Born Nicholas Anthony Iacona Jr., Stefano grew up in Chester, Pennsylvania. His father, Nicholas, Sr., was a union painter who died of colon cancer when Stefano was 15. After the death of his father, Stefano began using drugs and was eventually sent to rehab for six months. After rehab, he tried to become a model and built a portfolio. In 1989, he met a gay porn actor named Tony Davis who helped him enter into the gay adult film industry. Stefano's adult film career took off after meeting Chi Chi LaRue during a trip to Los Angeles. Stefano's looks were well received and his persona as a "hungry bottom" contributed to his popularity. His image and success caught the attention of Madonna, who used him as a model in her 1992 book Sex. While he was a popular performer, Stefano's family had no idea he was gay nor were they aware that he was performing in adult films. According to Stefano's older sister Linda, he told the family that he was a male model. She later found out about his real occupation but did not inform their mother. During his lifetime, he was the subject of rumors regarding his relationships with prominent entertainment industry figures who were known to be gay. At a May 1990 dinner and interview with Jess Cagle and Rick X, Stefano discussed an alleged series of "dates" with David Geffen, who at one point implored Stefano to quit using drugs. After the videotaped interview appeared on Rick X's show, OutWeek Magazine "outed" Geffen, who went on to announce his homosexuality at an AIDS fundraiser. Stefano danced at the Gaiety Theatre, New York in the late 1980s and early 1990s. He was one of the more famous Gaiety dancers, having been featured in Madonna's Sex book in 1992, as well as having a biography written about him by Charles Isherwood, Wonder Bread and Ecstasy, that touches on his life as an erotic dancer at the Gaiety. Over the course of his five-year career, Stefano appeared in 58 gay adult films, and two music videos with Madonna. Despite his success, Stefano did not save his earnings and relapsed into drug and alcohol abuse. In 1990, he was diagnosed HIV positive.
In 1996, Stefano's life was chronicled in the book, Wonder Bread and Ecstasy: The Life and Death of Joey Stefano by Charles Isherwood. His life is also the subject of a one-man-play, Homme Fatale: The Fast Life and Slow Death of Joey Stefano, by Australian playwright Barry Lowe. Director Chad Darnell has been working on a film based on Stefano's life. The film has been in development since 2010 and is tentatively titled X-Rated. A second biography of the actor, Joey Stefano: The Life, Loves & Legacy of the Prince of Passion by British celebrity biographerDavid Bret was published in 2015.
