Harm reduction, not abolition – is the moral and humane thing to do

This article is a little different to my usual writing. I have been in an introspective and philosophical mood in recent times and when I heard the news that California had recently refused to implement new rules that would reduce adult films shot in that state to little more than this:naked-gun-safe-sex

I felt compelled to write about it. While it may not directly touch on what I do as a male escort, I hope that on reading it people will understand the broader point and how it relates to sex work – and in fact pretty much all of our lives.


The Californian Occupational Safety and Healthy Standards Board recently failed to pass new regulations that would force porn performers to use condoms, dental dams, and even goggles to protect them from the risk of sexually transmitted infections while making films and images about sex.

It was a win for that most elusive of beasts: common sense and incidentally for the concept of “harm reduction”. Even if only marginally (the board failed to achieve a four to one majority by just one vote).

The adult film industry in California already has a system for ensuring the health and safety of its performers. It is called PASS (Performer Availability Screening Service) and is administered by the Free Speech Coalition. It provides bi-weekly STI testing for performers, the results of which are held in a secure, private database, and allow producers and agents to see the availability of performers (but nothing detailed about their health information). It also provides performers with access to both testing, and – in the case of an infection being detected – support and treatment services.

It’s a good system. From what information I can find online, it works. Under that system there hasn’t been a case of HIV transmission on the set of an adult film in California in over 10 years (2004 was the last recorded time in California, which prompted the shift to bi-weekly testing with higher sensitivity testing methods).

There was an on-set transmission of HIV between to male performers in Nevada in 2014, however it appears that it happened under less stringent testing standards – which really just re-inforces the point. PASS works, less rigorous testing does not.

So what has all of this got to do with sex work and my blog? The short answer is: the PASS system is a good demonstration of sensible, tolerant attitudes toward dealing with a real risk (STI transmission between performers).

It accepts that there is a risk and that it needs to be taken seriously, and it sets out to minimise that risk without creating unintended adverse side effects. This is classic “harm reduction”.

Harm reduction means that we acknowledge that there is a problem (like the dangers of drug use, or sex work, or driving a car, or many things), so we look for ways to reduce that harm – without imposing the unrealistic expectation that we can eliminate risk and harm entirely. Aiming for perfect safety usually results in the creation of other, sometime worse problems. PASS by all accounts seems to be a strong example of effective harm minimisation, along with the pioneering needle exchange and safe injecting rooms in my home town of Sydney in Australia. People may not like these things, or drug users, but at the end of the day they have saved lives, and reduced the severity of the consequences of drug use; something that “The War on Drugs” – or prohibition – has singularly failed to do – ever.

For a more mundane example, the automotive industry is replete with harm reduction efforts: seat belts, laminated and safety glass, passenger safety cells, air bags, crash testing, collision standards, blood alcohol limits, licensing, driver training, anti-lock braking, electronic stability control, automated emergency braking. The list goes on – and on. No-one in their right mind would try to directly, or indirectly ban cars or driving on public roads. We can see that they provide value to our society, so we accept the inherent risks that they pose to people’s health and safety – while at the same time trying to minimise those risks.

Sadly, our species pre-occupation with what I would call misguided (or “the right king of”) morality – often begat from religion, clouds otherwise sound judgment and decision making when issues like sex (and drugs) are involved.

Misguided morality starts from an assumption that there can and should be absolute answers. “Sex outside of marriage is bad and shouldn’t happen”, “drugs of addiction are destructive”, “taking pleasure from sex outside of a monogamous relationship is wrong” etc. These are all things that, if you were bought up inside a society steeped in the traditions and strictures of Abrahamic religions that you would likely recognise and have a position on.

But few people would take a fixed position about driving cars. The statement “driving a car on the road is wrong because 1,156 people died in car crashes in Australia in 2014” [1.] would be dismissed outright by the vast majority (issues of Climate Change and environmental impact aside). We would instantly reply “yes but!”.

Why? Because we recognise that our economy, and entire way of life (in this country and others) is built on the availability of personal, private transport. We automatically weigh the cost (1,156 people’s lives) against our inherent knowledge of and selfishness towards the benefits of having personal private transport.

