There are a few options.
http://www.verotel.com/ has a Ticketsclub membership system which takes normal Visa/MC and carries no high-risk merchant fee. Your total charges must be below some cap which is somewhat generous for a small site. Webmasters that promote sites often do not like Verotel or the affiliate program that Verotel includes.
http://www.ccbill.com/ would handle credit card processing, membership and I believe recently hard-goods. They do pass through and mark up the Visa High Risk application fee which I believe is now $1000 per year. Sites go through an approval process, must have a 'full site' prior to review and at last check, it took a few days to get approval on a new site. Webmasters that advertise as affiliates generally like to promote CCBill powered sites because they don't need to hit a minimum to get paid if they only get one signup - their payment is combined with the other affiliate payments. That being said, the affiliate management side of CCBill leaves a little to be desired.
http://www.ccbtools.com/ has written a front-end that integrates very nicely with CCBill powered sites.
http://www.paycom.com/ is an alternate processor that also handles affiliate payments and has a 'hosted' version of MPA3 that keeps track of affiliates and stats. Paycom is probably the second preferred processor for affiliate payments.
If you're going to run anything with adult, getting around the T&C and hoping you don't get caught is probably going to leave you in the same situation, perhaps with money stuck for months with the processing bank.
With that said, if you do opt to get your own merchant account to handle hard goods, pay per view, etc,
http://www.netbilling.com/, Mitch Farber, can work with you and help you get a high risk merchant account. They also offer call-center/customer service for a fee so that you don't need to worry about that. I do not believe they handle payouts which means you need to look at MPA or Nats to integrate and handle affiliate payments.