LOS ANGELES — With concern about monkeypox becoming widespread in the adult industry, XBIZ spoke with industry health advocate and PASS Executive Director Ian O’Brien about awareness, prevention and the status of the infectious disease outbreak.
“PASS is committed to protecting the health and safety of our industry,” O’Brien told XBIZ. “As new research and tools become available, we will seek to use them.”
As of now, O’Brien added, “we believe we can achieve the greatest impact by directing our focus on increasing vaccine access and spreading awareness around the new production guidelines we have released in response.”
Monkeypox Testing More Complex Than Other STI Testing
O’Brien emphasized that one of the issues the community needs to be aware of is that “we cannot currently test for monkeypox the same way we do for other STIs.”
This complicates dealing with monkeypox using tracing protocols that the industry has developed for regular STI testing and the PASS system.
“While tests are available for monkeypox,” PASS cautioned in one of several statements on the outbreak, “current gold standard testing requires the swabbing of visible lesions that are sent off for confirmatory testing.” Results are then reported in detail to the public health departments monitoring monkeypox infections.
According to the PASS statement, “This means a person would have to be visibly symptomatic before they can be tested — which presumably means they wouldn’t be on set in the first place.”
Moreover, the limited availability of testing, the additional credentialing required of the testing staff and the additional administrative requirements from public health authorities “make the current logistics of testing for monkeypox unrealistic,” PASS explained to the community.
“There are a number of screening tests in current development, and if one looks like it could be an effective tool for our industry we would certainly look into adding it to the testing panel,” the statement noted.
Production Hold ‘Would Not Solve’ Monkeypox Issue
Another question that O’Brien and PASS addressed is whether reported cases of industry members who may have been exposed to monkeypox would warrant a production hold similar to the ones called for positive HIV tests.
“We do not call production holds lightly, as they have significant impacts on the lives of people in the industry — a lost shoot could mean the difference between making rent money or not for some folks,” the PASS statement explained.
When PASS calls a production hold for HIV, the statement continued, “we do so knowing that they will be effective and finite for two reasons: 1) we will either be able to identify and contain a potential infection, or 2) enough time will pass that any infection that might be in the talent pool would have enough time to be detected on our testing panels, so having everyone retest is a viable option.”
For the current monkeypox outbreak, however, “neither of these are currently true,” PASS explained.
“There is currently no mechanism for us to track potential infection in the industry as it is not something that can be screened for through our testing partners in the same way as STIs,” PASS added. “As we have no way of knowing what the current prevalence is of monkeypox in the industry, and no way to screen for monkeypox to keep it out of the industry — we’d have no way to evaluate whether a production hold was effective or not and we’d have to continue it for an indeterminate amount of time.”
The industry health protocol group acknowledged, however, that “our knowledge of the situation and available tools could change — and if a production hold became a meaningful tool to keep people safe, we would consider using it.”
Adult Industry and PASS Participate in National Conversation Regarding Monkeypox
Last week, performer, director, activist and PASS spokesperson Siouxsie Q spoke to the Los Angeles Times for an in-depth feature on the impact of the outbreak on different areas of sex work.
The LA Times praised PASS as “an organization focused on the health and safety of workers in the adult industry, which has argued that sex workers are at heightened risk, regardless of gender.”
Siouxsie Q told the newspaper that, “because jobs in the industry often involve skin-to-skin contact, ‘it’s super important that all genders who do this kind of work for survival have access to the health resources we need (namely, vaccines) to stay as safe as possible.’”
O’Brien also spoke at length with Buzzfeed in late August, noting that PASS had “put out some information urging the industry to pay attention, to be cautious. We contacted our production contacts to say, ‘This is happening. We're monitoring it.’”
“Most of our strategy, as an industry, has been really reliant on screening and testing for infectious disease prior to folks being on set — this works really well for STIs,” O’Brien told Buzzfeed. “Since PASS’ inception, we’ve never had a single transmission of HIV on set.” PASS has been in operation since 2011.
O'Brien added that although the standard screening system worked “pretty well for COVID, we couldn’t use the same strategies for monkeypox because there is no screening test. We debated if we should help with guidance around identifying potential lesions, but that felt a little bit like playing doctor and asking folks to be armchair dermatologists.”
PASS’ guidelines, O’Brien said, urge performers to skip work if they “develop any sort of suspicious rash, lesions, or bumps, or ‘feel sick,’” as well as to “clean and disinfect surfaces, bedding, and clothing” and to try to get the vaccine.
When the first guidelines came out, O'Brien noted, the monkeypox vaccine was available in Los Angeles to gay men who had had rectal gonorrhea in the preceding three months.
“I understand the risk evaluation there,” he said. “But I don’t think pragmatically that’s how communities access things.”
In response to some health professionals recommending abstinence, O’Brien explained to the mainstream news site that “abstinence means something radically different to somebody whose livelihood depends on sexual activity.”
Instead, O'Brien explained, PASS decided to make it a priority “to get folks who we believe to be at risk as much as access as we can.” This strategy, Buzzfeed reported, was helped by the fact that James Bell, director of the PASS board, is also director of sexual health services for the Los Angeles LGBT Center, “which had received a significant supply of the vaccine from the Los Angeles Department of Health.”
“Jamie and the folks at the LA LGBT Center really advocated for being able to put on a clinic for folks of all genders in sex work,” O’Brien told the site.
Other mainstream media outlets that recently spoke with PASS about the monkeypox outbreak include Rolling Stone and radio station KCRW.
Resources for Performers, Sex Workers and Adult Industry Members
Free Speech Coalition Executive Director Alison Boden told XBIZ, “Ian and the PASS team have had a significant impact on the national conversation around monkeypox, and most importantly, managed to direct public health resources to where they’re needed: our production community on the front lines of this outbreak.”
Boden added that the FSC’s mission to protect the rights and freedoms of the adult industry “obviously includes ensuring its safety, and we’re proud to support the PASS team’s incredible efforts.”
For more information on monkeypox vaccine access for adult industry members, click here.
To sign up for a Monkeypox vaccine clinic for sex workers in West Hollywood on Friday, Sept. 9, click here.
For the new production guidelines recommended by PASS regarding monkeypox awareness and prevention, click here.
For PASS’ general monkeypox info page, click here.
For more on the vaccine, click here.
For infectious disease memos, including monkeypox tracking, click here.
To learn more on how to help PASS with advocacy for sex worker access to the monkeypox vaccine, click here.
For more up-to-date information, follow PASS on Twitter.