At what point does a well-intended strategic safety practice become calculated discrimination? Does serosorting even hold currency in today’s sophisticated sexual landscape, and is what’s potentially replacing it any better? We sort through some of the blessings and pitfalls of what it means to make fucking decisions based on HIV status, and how that’s changing.
Even if you haven’t heard of serosorting, there’s a chance you might have done it, or are currently doing it. So what does ‘serosorting’ mean anyway?
For simplicity let’s say serosorting means choosing sexual partners on the basis of a common or shared HIV status:
- Poz guys only fucking other poz guys
- Neg guys only fucking other neg guys
A popular reference for slang, Urban Dictionary makes an important distinction in a definition from 2009 as “seeking sex with only other persons of your serostatus so that you do not have to use protection. serostatus also known as HIV status.” Notably, the author of this post offers a tip that “sero sorting is not effective at preventing HIV transmission.” We’ll unpack that bit later on.
In the meantime, let’s be honest. This is not about holding hands. This is largely about condomless, raw, bareback sex!
Why and when did this come about?
By the time 1998 rolled around, some poz guys were either pretty pissed off about stigma because of their HIV status, or were apprehensive about having to disclose it for each and every hook up – as was the law for some states and territories at the time. Some of those laws still apply today.
Back then, access to early treatment wasn’t as typical as it is now, and it wasn’t known that Undetectable = Untransmittable. It’s also conceivable that poz guys believed they were dangerous to HIV negative guys and didn’t want to pass the virus on to them.
As a result, a lot of poz guys found it less of a hassle to stick with just fucking each other, and excluded anyone with a different HIV status. And that meant choosing to not fuck neg guys — especially bareback.
“…being propositioned for raw sex might be confronting.”
If we jump ahead to 2006, what we know today (that having an undetectable viral load means it’s not possible to sexually transmit HIV) wasn’t common knowledge. After 25 years of being afraid, neg guys who didn’t know any different were found to be strategically limiting their choices to other guys who also said they were HIV negative.
And herein lies our first problem with serosorting…
Does serosorting work as a strategy to prevent HIV?
Short answer: Not really
Full answer: The pitfall of neg/neg serosorting is that you have to absolutely know you’re both HIV negative. Even if you and your hook up just swaggered out of a rapid test clinic together, sorry, but you still can’t be totally sure that you are indeed both HIV negative – any possible exposure to HIV within the test’s window period might not show up in the results. A window period is the time between when someone acquires HIV and when it will show up on a test. While most cases are picked up within a four week window period, some may require up to 12 weeks to show in test results.
This is why serosorting has sometimes been called ‘seroguessing’. And guess what? If you’re fucking without any form of protection against HIV, you cannot be sure of your status since your last test.
Now if somehow you are absolutely convinced you’re both HIV negative… well, Top to Bottom says it best: “In theory, if two HIV-negative guys fuck without condoms then there is zero risk of transmitting or contracting HIV.” The key here is being absolutely sure you’re both HIV negative.
Is serosorting really that bad?
Serosorting as a strategy for neg guys is fundamentally flawed, but there’s still one thing worse: not using any HIV prevention strategy at all!
Even science says so. One study appearing on NAM aidsmap reported exactly this. It also mentions that serosorting is way less effective than 100% condom usage, monogamy, topping only, or ‘strategic positioning’ (which means limiting sexual activity to only bottoming for neg guys, or neg guys only topping when fucking poz guys).
“using any form of protection is better than not using any at all.”
That article was published back in 2012, and with today’s more common use of biomedical HIV prevention strategies regardless of HIV status, things get more interesting. For starters, all of the strategies considered more effective than serosorting are themselves less effective than poz guys maintaining an undetectable viral load (which prevents onward transmission), and neg guys using PrEP to protect themselves.
But besides it being a flawed HIV prevention strategy, there’s one other issue with serosorting we need to talk about: ‘serodiscrimination’
Is it OK to discriminate?
Short answer: Good intentions may have unintended consequences, and just because a lot of people do it doesn’t make it right.
Full answer: Nobody is obliged to fuck anybody else, and everybody has a right to make their own decisions about who they don’t or do sleep with for whatever reasons — with consent, of course!
While consciously choosing to reject a root on the sole criteria of their HIV status seems as if it could offer some form of comfort, security and safety — which applies to both poz and neg guys here — it’s not without social repercussions that enables sexual exclusion, creates segregation and reinforces stigma.
Swiping left on some hottie’s profile specifically because of his HIV status — whatever that may be — is limiting your choices for friendship, romance, or just a damn good fuck. Ultimately, how you make decisions is your prerogative. But perhaps it’s worth noticing and considering what criteria you’re using to do so, and whether his HIV status plays a part.
Besides, these days, somebody else’s HIV status isn’t as important to a lot of us as it used to be. However, new ways of selectively excluding each other might be creeping in instead.
What’s happening now?
Our knowledge of HIV prevention and the language we use for it is shifting. [+U] as a symbol for undetectable guys has arrived all over the apps and ‘Negative on PrEP’ is boldly proclaimed on many profiles too. That doesn’t necessarily mean everyone in either of these groups doesn’t use condoms… but it does seem as if the way some of us are hunting for dick and ass might be less focussed on HIV status, and more concerned with what kind of safety practices we have in common: ‘strategy-sorting’
Maybe you use biomedical options — that goes for poz guys taking treatment and neg guys using PrEP. Maybe you only use condoms whatever your HIV status. And maybe you mix it up using whatever works for you and the people you’re with at the time. Any and all of these options are great for managing your sexual health and significantly reducing your chance of transmitting or acquiring HIV.
Let’s consider it from the perspective of someone who’s comfortable with bareback sex, regardless of their HIV status. Some guys who primarily use biomedical strategies may find it a lot more desirable to stick with just fucking each other. And that could mean choosing to not fuck guys who prefer using condoms.
It’s the same the other way too: for someone who only uses condoms, being propositioned for raw sex might be confronting. And that could mean choosing to only seek out and fuck other guys who also prefer condoms.
“If you don’t want to use condoms, remember that some guys still do.”
These respective strategies are convenient for both parties based on desire and risk calculation. Serosorting between poz guys was observed more than a decade ago, and the totally natural desire to fuck raw without judgement was a strong pleasure driven catalyst for it. If this is all just a little bit of history repeating, let’s learn from our past to influence our future.
If you don’t want to use condoms, remember that some guys still do. And that’s OK. You don’t have to fuck each other if you don’t want to.
If you really have a strong desire to use condoms, remember some guys don’t. And that’s OK too. You don’t have to fuck each other either.
Sometimes when other people do things differently to the way you do, it can be tempting to perceive their way as less valid than yours, or even just plain wrong. So if you do find yourself in one of these situations, recognise you’ve both got a lot in common: You’re both making your best effort to protect yourselves in ways that work for you. Know the facts and be kind to each other. And remember — using any form of protection is better than not using any at all.