Accuracy of Adult Industry Testing Questioned by the Jilted (UPDATED)

Dec 12, 2013
Adult Business News
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Accuracy of Adult Industry Testing Questioned by the Jilted

Analysis by Michael Whiteacre

A friend phoned this evening with some kind words about TRPWL’s coverage of the adult production moratorium that was lifted today, and along the way he mentioned a curious thread on a gossip site run out of Georgia by a feller named Mike South.

The subject was the aforementioned moratorium, and a commenter who uses the moniker “jilted” — with a writing style and penchant for typographical errors I found strangely familiar — chimed in with this:

The lifting of the non existant [sic] moratorium is based on Diann [sic] Dukes [sic] complete misunderstanding of the capabilities of the APTIMA RNA test. 9-11 day window period, BULLSHIT!!!!

I have sent Mike the details of this bullshit claim. I know Mike has been busy today so I will give him some time to post it, if he cant get around to it I will pput [sic] it in the comments here.

Long story short, APTIMA has NEVER made the 9-11 day claim, this is anecdotal evidence and best case scenario outcomes.

PERFORMERS< there is no 9-11 day window for this test, and if you are relying on this to ensure your safety you are making a HUGE mistake, not only with your own life, but the lives of everyone you have contact with.

Sounds scary, right?

It appears that Mike South read Tim Tritch’s — I mean, jilted’s comment and email, then limped onto Twitter:

South - Gentech

I gotta tell ya, I started shakin’ like a dog shittin’ razor blades! Mike South had taken time away from opening the Christmas gift box he received from MikeSouth .com habitué Shelley Lubben to share his brand new and totally not appropriated wisdom with the world!

However, I was puzzled when a copy of a test result from a PASS-certified facility revealed the manufacturer of the APTIMA test to be listed as “Gen-Probe” not “Gentech.”

‘Well, maybe that’s a typo,’ I reckoned. ‘The adult industry must’ve got it wrong — I mean, Mike South, the man who won an AVN award for Best Amateur Porn Video in 1997 can’t be wrong! Right?”

I decided to try an figger this’un out! I was stunned, however, when a visit to the FDA website confirmed that Mr. Accuracy had gotten the name of the manufacturer wrong.

Proper Name:   Human Immunodeficiency Virus Type 1 (HIV-1 Nucleic Acid Testing/Synthetic)
Tradename:       APTIMA HIV-1 RNA Qualitative Assay
Manufacturer:   Gen-Probe, Inc

The test’s Package Insert (PDF format – 608KB) can be downloaded here.

Incidentally, page 15 discusses reactivity, and clearly shows that it has the single shortest window period of all HIV tests.

Okay, so Mike “Top Dog” South had made a typo — maybe he was having an allergic reaction to the pink lip gloss Lubben sent him. But what about the conclusions he lifted — err, excuse me — shared with jilted? Was it possible that every doctor associated with every PASS-certified lab was lying? Could it be that infectious disease expert Dr. Peter Miao knows less about HIV testing than an IT guy turned hillbilly bukkake shooter turned failed strip club manager and blogger?

Feelin’ a mite befuddled, I figgered I was a-needin’ to do little Google search about the accuracy of PCR testing (employing the “scholarly article” option, because compared to South’s site, TRPWL is a house of learned doctors), and selected a fully-cited review article from page one of the search results.

It was a-written by Mark Ringstrom of the Wisconsin Division of Public Health, and it reads in part:

PCR detection of HIV-1 nucleic acid in vivo is considered by many to be 100% sensitive, and is often used as the gold standard by which other testing methods are compared. [10] … And, as a perfunctory note, the difference in performance between RNA and DNA seeking assays seems to be minimal, with historical discrepancies in sensitivity and specificity long since resolved. [8]

The degree to which NAT [a Nucleic Acid Test] with PCR can narrow the pre-diagnostic window has been less well studied. Given the well-defined sensitivities described above, it is clear that the length of the pre-diagnostic window is simply a function of the rapidity with which a person becomes viremic. In his review of the natural history an acute HIV infection, Kahn estimates that initial viremia occurs as early as 3 days or as late as 11 days after infection [15].… Three other studies indicate that detection with PCR can shorten the pre diagnostic window period to 11 days. [1,6,9] Therefore, with the window of detection ranging anywhere from 3 to 11 days post infection, a significant improvement is realized over the antibody based tests previously described.

