Tim Evanson writes: I hope that your article (“PCR-DNA Shocker-update,” May 14, 2004, 15:15 PM PST) is tongue-in-cheek. That the PCR-DNA test is not useful in identifying who has HIV and who does not, nor in determining which person “was infected first,” has been well-documented for many years and is a well-known fact. I have posted about this for the last several years on the newsgroup rec.arts.movies.erotica. Indeed, below is my most recent post on the issue (dated April 16, 2004 1:11 PM, under the thread “AIDS testing”).

I am a gay man, and many of my friends have HIV. Many of them are also on triple-combo therapy. Subsequently, their viral loads are undetectable by PCR-DNA tests. This does not mean they no longer have HIV. It also does not mean they are not infectious (they are).

One simply has to wonder how many people in the adult film industry have HIV, but are taking the right drugs which enable them to keep their viral load suppressed to a level low enough not to trigger AIM’s PCR-DNA tests.

PCR-DNA testing will not protect the adult film industry from HIV. It simply will help limit its impact.

It may be that performers wish to risk it. It may be that HIV-positive performers wish to take the risk of re-infection (as many gay porn performers do) and engage in unprotected sex with other HIV-positive performers. If the model is fully informed about the risks and consequences of their actions, it seems to me that a director could ethically hire such an individual for bareback sex performances.

I agree with Scott O’Hara, the gay adult film legend who died of HIV in 1999. Writing in the AIDS magazine “Art & Understanding” in November 1998, about the virulently anti-bareback journalism of Michelangelo Signorile and Gabriel Rotello, O’Hara said: “I don’t tell other people to go out and bareback. I tell them, evaluate your situation. Make your own choice. I’ve checked my own premises and found the advice from the Signoriles and Rotellos of the world to be, well, not applicable to me. I have to say I have listened to them, I like them and respect them, they have also checked their premises and come to their own conclusions. The only thing I disagree with is their trying to tell someone else how to live their life.”

I think that is applicable to the situation in the straight adult film world as well.

Tim Evanson

Washington, D.C.

“Darrin” <[email protected]> wrote in message news:rame.1081956021p11296@linux…

I do NOT know the details of how AIM screwed up with Marc Wallice (tell me where to see both sides of the argument please), but they have a chance to do a great thing and avert a crisis in light of Darren James’ HIV positive diagnosis.AIM tests for the presence of HIV antibodies, not the actual HIV virus. (FYI, a list of FDA-approved HIV tests is available at http://www.fda.gov/cber/products/testkits.htm).

The FDA estimates that most HIV-1 (the most common type of HIV virus in the U.S.) antibody tests give a false-negative about 0.5% of the time. That is, 1 in 200 tests will incorrectly say that the person is clean when in fact they have HIV. False-negatives and false-positives (the test says you have HIV when in fact you are clean) can be caused by any number of problems: infection is too recent for antibodies to show up in the blood, saliva or urine; the test procedure was not correctly followed; the person is infected with a variant of the HIV virus that is not detectable by the test; an improper test is used (e.g., the test was for HIV-2, not HIV-1); the specimen was not handled correctly (e.g., sample was contaminated, temperatures were too high or too low, sample was old, etc.); failure to correctly load the sample into the test; other immune problems (e.g., your immune system is in complete collapse and cannot produce antibodies); and failure to read the test results in a timely fashion (e.g., waiting too little time for results, waiting too long for results).

Remember, too, that there are a variety of HIV antibody tests on the market. However, all of them test for ANTIBODIES. They do not test for the HIV virus itself. The human body requires time to respond to the HIV virus. The U.S. Centers for Disease Control and Prevention (CDC) estimates that 95% of people infected by HIV will produce antibodies within 3 months. By the end of six months, 99.9% of people will produce antibodies. The three-month period is commonly called “the window.”

Because of the window, HIV antibody tests are NOT considered reliable prior to three months.

During the window, an HIV-infected person CAN infect other people. Indeed, a person who is infected with HIV may not have any antibodies to the virus at 2.5 months, and yet they may be highly infectious.

