Could safer porn promote safer sex?
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A proposal to require all porn actors in California to wear condoms on set is meant to protect the performers from sexually transmitted infections.

But some public health experts are hoping it will protect the public as well — because when it comes to porn, a growing body of evidence suggests that in some cases, viewing leads to doing.

In particular, researchers say the growing popularity of unprotected sex in gay porn may be playing an important role in the persistence of HIV and other sexually transmitted infections among gay and bisexual men. So they’re hoping the reverse might be true, too: Requiring actors to wear condoms on screen could encourage porn viewers to wear them in real life.

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Eric Schrimshaw, a health psychologist at Columbia University’s Mailman School of Public Health, coauthored a study last year that found 34 percent of gay porn featured unprotected anal sex.

And a separate study last year by Kimberly Nelson, a clinical psychologist at Brown University, found that gay and bisexual men were more likely to have unprotected anal sex if they had watched such risky behavior online in recent months. Not only that: Their risk increased in direct proportion to the amount of condomless porn they watched. That study was funded by the National Institutes of Health.

It echoed a similar study, also funded by the NIH, that was published in 2013. It, too, described a dose-response relationship between watching and having unprotected anal sex among gay and bisexual men.

The author of the 2013 study, epidemiologist Simon Rosser of the University of Minnesota, notes that watching porn in general — even watching a lot of it — doesn’t increase the risk of having unsafe sex. The correlation only holds with porn depicting unprotected anal sex.

These studies don’t prove causation, but Nelson said she hears it from the men she talks to for her research: “They all say, ‘There’s no doubt this is impacting behavior in the community,’” she said.

California workplace regulations already require employers to take measures to prevent the spread of disease, but the adult film industry has argued that the language is vague and doesn’t require its actors to wear condoms. The proposed update would make that requirement explicit. It would also compel adult film producers to cover costs of vaccinations, testing, and medical monitoring related to HIV and other sexually transmitted infections.

The state regulatory board is expected to vote on the proposal in February. If approved, the rules will take effect in July 2016. Willful violations of the standards are punishable with a fine of up to $70,000.

The Free Speech Coalition, the trade association for the adult entertainment industry, opposes the regulations. Industry representatives have argued that the regulations were designed for health care settings and are “unworkable” on film sets, and that they remove performers’ control over their own sexual health.

“We focus on performer choice — it affects them more than the rest of us,” said Mike Stabile, a spokesman for the organization. Plus, he said, the recent availability of drug regimens that can help protect against HIV infections means that condoms are no longer the only way to safeguard performers.

But Schrimshaw, the researcher at Columbia, said condom use is still critical for preventing sexually transmitted disease. He said the regulations are a step in the right direction — though he noted that they won’t affect porn filmed outside California.

Nica Noelle already requires all her actors to use condoms for the porn she directs at the Icon Male studio in New Hampshire. But she’s not happy about an industry-wide policy — especially if it’s being sold as measure to improve public health.

“Now the adult industry is responsible for the sexuality of society at large? No,” she said. “That’s not fair, and that’s not right.”

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