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Serosorting: HIV prevention tool, or just plain discrimination? #HIV #AIDS

Serosorting: HIV prevention tool, or just plain discrimination? #HIV #AIDS

I’ve gone off the rails on this subject before, and apparently it’s time to do it again.  I know this article won’t show up anywhere else.


Here’s your big word for the day, kids: serosorting, the process by a which a person restricts unprotected anal sex to partners known to be HIV negative.  You see, boys: when you put it in your profile “DD free, HIV negative-you be too” etc., etc that’s called serosorting.

It’s being touted as an HIV prevention tool too, albeit a semi-effective one:

An meta-analysis of HIV-negative gay men’s sexual behaviour and HIV incidence rate in four HIV prevention studies, presented earlier this month at the 19th Conference on Retroviruses and Opportunistic Infections (CROI), has found that attempting to ‘serosort’ by restricting unprotected sex to partners known to be HIV negative does have efficacy as an HIV prevention strategy, when compared with using no strategy at all.

Now, here comes the bit that makes my head hurt.  You ready? (from the same piece, and bolding mine…)

Serosorting is, however, considerably less effective in reducing the chances of acquiring HIV than four other strategies: 100% condom use, monogamy, only having insertive sex, or ‘seropositioning’ (only taking the bottom role with partners known not to have HIV and being top with partners of positive or unknown status). Interestingly, 100% condom use was the least effective of these other four strategies.

‘Seroadaptive’ behaviours include any method of attempting to reduce the risk of HIV acquisition or transmission by altering one’s sexual behaviour according to the HIV status of partners. The term ‘serosorting’ has been used in various different ways. Most commonly, it means restricting unprotected anal sex to partners known to have the same HIV status as yourself. When unprotected sex between HIV-negative men is confined to a primary relationship, with condoms used in all other encounters, this has been called ‘negotiated safety’.

While some studies have found serosorting in HIV-negative men to be effective, others have not. Attempted serosorting by HIV-negative people has an inherent drawback that serosorting by HIV-positive people lacks: people can only be certain of their status up to the first time they risk exposure to HIV after their last negative HIV test. Research indicates that a large minority of people in high-risk communities who assume they are HIV negative in fact have HIV, and that a large proportion of men who ‘know’ their partner’s HIV status have, in fact, tried to guess it.

Go on, grab the Advil.  I’ll wait right here….


Now, let’s have the simple version of all of that.  Here’s the pillow talk version of all of the possible variations of this:

  • “You’re HIV positive, not interested sorry.  You’re really hot and all, but I can’t go there..”
  • “OK, we know you’re negative and I’m positive, so I’ll bottom for you..”
  • “OK, we know you’re positive and I’m negative, so you bottom..”
  • “You’re positive?  Hey!  Me too!  No need for condoms then..”

I’ve long since been an advocate for having conversations in and around your sex life, but this all just gives me a screamer of a headache.  The part that totally gets my knickers in a knot is those who’ll say that any guy is fair game in their sex lives – unless of course he’s positive.  Then forget that; over the side of the boat he goes.

Um, ok.  I’m a healthy gay male just like the rest of you, but how about NOT sleeping with someone because the two of you aren’t attracted to each other?  Hmmm?  Why is being positive an automatic disqualifier?

My partner Richard was HIV positive and we had an extraordinary sex life, and that included playing well with others.  A lot.  You know how we did that?  We put on a fucking condom!  Please don’t give me the “it’s too tight”, “they don’t fit”, “they’re uncomfortable” because you know what?  I’m 6’6″ and have size 13 feet (you boys know what that means…)  I promise you I’m packing way more than you are and I can get them to fit every single time.

We played with positive guys, and negative guys.  You know the guys we didn’t play with?  A/Those that we weren’t attracted to, and B/Those that didn’t verifiably know their status.  I still play with three of the guys to this day, (who are all in the same relationship) and yes, as I’ve admitted before, they are the only ones I play bare with.  You know why we do that?  I’ve known them for 13 years, I’m the ONLY one outside of their relationship they play with and we always, always get tested together.  We guard our serostatus with military precision and we’ve all stayed negative.

Here’s a little test for you.  It’s a bit in-your-face for those that unapologetically say that they won’t sleep with an HIV positive guy solely because of his status.  Meet Jack Mackenroth, a pretty public persona and a wickedly funny guy on Twitter.


If he came up to you in the bar, made it real clear that he’s totally into you and wants to go to your place to have wild, passionate, monkey sex – would you?

I sure as hell would, and I know a ton of guys that would too.

While you’re making out and getting ready to do the deed, he tells you that he’s negative, would you take him at his word?

Jack is HIV positive, and he’s been that way for 20+ years

So, apply that to your logic the next time you give someone the cold shoulder because he’s HIV positive.  And now, my rant is over.


(NOTE:  my above little “test” is nothing more than a hypothetical question.  I do not know Jack personally, and can speak to no facts about his sex life.  I use him solely as an example that appearances aren’t quite what they seem, and dumping a guy solely on his HIV status is to me nothing more than veiled discrimination)


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