…HIV RNA is the “first and only detectable virus-specific marker for 1 to 5 days” subsequent to viremia… [28]

G-o-l-l-y!  So, in other words, from the published work of multiple doctors and scientists we know that:

1) Detection of HIV is indeed possible within 11 days after infection, because viremia (the presence of the virus in the bloodstream) occurs between 3 to 11 days after infection; and

2) RNA is the earliest detectable marker for the virus, and it can be detected for days earlier than any other marker.

A closer look at the data in the studies and articles cited, and other data available online, indicates that it’s generally accepted that extremely sensitive PCR testing is over 95% accurate at 10 days. (I won’t bore you with the reams of technical mumbo jumbo; instead I’ll provide, below, the full citations for every source cited supra. I have more should anyone need further convincing.)

For reference, allow me to note that:

The HIV+ performer was diagnosed on December 6, which was 15 days after the last at-risk interaction between that performer and any member of the talent pool, on November 21.

Re-testing of talent potentially exposed to HIV from the infected performer began December 7, which was 16 days after the HIV+ performer’s last at-risk interaction with another performer.

The moratorium was lifted on December 12, which is 21 days after the HIV+ performer’s last at-risk interaction with another performer.

Welcome back to work, friends.

20131207-123707.jpg

Footnotes cited in the article quoted above.

1. Aprili G, Gandini G, Piccoli P, et al. Detection of an early HIV-1 infection by HIV RNA testing in an italian blood donor during the preseroconversion window period. Transfusion. 2003;43:848-852. 

6. Busch MP, Satten GA. Time course of viremia and antibody seroconversion following human immunodeficiency virus exposure. Am J Med. 1997;102:117-24; discussion 125-6.

8. Cunningham CK, Charbonneau TT, Song K, et al. Comparison of human immunodeficiency virus 1 DNA polymerase chain reaction and qualitative and quantitative RNA polymerase chain reaction in human immunodeficiency virus 1-exposed infants. Pediatr Infect Dis J. 1999;18:30-35.

9. Dax EM, Arnott A. Advances in laboratory testing for HIV. Pathology. 2004;36:551-560.

10. Fiscus SA, Pilcher CD, Miller WC, et al. Rapid, real-time detection of acute HIV infection in patients in africa. J Infect Dis. 2007;195:416-424.  

16. Kinloch-de Loes S. Treatment of acute HIV-1 infection: Is it coming of age? J Infect Dis. 2006;194:721-724. 

28.  Weber B, Gurtler L, Thorstensson R, et al. Multicenter evaluation of a new automated fourth-generation human immunodeficiency virus screening assay with a sensitive antigen detection module and high specificity. J Clin Microbiol. 2002;40:1938-1946.

Some background on a few of the authors:

 

An FAQ about STIs, Testing and Moratoriums

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Michael Whiteacre
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Michael Whiteacre

Whoever is careless with the truth in small matters cannot be trusted with important matters. ~ Albert Einstein

ernestgreene
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ernestgreene

Or as my old city editor at The Rocky Mountain News used to say: “Accuracy is just truth writ small. If we can’t get somebody’s name right, why should the readers believe us when we tell them the mayor’s a crook?”

But then again, South, like certain other bloggers not worth mentioning, has no interest in truth or accuracy. Their interest lies in trying to sleaze their way into some better gig by ass-kissing AHF.

Good luck with that. Earth to loudmouths: AHF, crooked as they are and that’s plenty crooked, would’t touch the likes of you with a barge pole.