If however I say “Drugs should remain illegal because in 2001 there were 1,038 drug induced deaths in Australia” [2.], I am pretty sure that you didn’t just add the statement “yes but!” after reading it. You took it at face value and – depending on the moral framework that guides you – felt sadness, happiness, disgust, contempt, or indifference.

This difference in response between my two examples is crucial – and it’s the main point that I am trying to make. When we allow misguided morality to influence our rational response to a given situation, we loose the ability to make the best choices to reduce harm and make our society (quantifiably) better.

If drug use disgusts you, then the idea of giving clean needles to drug users will likely be impossible to support – even though it improves the lives of and health outcomes for injecting drug users, their friends, and families, and reduces the burden of disease and death on the wider community (a very positive and beneficial outcome). But you can’t support that because you feel disgusted at the very thought of someone shooting up heroin – and possibly outrage at “your tax dollars” being used to pay for the needle that they do it with.

This is the crux of the problem. If we let our responses be guided by morality that distorts our ability to think clearly and rationally, then we will make decisions that unnecessarily and inevitably harm people (and more broadly) the planet.

Let me be very clear: harm reduction will likely never eliminate a problem, but if sincere efforts are made, based on rational thought then it will reduce the impact of the problem, perhaps to the point where it becomes a statistical curiosity rather than a public health crisis.

Many people, captured by misguided morality will immediately dismiss harm reduction because it doesn’t promise a complete solution. They will do this, while desperately clinging to the notion that an abolitionist solution – even one that is demonstrably harmful – is inherently better, and in fact the only solution that should be considered, because it conforms to their morality.

They do this because their own belief system is fixed and finite and blinds or inures them to the broader consequences of the actions that they propose.
To come back to California and its recent attempt to force the adult industry to change its behaviour we have an excellent example.

The adult industry itself decided that the best way to keep performers safe, while balancing the requirements of its customers was:

  • Bi-weekly, hi sensitivity testing
  • A database that allowed agents, producers, and performers to know that a performer had been recently tested and shown to be clear with a high degree of certainty

This is a system that the industry itself supports and uses, that has been demonstrated to allows adults to engage in their chosen profession with a very high level of confidence that if they use it, they will be safe. And it had reduced the incidence of HIV in adult performers to a statistical anomaly.

The new laws being pushed in California by the AIDS Healthcare Foundation on the other hand:

  • Specified less frequent STI testing
  • Imposed the use personal protective equipment that:
  • (in the case of condoms) can actually cause harm and increase risk of infection
  • Would lead to the product being laughed at and dismissed by many or most of its intended audience

One approach is based on the principals of harm reduction. The other is an underhanded attempt at prohibition. Not through honest, open debate and the implementation of the best science to hand, but by crippling a product, making working conditions unpleasant, and most of all less safe!

AHF is clearly trying to distort the porn industry into a vehicle for its own message, which, from my reading appears to be: that only widespread condom use can prevent the spread of HIV.

Whether that message is true or not (and that is unlikely certainly as medical technology advances), it is unfair for AHF to molest the lives of thousands of people in California who depend upon the porn industry for their livelihoods in the pursuit of its own goals.

Let me be clear: fighting HIV transmission is a good things. But doing so in a way that risks the loss or crippling of an entire industry and form of culture is not (remember AHF is a huge multi-national organisation – if it can get its way in California, then it would most certainly try to do so everywhere it can reach).
In conclusion I need to say the following: regardless of how any of us would like the world to be, regardless of what we want to be true, the world won’t comply – we only mistake occasional correlation for causation.

People selling sex, taking drugs, driving cars. All of these things have happened, are happening, and will continue to happen regardless of what beliefs any of us hold. So I put it to you that the truly moral thing to do in respect to our laws and our actions is to accept the reality of human nature, and then to find the most effective ways to ameliorate the negative aspects of it.

John.

[1.] https://bitre.gov.au/publications/ongoing/files/Road_trauma_Australia_2014_statistical_summary_N_ISSN.pdf

[2.] http://www.abs.gov.au/ausstats/abs@.nsf/productsbytopic/E32F06E91C80389DCA256D640001E0FF?OpenDocument#2.%20TRENDS%20IN%20DRUG-INDUCED%20DEATHS