Many HIV poz gay men still do not know what serosorting is about. There are also quite a few HIV+ gay men, and others, who are just as quick to make condemnations about serosorting, including judgments against those who promote and advocate serosorting. An prime example of that ignorance surfaced recently on a HIV men and women’s Yahoo group when someone posted a reply to a comment promoting an established social network dedicated to serosorting: ““…can’t something be done about this blatant porn site promotion? its is bad enough that it is pushing the bareback sex parties but now it is soliciting others to go to another site.”
Another member of that Yahoo group, whom I will refer to as Mr. Right, replied back to his comment: “I don't know. It’s up to the moderator. Freedom of speech and choice. If you don't like what you see then don't look. Everyone is not at the same place as you. But it’s there for whoever wants it. Don't read it. Take what u can use. And leave the rest. That's just my point of view. Are there any others?”
I totally agree with Mr. Right’s point of view. I’ll also add to that; the network being promoted is not a blatant porn site. Consensual barebacking with others of the same HIV status is an individual’s personal right. Everyone is entitled to have opinions and their rights to have opinions should be respected, but sometimes people should think before they post. Some reading that original post could easily make assumptions and judgments about poz gay men, fueling homophobia. I don’t believe that was the intent of the poster though. We already have enough to deal with as it is, living with HIV, AND dealing with discrimination prejudice for also being gay. And don’t push your morals and standards on the rest of us either.
Let us not confuse serosorting as “bug chasing or gift giving” – that is something entirely different. Serosorting is not promoting and advocating that one! I thought I better state this because there are some out there who will say jump onto that platform! Anyway…..
Robert Brandon Sandor is the Founder of POZ Global Connections, a social network on NING. In the February March 2007 issue of POZ MAGAZINE, from an article written by Lucile Scott,
“In the late ’90s, having lived with HIV for more than a decade, Robert Brandon Sandor found himself, thanks to the protease revolution, suddenly looking at a longer life expectancy-—and looking for love. Like many other HIV positive men, Sandor prefers to date and have sex only with positive men, both because he wants emotional support from someone who understands the strain of life with HIV and because he desires to once again engage in unprotected sex. However, short of wearing a T-shirt proclaiming his HIV status and romantic inclinations, he had few ways of locating other positive partners at the time. “There were no HIV-positive-only sex parties, socials, dating services or online hookup sites,” he says. So in April 1999, the resourceful Sandor placed an ad in NYC’s free gay magazine HX for a sex party he organized, called POZ Club—NYC (unaffiliated with this magazine). It was one of the first publicly advertised positive-only parties in the country. Sandor soon branded the monthly soiree Brandon’s POZ Party and took it digital, helping more men find the party’s dates and locations and letting them meet via an Internet message board.” (To READ THE FULL ARTICLE go to http://www.poz.com/articles/1941_11110.shtml)
Recently I solicited Robert for his help in writing this article to clear up the confusion and myths about serosorting. I appreciate and wish to thank him submitting the first part of this article. I have also included a bit more to give this article an unbiased balance. I also wish to thank Robert for his time, efforts and energy in doing what he does so well. I am certain many HIV poz and HIV neg gay men no longer feel isolated because of his endeavors.
Serosorting and SAFE SEX Serosorting Explained
By Robert Brandon Sandor
When you woke up this morning, you went along with your daily routine. IF you were asked this question: How many forms of HIV prevention are there? YOU would have said: Only two, abstinence and safe sex. This morning, your answer was correct. However, NOW you will know of a third; Serosorting.
Since the mid 1990's, SEROSORTING and Safe Sex Serosorting have PHYSICALLY broken the cycle of new HIV transmissions, and make safe sex SAFER.
Regardless if you are HIV+ or HIV-, man or woman, young or old and regardless of your race, income level, occupation or social status... mankind will be required to address the SEROSORTING issue. The inconvenient truth about SEROSORTING is that it BREAKS THE CYCLE of new HIV transmissions, and makes safe sex safer. For the past decade, this fact has NOT been proven wrong.
How serious are YOU about stopping HIV / AIDS? IF we want to stop the spread of HIV, we must break the cycle of transmissions. 30 years of data and other supporting evidence have proven to us that the current HIV prevention and harm reduction strategies have failed. Therefore, we should strongly consider breaking the cycle of new transmissions.
* What is SEROSORTING?
Serosorting is having sex with your own HIV status. Examples are: HIV+ people having sex with other HIV+ people, and HIV- people having sex with other HIV- people. Therefore, it is a physical impossibility to transmit new HIV when people Serosort because SEROSORTING PHYSICALLY BREAKS THE CYCLE OF NEW HIV TRANSMISSIONS.
* Who can SEROSORT?
Anyone can have sex, but only those who KNOW their HIV status and are SERIOUS about stopping the spread of HIV can Serosort. So, only HIV+ and HIV- people can serosort. This has led to the substantial increase in HIV testing and status disclosure across the nation in recent years.
