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Serosorting does help prevent HIV – up to a point
Gus Cairns, 2012-03-19 16:40:00
An meta-analysis of HIV-negative gay men’s sexual behaviour and HIV incidence rate in four HIV prevention studies, presented aerlier 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 having none at all.
Serosorting is, however, considerably less effective in reducing the chances of having HIV compared to other strategies such as 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).
‘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 use 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.
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