Lurkingreader
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Lurkingreader

It would seem you were unable to find anything that shows the APTIMA HIV-1 RNA Qualitative Assay could or would stop suppressed HIV from entering the performer pool. Care to debate accuracy in reporting or the truth of fine print? Care to debate informed consent and free choice of industry performers? Or how the industry hasn’t advocated an exemption to HIV discriminatory laws preventing them from EMPLOYMENT pre-screening for the performers they insist aren’t workers? Interested in how performers freely choose condom free without knowledge that testing doesn’t stop antibody positive virally suppressed HIV from entering talent pool, although it… Read more »

Michael Whiteacre
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Michael Whiteacre

Lurkingreader writes: “It would seem you were unable to find anything that shows the APTIMA HIV-1 RNA Qualitative Assay could or would stop suppressed HIV from entering the performer pool.” The issue of HIV suppressed with antivirals was not the subject of this post and has been covered in brief elsewhere on this site. See the comments to this post: http://therealpornwikileaks.com/leaked-mike-south-emails-reveal-man-built-rob-black/ In short, there is NO valid science behind that claim. Even former AHF consultant Tim Tritch has stated this many times. 1) There is no peer-reviewed scientific evidence to support the theory that a PCR test would ever fail… Read more »

Lurkingreader
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Lurkingreader

I suggest you speak with and look to the medical and scientific communities who created and designed the antiviral drugs that suppress HIV to non-detectable levels. For the proof …the studies that prove the ART is working and effective when it suppresses the viral level to the goal of non-detectable. When the approved facilities come out and verify the truth of your assertion that EVERY industry approved HIV 1 screening test is accompanied by the ELISA (antibody test) your claim will have merit. Until then show where these approved testing facilities demonstrate this policy beyond using ELISA as the FDA… Read more »

Michael Whiteacre
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Michael Whiteacre

HAHAHA! That’s not how it works. I challenged you to back up your assertion with facts and, being a know-nothing troll, you failed. Until and unless you provide any peer-reviewed scientific evidence to support the theory that a PCR test would ever fail to identify a patient who is on ARV meds, I have nothing more to say to you on this matter.

I don’t run off on errands to please anonymous trolling Mike South fans.

Lurkingreader
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Lurkingreader

Nope…you’d rather play a five year old name calling game than back up your assertion that the testing system you promote does what you say it does. Prove the ELISA is run with EVERY industry HIV1test and I’ll stop shouting from rooftops that this is ludicrous and defeats the purpose of the APTIMA HIV 1 test approved by the FDA as a diagnostic tool with secondary antibody testing required for diagnosis….nothing about additional tests for the screening purposes the industry chose this test for. Logic dictates that if the labs were running ELISA antibody testing in addition to the APTIMA… Read more »

Michael Whiteacre
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Michael Whiteacre

No, wrong again. There are different kinds of syphilis tests, just as there are different kinds of HIV tests, and the syphilis tests used by the adult industry are reportable tests that have been ordered by a doctor, not lab reference tests.

Hey, how’s the weather in Ohio, Nick East?

I don’t care where you shout from, ol’ buddy, but you won’t be shouting here. This ain’t LIB. Bye, bye…

Anthony Kennerson
Guest

Ummm…isn’t is standard procedure that Aptima is run along with Western Blot and ERISA as the standard for FSCPASS testing of HIV?? And, isn’t it standard procedure to use PCR testing such as Aptima as a follow up for when WB and ERISA tests prove inconclusive?? Funny, but every test I’ve seen on Twitter happens to contain ERISA and Aptima together….or maybe I’m seeing things?? Also….can our lurker come up with any case where someone whom has been tested negative using Aptima or any other PCR testing would later turn up positive using ERISA in the same latency period? If… Read more »

Michael Whiteacre
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Michael Whiteacre

Anthony, Western Blot, etc. are confirmatory tests used to confirm a preliminary HIV diagnosis. The only antibody tests result reported on PASS tests are for things like syphilis, not HIV.

“Lurkingreader,” formerly known as “Reader” in the previous comment thread I referenced, is our old buddy, bitter porn washout Nick East, now living in exile in Ohio.

