orting, which is choosing sexual partners based on a discussion of one’s HIV-status, and seropositioning, which is choosing sexual roles and activities based on one’s HIV-status. These community-driven strategies to prevent HIV fall under the umbrella term seroadaptation.
How Could Serosorting and Seropositioning Lessen One’s Risk Of Contracting HIV?
Gay men have been reporting for years that they are choosing their sexual partners and sexual practices based on their knowledge of their partners’ HIV status. Studies conducted primarily among men who have sex with men (MSM) in the United States suggest that both HIV infected and uninfected men try to reduce HIV transmission risk by learning their partners’ HIV status and choosing to have certain types of sex based on that information.
What Does the Term Serosorting Mean?
Some HIV infected people are choosing to date, develop relationships, and have sex only with others who are also HIV infected. The choice of sex partner based on disclosed HIV status has been referred to as “serosorting.” This may reduce anxiety about possible condom failure and offer a greater sense of support when dating others who can understand firsthand the experience of living with HIV. While serosorting among HIV infected individuals may reduce the likelihood of HIV transmission to those who aren’t infected, there are other important issues to consider if condoms are not used. These include the risk of STIs and reinfection. Serosorting among HIV uninfected persons has also been reported. See: Learn more about reinfection.
What Does the Term Seropositioning Mean?
Seropositioning has been used to describe the choosing of certain sexual behaviors and sexual positions based on someone’s HIV status and the status of their partner. This means that partners, once they disclose their HIV status to one other, may consider the perceived risk from some type of sex, for example engaging in anal sex, and whether to use a condom or not. Two HIV negative people might choose to not use a condom if they believe that risk of HIV transmission is not possible. Two HIV positive might make a similar decision, thinking that since they are both already infected, the use of a barrier is not necessary.
There are data suggesting that HIV negative serosorting, but not seropositioning, may provide modest protection from HIV. It is important to stress that for serosorting to be effective, it requires accurate knowledge of HIV status and high levels of status disclosure to sexual partners. However, recent studies in the US show that one in five individuals who are HIV infected don’t know that they are, and this number is likely higher in settings or in specific populations where HIV testing is less common.