the actors" train of thought because then they call under OSHA. This might just be a way of convincing people that this is all about the actors'/actresses' safety and not about trying to curb public perception of sex with/without condoms.

Out of curiousity, how does the industry not have to fulfill Cal/OSHA now? Is it that performers are not currently employees and the proposed law would change that?

They aren't employees I'm pretty sure currently. Unsure if they are technically contractors, or if 'actors' fall under a different category overall.

This does seem like stupid legislation.

The argument for condom use in porn in not so much about protecting the actors, but rather communicating to the audience that condom use is "cool", "the thing to do", etc. etc.

The gay porn industry is mostly there (there are a few production companies that specialize in barebacking, but they're generally frowned upon).

Whether the govt. should be involved or not is a different question altogether.

> Whether the govt. should be involved or not is a different question altogether.

I think it's the main question, actually.

I think I've given up on the questions "is this very bad?" & "should this be illegal" not getting mixed into one.

I'm saying that I think it's the main question because if the government doesn't get involved, then people aren't coerced into applying someone's opinion about what is good/bad/desirable/etc, so the impact is much smaller.

Not saying that the two things are one and the same.

"For one, the adult film industry would have to make every performer an employee to satisfy the California's Division of Occupational Safety and Health, better known as Cal/OSHA, laws."

This sounds like the root cause of all the problems he lays out with the new law. Not condoms. I don't understand why he frames the article in terms of condoms. I also don't understand why you wouldn't be able to mandate condom use without making performers full employees.

Especially if they're currently able to mandate monthly testing without making performers full employees.

That monthly testing will become illegal if they become employees. See the Marginal Revolution post linked to above.

He frames his argument in terms of condoms because the legislation is framed that way.

This reminds me of the book More Sex is Safer Sex by Steven Landsburg.

That's the same argument for marijuana legalization.

People like sex way too much. If you look at it objectively, sex is hilarious, and if it weren't for people's rationality being overridden by their desire for pleasure, everyone would be way too embarrassed to have sex, especially in public.

How can you look at something objectively and find humour in it? Humour is a subjective experience.

Similarly, if people were strictly rational, the concept of embarrassment would not exist.

Here we have humans: the most ingenous and powerful species on the planet, yet they like nothing better than rubbing their bodies together and making funny noises.

Or the law could require both condom use and std tests

The point of the article is that it seems like the law is pointless and only introduces complications and special cases to existing laws. And the simple truth is you cannot stop pornography from being produced, you'll just turn it into a black-market affair. That may be an acceptable problem for certain types of exploitative porn, but for the general body of pornography it's generally a bad idea.

The point of the article is to miss the point. It frames the condom requirement as a protective measure for performers, a possibly flawed solution that threatens to cost lives by pushing some performers outside the very effective safety regime that is already in place. However, that is not the intent at all. The intent is to require the porn industry to portray safe(r) sex. The movies do not portray professionals in a highly regulated industry having sex with each other in a professional setting. They portray people routinely having unprotected sex at the drop of a hat with whatever babysitter, repairman, job applicant, or high school student who happens to be nearby.

Whether that's a good enough reason to require condom is worthy of discussion, but this guy evidently doesn't want that discussion to happen.

But people don't want to watch that. The barrier to entry for creating and distributing porn is so low these days that it's almost guaranteed to just push more of the industry into the "amateur" realm.

Yeah, that's a good argument. It should be discussed and balanced against the true intent of the legislation, not against the phony and disingenuous idea that it's meant to protect performers.

> Whether that's a good enough reason to require condom is worthy of discussion, but this guy evidently doesn't want that discussion to happen.

So is unprotected-sex pornography the newest scapegoat we're erecting to cover up our profound failures in sexual education? The last 15 years have seen schools engaging in the most ridiculous forms of sexual education imaginable, and then we wonder why people don't make informed decisions. It must be the porn.

It's this kind of authoritarian control-their-thoughts logic that gives rise to all sorts of absurd laws. It's not even clear that it'll do anything. It's legislation for the sake of itself.

So we can have that discussion, but I don't think it's going to go anywhere for that argument.

So is unprotected-sex pornography the newest scapegoat we're erecting to cover up our profound failures in sexual education?