I am not sure what antibody test AIM uses. The quickest tests, such as OraSure’s OraQuick Rapid HIV-1 Antibody Test, are considered “preliminary” tests only. That is, they must be confirmed with an actual HIV-1 antibody test. OraQuick is 99.6% accurate.

However, the most commonly used HIV antibody test is the ELISA test. (For more information, see the San Francisco AIDS Foundation’s Web site on HIV testing at http://www.sfaf.org/aids101/hiv_testing.html.) Test results are usually obtained in 3-4 hours. But since most samples are sent to outside labs for processing, results are usually known in 2-3 days. ELISA tests are about 99.5% accurate. ELISA tests almost always confirmed with what is called a Western Blot test. If the Western Blot test also comes back positive, there is a 99.9% accuracy.

There are also “PCR tests” which look for the presence of HIV itself in a person’s bloodstream. PCR stands for “polymerase chain reaction.” PCR was invented in the 1980s. Scientists know that they have a minute quantity of some DNA or RNA in a sample. But it is so small, they cannot find it. PCR is a process by which DNA or RNA is multiplied millions of times. Then the sample is fed through a sieve of gelatin, so that only samples of DNA or RNA of large-enough size remain in the sample. (For more information, see http://www.accessexcellence.org/AB/IE/PCR_Xeroxing_DNA.html.)

There are two kinds of PCR tests. One test, called the branched-chain DNA test (bDNA), is made by Chrion, a pharmaceutical company. The reverse transcriptase polymerase chain reaction or RT-PCR test is made by Roche Laboratories. Scientists know that HIV has RNA, but not DNA. (RNA is sort of “primitive DNA.”) Each tests for the amount of HIV virus in a sample of blood, urine or saliva. This is called “viral load.”

The RT-PCR test multiplies HIV RNA by a factor of approximately one million. Scientists know that HIV RNA has a certain “pattern” or structure. They can create a chemical “mirror image” of this pattern on a probe. Like interlocking gears, the HIV RNA will then stick to the probe. The probe is dipped into the sample, and the amount of HIV RNA on the sample is measured. From that amount, the scientists can mathematically work backward to determine how much HIV virus was in the person’s blood, urine or saliva. But because the amount of HIV was mathematically calculated, we say that the RT-PCR test only measures HIV RNA “indirectly.”

The bDNA test is different. It, too, uses a chemical solution to multiply HIV RNA by a factor of about one million. Then, a new chemical is added. This new chemical sets off a chemical reaction so that the HIV RNA emits light. More light means there is more RNA. The amount of light indicates the level of RNA in the sample. This test is said to measure HIV RNA directly.

The problem with both PCR tests is that same sample can give different viral load measurements. And as anyone with HIV knows, you can be infected with HIV and still have “no detectable viral load.” (For more information, see http://www.sfaf.org/aids101/viral_testing.html.)

Hence, PCR testing is not considered an accurate test of whether a person has HIV or not. PCR testing should ALWAYS be backed up with traditional antibody testing after the window period is over.

AVN.com is reporting that James had his first positive test on Friday, and had a confirmation test on Tuesday. It is not clear whether AIM used a PCR test first and confirmed it with ELISA, or whether they used a rapid HIV-1 antibody test like OraQuick and then followed it up with an ELISA test Monday, or whether they did an ELISA test on Friday and a Western Blot on Monday.

Lastly — remember that the industry standard is “an HIV test within the last 30 days.” Remember, though, that the window period is 90 days (three months). I could be infected with HIV and be inside the window period. I could even be tested three times within that window period, and still come up “negative.” That does not mean I am clean. It simply means I have HIV, but no antibodies have been produced by my body yet. In fact, let’s say that I am tested on the 90th day of my window period. I’m one of those wacky-immune-system people who hasn’t produced antibodies within the first 90 days. I get an HIV antibody test that clear me for another 30 days of work.

In essence, I could work for 120 days — four months! — without testing positive for HIV. I would have HIV, and I would be infecting people. But no test will show this.

Did AIM fuck up the test? Was Darren James a false-negative? Did Darren James just slip through the window period. We don’t know.

But you can see how the industry’s “HIV testing regime” really doesn’t do much to protect performers. It simply catches problems after they have already occurred. Tim