PORN VALLEY – "I'm exhausted," sighed Dr. Sharon Mitchell, founder of AIM Healthcare.
And why wouldn't she be? Between dealing with the various city and state health agencies, responding to phone calls from information seekers inside and outside the industry, and getting the test results on all the people who've been tested as a result of the now nearly two-week-old performer HIV case, she's ready for a month-long nap.
"We've tested 15 people so far," Mitchell confirmed. "That's first, second and third generation, and we've counted three professional possible exposures, but that's because we go back one month. We start counting from her last test, so I think we went back to 5/5."
And why test people who've had sex with people who've had sex with people who've had sex with the original infectee?
"We've overinvestigated this as a form of self-protection," Mitchell explained. "We've gone way and above the call. We've gone to third generation private parties, which is beyond anything we've ever done before. The fact is, I don't expect there to be any more cases coming out of this one patient because her viral load was so low – and that's because we're dealing with early detection and we catch these things so early, so the chances of transmission were minimal."
But Mitchell was particularly incensed by OSHA special counsel Amy Martin telling the Los Angeles Times, "If you're going to err, err on the side of caution; don't say let's wait another seven additional days and meanwhile, let's go make some more unprotected films. We think they're creating a hazard by sending people into a known unsafe work practice. They're who the industry relies on to stop the people from working."
"That is unequivocally, documentedly untrue," Mitchell responded. "It is not up to us to say, 'Oh, let's just wait seven days and not tell anybody.' That's not what we did. The reason why this took seven days to come back is because AIDS Epidemiology doesn't, to the best of my knowledge, at this point accept the PCR-DNA test, since that is an early detection test, on its own."
"I did not purposefully wait seven days," she reiterated. "The fact is that PCR-DNA is an early detection test, and what AIM does for the benefit of our clients, the population that we serve, and for reporting and scientific purposes, we double-check by another PCR-DNA test; then we do an RNA test to see what the viral load is. Then we send out an Elisa test, which is an antibody test. Now, that is the test that the county really needs to go on, and that's the one that would be used anywhere. Most tests in the county of Los Angeles, when those Elisas are positive, they go to a laboratory called Specialty Laboratories, located somewhere out there in the desert, and they do the Western Blot confirmatory testing up there, which says how many bands positive are they, proteins and antigens and so forth. Part of the reason AIM does this is so we can do an accurate reporting and so we can compare with the RNAs and the DNAs and roughly tell when someone was exposed based on the amount of virus. That Western Blot is the standard FDA-approved reporting test that is necessary to report. In this case, it took seven days to come back; we did not get the results until Wednesday afternoon and it went in the mail yesterday morning because it cannot be faxed or called in; this is confidential information so it was reported less than 24 hours after we received the final confirmatory results by Elisa and Western Blot form Specialty Labs. And that, I believe, is the law. You don't want to sit on these things, and clearly, I never would have."
But why not report the results of the first PCR-DNA test to the county?
"Because in the past, we've been told that a complete report does not exist until the Elisa has been confirmed along with the PCR-DNA along with Chlamydia, gonorrhea, syphilis," Mitchell explained. "That's what the county health department commanded last time."
"If I thought this was another Darren James situation and we had 13 women at risk and we were going to get three to five positives, there would be a lot more information being dispersed than there is," Mitchell assured, "but being that this was such a very low dose, that's probably why it took seven days for the Elisa to come back from Specialty Labs."
Part of Mitchell's trouble is that mainstream journalists, who have little idea how AIM or the adult industry work, and who give more credibility to the assertions of the L.A. County health officer Dr. Jonathan Fielding and AIDS Healthcare Foundation president Michael Weinstein than to the reports coming from Mitchell and the AIM staff.
"They think there's bad guys," Mitchell asserted. "They think there's wrong-doing. The truth is, AIM is not in the porn industry; we are a testing site. We serve civilians and adult entertainers alike. We do reporting like everyone else. If this happened down the street – look, someone sero-converts [becomes HIV-positive] in the United States every nine minutes. You can't tell me that L.A. County is going to make a big deal out of someone just coming in off the street who has a low viral load, who has sex, and probably most of these encounters have had sex with a condom on. But mention that the woman is in the porn industry and the paranoia cranks up to 11."
But despite the assertions of OSHA's special counsel, Mitchell says that the OSHA personnel who pulled a surprise inspection of AIM's premises on Wednesday afternoon came away satisfied.
"Fortunately, it was Deborah Gold, who I'm very familiar with and have been working with, talking about workplace issues way before Darren James," Mitchell noted. "I've known her for many years, at least 10 years, and she has been a real good source of advice and guidance."
And what of the assertion that AIM withheld records from OSHA during the inspection?
"They came in to ask specific questions about specific talent members," Mitchell recounted. "They wanted specific records. They were flown down from Sacramento; this wasn't some local people, so they obviously expected a problem, and I resent the fact that the L.A. Times made it seem as if we had not been cooperative. I don't know where that came from. We're not hiding anything."
"The procedure is, they have to ask us verbally, 'Can you hand over these records?'" she continued. "At that time, we have the choice to say, 'No, we're not prepared to at this time,' and what they do is go back and reiterate the request in writing and then they ask you again, and then we can prepare legal documents. But by law, they're asking us to report very special things that aren't really legal to report, such as the names of the production companies that the performers worked for; if they're a U.S. citizen or not; who is their agent; how many times have they worked?"