I'm pretty sure all the supporters of this legislation are strongly in favor of comprehensive, explicit sex education in public schools. The idea that they're working to undermine sex education by using porn as a distraction is ludicrous. If anything, condoms in porn will increase the credibility of sex education in kids' eyes. We know kids are skeptical what they're taught in the public schools is artificial, idealistic BS that will never fly in the real situations they're faced with. (And who can blame them?) We know they're not just influenced by porn but often consciously turn to it as a source of information about sex. Seeing condoms in porn, even if they're only used in 10% of the porn they see, encourages them to think, "Huh, I guess real people actually do this. It's a normal practice that I can reasonably demand of my partners without being a total priss/dweeb." The legislation won't do anything to either promote or discourage better sex ed, but it will make it easier for students to trust the sex ed that is actually offered to them. In what way could it possibly detract from sexual education?

Sex education has no credibility. Abstinence only sex ed doesn't work, but guess what? Neither does any other kind.

http://www.mathematica-mpr.com/abstinencereport.asp

Lack of contraceptive education effectiveness http://www.mercatornet.com/articles/does_anything_work_in_se...

Here are some experts (the American Psychological Association) who disagree with your link:

http://www.apa.org/releases/sexeducation.html

The research on adolescents’ sexual behavior shows that comprehensive sexuality education programs that discuss the appropriate use of condoms do not accelerate sexual experiences. On the contrary, evidence suggests that such programs actually increase the number of adolescents who abstain from sex and also delay the onset of first sexual intercourse. Furthermore, these programs decrease the likelihood of unprotected sex and increase condom use among those having sex for the first time.

To put your second link in context, the author is a conservative Catholic writer who calls gay marriage "a threat to religious liberty" and accuses contraception supporters of "Condomism" (sounds like Communism, get it?) The first Google result for her name is her home page, titled "Dr. Jennifer Roback Morse - Your Coach For The Culture Wars," though if you click the link it appears the site is defunct.

Here's what she says about childhood obesity:

"My amateur diagnosis is that the childhood obesity problem is a direct result of the whole constellation of social changes initiated by the sixties. Working mothers, feminism and zero population growth all played a role."

I hardly think the APA committee is unbiased, but I think I'll stick with them over "Your Coach For The Culture Wars" who blames childhood obesity on the sixties.

This may be their true intent, but they chose not to pursue this goal directly (I'm guessing because a direct attack on free speech would have less chance of succeeding). Instead, they're filing a complaint with the Division of Occupational Safety and Health. "we see it as our duty to pursue action on the issue of safety in the workplace": http://www.aidshealth.org/news/press-releases/ahf-to-file-ca...

What about this point?

>Second, condom-only regulation would also encourage a black market in adult film production. So movies featuring no-condom sex would not only still exist, but those actors and actresses would no longer be required to participate in the industry's HIV testing program, increasing the risk of an HIV outbreak in the industry and the population at large. One need only look at prostitution to see what happens when an industry operates underground.

It should also make an exemption for allowing employers to refuse to hire HIV-positive actors. In most cases, this would be horribly discriminatory... but when your job involves putting your sex organs inside other people's bodies... I don't think that restricting the job to the HIV-negative is going to be too damaging to society :)

If HIV infected surgeons are allowed to operate, why shouldn't HIV infected persons be allowed to act in a porn movie?

They should be. But producers should be able to choose not to hire them.

that entirely depends on the precautions taken.

Because the surgeons aren't spraying their bodily fluids into you.

And nobody using a scalpel EVER accidentally cuts themselves

Do you have figures for the number of surgeons who cut themselves during a procedure?

I think this may be a place where anti-discrimination and OSHA bump up against each other. If producers can't turn down HIV-infected actors, then aren't they endangering their HIV-negative actors?

To answer your question, the risk of a condom breaking is much higher than a surgeon getting bodily fluids into a patient. Sexual intercourse necessarily involves production of bodily fluids with nothing but the condom to contain them. A surgeon is not required to produce highly infectious fluids as part of performing an operation. If a latex glove breaks during an operation what are the chances that some HIV-infected fluids will leak out and into the patient? What are the chances that an actor/actress will be infected when a condom full of HIV-positive semen breaks inside of them?

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