Anthony Kennerson
Guest

Umm-hmmm. Thought so. And, thanks for the correction, Michael.

Anthony Kennerson
Guest

Also…wouldn’t logic show that those who have access to antiviral drugs that may reduce the load count of HIV below levels reportable by PCR testing (if that is indeed true) are those who have already been found to have had the virus? Otherwise, how in the hell would they know about being infected in order to access the antivirals in the first place?? That’s not quite the same as Aptima catching an acute infection right off the bat, now isn’t it?? If someone is already infected enough and taking antivirals, then they shouldn’t be shooting porn to begin with, condoms… Read more »

ernestgreene
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ernestgreene

I remember Nick quite well. I tossed him off an Adam&Eve set for which I’d hired him, reluctantly, to do a scene. He showed up with an expired test and whined that it was “only” one day out of date. Right. Great thinking there. I fired his ass on the spot. When I confronted him with this on HUFFPO, he pretended not to remember. Ad “liar” to his resume. And another item that belongs on there is his tireless work on behalf of Jim South et al back in 1993 when the first group of het performers and directors tried… Read more »

ernestgreene
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ernestgreene

There remains to be a single verified instance of anyone who is HIV+ and on ARV therapy testing negative on a PCR. Hasn’t happened and won’t happen. The test is hypersensitive and will pick up viral material in the bloodstream even if the viral load count (a completely different measure) drops through the floor. This is just the latest hogwash from the usual hogs. So, if there are all these HIV+ performers on ARVs barebacking all over the industry, why aren’t we all dead? To all those who insist that the testing system is a failure and protects no one… Read more »

Michael Whiteacre
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Michael Whiteacre

Precisely, their claim is not even internally consistent. If these performers on ARVs 1) are still able to infect others AND 2) can avoid detection via PCR testing, then why don’t we see a ton of new “acute” HIV cases? Their absurd hypothesis requires a passel of inexplicable new infections to hold water.

Fake Mike South
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Fake Mike South

Dagnabbit Whiteacre. I was busy at the 64th Annual South Family Jack Off Competition followed by some good ol’ dining at Zaxby’s. I placed 17th so I’m finer than frog hair split four ways. Why did yall have to go and post facts? Might could yall not make me look like a lost ball in high weeds? Now yall must pardon me, I’m fixin’ to go fetch some statements from my backers and make some things up to tell Crackhead Rob.

Michael Whiteacre
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Michael Whiteacre

Do ya mean “fetch” or “felch,” Mike?

And what in tarnation was Zaxby’s a-doin’ lettin’ your clan in their fine establishment? I reckon now they’re a-gonna have to sanitize the whole Zalad bar!

Fake Gene Ross
Guest
Fake Gene Ross

Fake Mike South, please stop advising Crackhead Rob. He is in arrears 2 months with his 40 Xanax payments to me for my site and I may have to repossess it. If that is how I proceed, I do not want the site’s integrity further damaged by your mentoring. If anyone is interested in a porn gossip blog, I will consider lump sum payments of a crate of Glenfiddich or an El Salvadorian teen, preferably male. As for all of this HIV clap jap, the testing is all bupkis. If you want an infallible option you should turn to the… Read more »

mharris127
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mharris127

Actually Rob comes across as a meth head to me but I guess opinions differ. How’s the margaritas now that work doesn’t get in the way of drinking them, Fake Gene?

Have fun, Michael and Sean. This sounds like a good thread to keep up on.

Fake Gene Ross
Guest
Fake Gene Ross

The Colon-Ritas have been sliding down my gullet with ease and high frequency. I was inspired to imbibe in Colon-Ritas after being solicited to adorn my former site with adverts touting a unique venture by the moniker of AssholeSmoothie.com. My interest was piqued and my throat was parched. I liberated my Aztec ingenue from his restraints and enlisted him to try his hand as a mixologist and a tumbler. He then squatted over me and expelled the Patron rich concoction, as my mouth was gaped in anticipation. The insolent twit refused my request for a second go round where Southern… Read more »

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