AIM's Medical Director, Dr. Colin Hamblin, confirmed that clinic personnel are directed not to simply hand over every document requested, since the release of some could violate the patients' privacy rights.
"They can either ask for them in writing or in person," Hamblin explained. "What I told Brooke [Hunter, AIM's office manager] is, if they ask for anything, make sure you get it in writing and we'll put it together as a nice clean package and submit it, because the last thing you want to do when they ask for something is give them something that violates HIPAA [the Health Insurance Portability and Accountability Act] or is incomplete. So they said, 'Okay, we can ask for this in writing.'"
"Supposedly, the whole reason they came down to do this emergency inspection is that we were resisting or slow in giving stuff up and that's why they showed up," Hamblin continued. "That's bullshit. You're supposed to serve the medical director on that stuff, and I'm the easiest person to reach. If they wanted something, I would have been glad to have talked to Amy Martin or the OSHA guy; all they have to do is pick up the phone. But everyone I've asked has said there's no way in the world you can give them the level of information they're wanting. It's a violation of HIPAA and there's no law to support it."
Mitchell thinks that the officials are under some startling misapprehensions about what information AIM has.
"They think we have some secret database that absolutely has the exact number of times people work during a day in the San Fernando Valley and exactly what sex acts they did, which is not true," she asserted. "We don't keep track of every single encounter in the Valley that takes place in the industry. We don't have a database like that. There is a rumor in the county that we are hiding something like that. That's not true, We just use our testing database and our legal releases to share with this population so they can get to work safely, and before they enter the industry, that they have enough preventative information so they can make a healthy choice whether to enter it or not, whether they're prepared to, and when they leave, that they have a safe transition out; if they need a little help with education, we have a little money earmarked for that, or detox funds, we have special funds for people that need help that are on drugs or alcohol."
Indeed, it's AIM's willingness to keep confidences so long as they don't involve threats to the health of the community that's made AIM as successful as it is.
"People cooperate with AIM. Why? Because they trust us; they know we're around; they know we're going to do the right thing; they know we're there when they dial the phone. Why? Because it's been there for almost 12 years."
And that trust has had its effect on the performing community.
"Though the recent HIV outbreak isn't totally resolved, I still feel empowered to at least make informed decisions about rather I work or not," blogged popular actress Marie Luv. "I chose not to work until I get more information regarding the involved parties... I was told that AIM has the situation under control. So I decided to put myself under quarantine until they find the person who gave her HIV. Right now there are so many rumors going around that its hard to dissect the truth. Mainstream media is reporting 16 positive HIV cases in porn within the last 5 years & that is not true at ALL. AIM is open to anyone who wants to get tested. According to AIM, the positives that were reported to the Department of Health had nothing to do with porn performers and these person(s) had never performed in an adult film production."
Mitchell also disputes the figures regarding sexually transmitted infections (STIs) in the industry which were recited at the press conference held by the AIDS Healthcare Foundation Thursday afternoon, claiming that over the past three years, over 2700 infections of adult performers had been reported to the County Health Department.
"They probably got their figures from Dr. Fielding," Mitchell surmised. "We do have to report Chlamydia and gonorrhea, and the county still funds us on our syphilis program; they provide free syphilis testing for us. And this is something we do report in two different categories, industry and civilians, since we have so many civilians that come in. I don’t know which figures they're quoting, but I'm guessing it's ones they came across in some report they [County Health] did a while back, and what they did was count all the retests as double positives, or if someone got reinfected in the same year, they counted that twice too."
"The only reason the county has these numbers is because we do such stellar reporting, and because our contact system is so uniquely fast," she added. "If these people were tested in a county clinic, their results would take up to two weeks to come back, and they would have to use medication that you would have to take more of to test negative, and it would take seven days before you could retest, and by the time they retested you, it would take another couple of weeks for the results to come back. If you compare AIM to their snail pace, if they were even to try to handle this situation without us already doing the investigation and contacting, they wouldn't have these numbers that they've blown out of proportion."
In fact, Mitchell suspects an ulterior motive in all the public outcry raised by Fielding about this lone HIV infection.
"The reason why I think the county wants all this information is, I think they're just slowly imitating what AIM does and trying to build what we've built over the years," Mitchell asserted, "and they think if they can go to the CDC [Centers for Disease Control] and say, 'We can do this better; give us money; we can be the disease czars of the porn industry because we can handle it better.' Every 'investigation' that they've reported to the CDC that's shown up in the literature, they have been AIM's investigations. When the county gets all of the information, they basically copy everything that we've reported, or go ahead and harass these poor people [performers] until they tell them all the information that AIM did, and they report it and they get this credit for it like they did some incredible partner reporting, but they're just copying our investigation and turning it in and taking credit for it."
So is there an end in sight yet?
"I don't know," Mitchell sighed on Friday morning. "I expect them to show up with warrants today to seize the records. There's just been so much talk about it, I'm just worried that that's going to happen."
And sure enough, at 4 o'clock Friday afternoon, OSHA inspectors appeared at AIM's Van Nuys facility.
"They showed up with a request for a lot of the usual IPP [Individual Program Plan] and safety stuff, but also some very outlandish personal information about our patients and our contracts with our production company clients that we're obviously not happy about," Mitchell said. "We're going to have to speak to our attorneys about what they're entitled to — but I just knew they'd show up on Friday. There goes my weekend!"
Oh, well – she can sleep next month ... maybe.