Many guys - positive and negative – try to reduce their risk for transmitting HIV by only having sex with other guys with the same HIV status – or guys they assume have the same status as them. This is called “serosorting.”

The idea is that if poz guys are only having sex with poz guys, and negative guys are only having sex with negative guys, then negative guys can’t get infected with HIV. So everything’s cool, right?

There are some things for both poz and negative guys to consider when serosorting:

 For HIV-negative guys:

You can’t be sure your partner is HIV-negative.

• He might not know his status: 30% of people with HIV don’t know it. He might have had unprotected sex since his last HIV test, or he might have been infected within the window period before his last HIV test (up to 12 weeks) and it didn’t come back positive. He might not understand how testing works, or assume he is HIV-negative because he has no symptoms or he gets blood work done frequently.
• He might not be telling the truth about his status, or about getting tested. Disclosure of HIV-positive status can be risky for a number of reasons, and difficult if you fear being rejected by the person you love, or are attracted to.
• In either case, serosorting with guys you think are negative might be riskier than having sex with a poz guy who knows his status. Research shows that the likelihood of HIV transmission is highest soon after someone is newly infected because their viral load tends to be high, and least likely when a poz guy has his HIV viral load controlled by treatment.

If you are going to have unprotected sex with other guys you think are HIV-negative, here are some strategies to consider:

• Get tested for HIV and other STIs on a regular basis.
• Talk to your partner about his HIV status, and don’t make assumptions. Don’t assume his status or sexual health hasn’t changed since you last discussed things with him.
• If you can’t have an open and honest conversation with your partner, or can’t be sure of his HIV status, consider what information you don’t know and whether you are comfortable with this risk.
• If you are a trans guy be aware you may be able to become pregnant.

 For HIV-positive guys:

It’s not just about HIV.

• Poz guys can be more vulnerable to getting other sexually transmitted infections, like syphilis and hepatitis C. STIs can be difficult to treat if you are HIV-positive. They can also progress much quicker and increase the amount of HIV in a poz guy’s semen and other parts of the body.
• Drug resistance is when HIV mutates so that specific HIV treatment drugs (or an entire class of drugs) become less effective. No one is sure to what extent practicing safer sex prevents drug resistance. Drug resistance in people living with HIV in the US and Canada has been reported to range from 5% to 20%.
• Some people have drug resistant strains of HIV right from day one, when they first became HIV-positive.
• Treatment experts focus on being as regular with a treatment routine as possible (called treatment adherence) as the primary way of lowering chances for drug resistance to happen.
• Dual infection -- you may have heard of this as superinfection, reinfection or co-infection, but they are not all quite the same-- refers to a person who becomes infected with a second strain of HIV. While there are cases of this, it is considered rare and not yet fully understood.

If you are going to have unprotected sex with other poz guys, here are some strategies to consider:

• Get tested for STIs and hepatitis C on a regular basis.
• Talk to your partner about his HIV status, and don’t make assumptions. Don’t assume their sexual health hasn’t changed since you last discussed things.
• If you can’t have an open and honest conversation with your partner, consider what information you don’t know and whether you are comfortable with this risk.
• If you are a trans guy be aware you may be able to become pregnant.

 Serosorting (or“Seroguessing”)

Sometimes serosorting is called ‘seroguessing’ because it’s often based on a guess about a person’s HIV status. Both HIV-negative guys and HIV-positive guys might assume the guy they’re having sex with has the same HIV status as them. These assumptions can be based on:

• Where the guy works or volunteers, such as an AIDS organization
• Where they met, such as a barebacking website
• What he mentions (or fails to mention) in an online profile, such as “always has safer sex”
• If he participates in community events or political actions related to HIV/AIDS
• What he might mention in passing, such as the name of medication, medical clinic, medical condition or health benefit

He might be making an assumption about your HIV status, too. He might assume you know his status based on a sign he has given (e.g. HIV medication on a table, always use a condom, etc.) That’s why it’s important to talk about it so you’re both on the same page.

Disclosure

When we think of HIV disclosure, some guys think it’s up to the poz guy to disclose his status to all sexual partners.

Disclosure doesn’t prevent HIV. Talking openly about HIV and our HIV status can help make our risk reduction strategies work better and that’s up to all of us, whether we’re poz, negative, or we don’t know our status.

Disclosing an HIV-positive status can be difficult, and can result in a loss of privacy, discrimination, and increasingly, criminal charges. In this kind of environment, relying on someone else to disclose his HIV status to you isn’t a reliable risk reduction strategy.

Since disclosure can be difficult, some guys try other ways of sending the message about their positive or negative status: putting on a condom (or not), leaving medication in plain view, or using other signals. These signs can be misinterpreted very easily, so don’t assume he got the message based on indirect actions instead of actually saying your status.

If you’re positive, but don’t feel comfortable telling him your status, you can try alternatives to disclosure, such as having sex that is low risk for passing on HIV, and using other risk reduction strategies outlined on this website. Keep in mind that risk reduction strategies will not always protect you against criminal charges for non-disclosure, because the law is currently being interpreted in different ways. To understand more about HIV non-disclosure and the law contact:

HIV/AIDS Legal Clinic of Ontario
or call 1-888-705-8889

Canadian HIV/AIDS Legal Network