Serosorting is the name given to the act of selecting sexual partners and practices based on perceived HIV status before any other criteria. Serosorting is a term used most often by MSM and means choosing partners who one things are of the same HIV status as them.
Why do people serosort?
Some people serosort because they believe that having sex with someone who has the same HIV status will prevent new cases of HIV infection. Others engage in serosorting because they prefer unprotected sex, but don't want to put others at risk.
How can one be certain about a potential partner's HIV stats?
One can only be certain by having first-hand knowledge of another's HIV antibody test result. Moreover, serosorting may be problematic for those believing themselves to be HIV negative if they were recently infected because the window period that exists between the time of exposure to HIV and development of HIV antibodies. The HIV antibody test can be negative and the person might be in an acute infection stage, when viral transmission is more likely to occur. Testing during a window period may produce inaccurate results. Before serosorting, individuals who believe themselves to be HIV negative should consider any risky behaviors they may have engaged in since the time of their last HIV testing. Persons who are HIV negative, especially MSM, and are sexually active should be tested every six (6) months. Serosorting does not offer complete protection. If in doubt, wear a condom. This will also provide protection for other sexually transmitted infections (STI's).
Are there any health risks for HIV positive persons associated with serosorting?
If an HIV positive person engages in 'high risk' sexual activity such as anal sex without a condom when serosorting, there are risks of transmitting (giving) or acquiring (getting) a sexually transmitted infection such as rectal or penile syphilis, gonorrhea, herpes, Chlamydia or LGV (Lymphogranuloma Venereum). Other 'high risk' practices, such as fisting, may place one at greater risk of acquiring hepatitis A, B and C and enteric infections (e coli, Salmonella, etc.). There is also a risk of acquiring a second strain of HIV-1 after one strain has been established. This is often referred to as HIV 'reinfection' or 'superinfection'. Evidence has shown that reinfection also increases the chance of drug resistant HIV being transmitted.
Should a person living with HIV or AIDS be concerned about HIV superinfection?
Superinfection is a concern for two (2) reasons. First, it may be a way for someone with HIV or AIDS to acquire resistance to HIV treatment. Second, superinfection may lead to more rapid disease progression.
What we do know...
- Superinfection does happen. However, it is not clear how frequently is does occur and under what circumstances.
- Current clinical management of HIV disease does not include tools to identify superinfection. The cases that have been reported have been identified through research studies involving specialized laboratory procedures.
- Although superinfection could complicate antiretroviral therapy, and potentially drug resistant testing, the clinical implications for an individual are still unclear.
What if someone living with HIV wants to serosort with another HIV infected person, but only engages in unprotected oral sex, are there still risks of HIV superinfection in this situation?
As with other forms of risk or harm reduction, one may lower their risk of infection, in this case, HIV superinfection. However, risk reduction practices do just that, they reduce risks but do no eliminate them.
For more information on serosorting, safer sex and risk reduction...contact i3 at 651-9175.
This information was obtained from the New York State Department of Health...March 21st, 2007.