* How can a person SEROSORT?
People can Serosort by doing the following:
1) Get an HIV test and knowing their HIV status.
2) Understanding and accepting the responsibility of being HIV+ or HIV-.
3) Disclosing their HIV status to others PRIOR to having sex.
4) Having sex with those of the same HIV status.
* Why should anyone SEROSORT?
To finally stop the spread of NEW HIV transmissions once and for all, and to finally put an end HIV / AIDS.
* What are the limitations to SEROSORTING?
There are NO limitations of serosorting. ANYONE can serosort regardless of: race, age, gender, sexual orientation, income level, political or religious affiliations, geographical region or language. SEROSORTING DOES NOT DESCRIMINATE. Therefore, serosorting has become the most common method to prevent the spread of new HIV transmission in recent years.
* What are the 3 ways to SEROSORT?
The three ways to serosort are:
1) When HIV- people have safe sex with other HIV- people, NO HIV- person gets infected with HIV.
2) When HIV+ people have safe sex with other HIV+ people, NO HIV- person gets infected with HIV. And ...
3) When HIV+ people have bareback sex (sex without condoms) with other HIV+ people, NO HIV- person gets infected with HIV.
(When people of the same HIV status have safe sex, this is called SAFE SEX SEROSORTING.)
Therefore, Serosorting is another form of HIV Prevention and Harm Reduction, and only for those who are serious about stopping the spread of HIV. When people serosort, it is a physical impossibility to transmit NEW HIV to HIV- people.
This HIV prevention and harm reduction strategy is very successful for those who can not afford very expensive health care, HIV related medications and LONG TERM HIV care. The billions of Dollars / Euros SAVED could be applied to FOOD, HOUSING, NEW JOB OPPORTUNITIES, and overall SOCIAL EMPOWERMENT.
* What does SEROSORTING PROMOTE?
This is truly the MOST EXCITING period in HIV prevention! Serosorting promotes many things that the HIV "experts" and "professionals" have not yet realized, and it will be up to the researchers to document them. A short list is:
1) Regular HIV testing for HIV- people,
2) Encourages those who are not tested, to get tested,
3) Communication between potential sex partners about HIV and other STD's,
4) HIV / STD and sexual health awareness,
5) Lowers the stigma of HIV, HIV testing and sexual health issues,
6) Safe sex,
7) Harm Reduction,
8 ) Psychological EMPOWERMENT
9) Economic GROWTH
10) RESPECT - HIV+ people (gay and straight) respecting the rights of HIV-negative people to stay HIV-negative, AND HIV-negative people respecting HIV+ people for helping to make this possible.
A question would have to be answered: WHERE is the Safe Sex Serosorting research data?
Thus, to PROMOTE Serosorting and Safe Sex Serosorting as options of HIV Prevention and Harm Reduction; INCREASES public awareness, sexual safety, HIV / STD prevention and COMMUNICATION between potentional sex partners (gay, bisexual, straight). To promote Serosorting and Safe Sex Serosorting is to promote a new STD communication strategy for the 21st. Century.
The sooner we stop NEW HIV transmissions, the sooner we can move forward in helping each other globally. Rising fuel costs for transporting food and medical supplies are hurting EVERYONE. Therefore, mankind would need to decide, once and for all - Do we REALY want to stop the spread of HIV, Yes or No?
Serosorting vs. The Current HIV Prevention Strategies:
SEROSORTING CURRENT HIV PREVENTION STRATEGY
Condoms used YES YES
HIV Testing required YES YES
Status Disclosure YES YES
Condoms NOT used* YES NO
BREAKS THE CYCLE of transmission YES NO
* HIV+ men can have safe sex (Safe Sex Serosorting) or unsafe sex (Serosorting) and STILL will not infect an HIV- person. HIV- people can only have safe sex (Safe Sex Serosorting only).
Therefore, Serosorting (and Safe Sex Serosorting) is the application of the current HIV prevention strategy, and taking it one step further: MY HIV Prevention Strategies (SEROSORTING and SAFE SEX SEROSORTING) PHYSICALLY BREAK THE CYCLE OF TRANSMISSION.
EVERY doctor, researcher, specialist or scientist will agree with this fact - When we PHYSICALLY BREAK THE CYCLE of transmission of any disease, plague or virus, we stop transmission - GUARANTEED.
To PHYSICALLY BREAK THE CYCLE OF HIV transmission, is to cease the transmission of the HIV Virus from an HIV+ person to an HIV- negative person. Period.
This is done through Serosorting and Safe Sex Serosorting.
The Oxford Thesaurus defines BREAK as: Break apart, Fracture, Split, Debilitate, Discontinue, Interrupt, Sever, Divide, Separate, Discintegrate, Discontinue, Stop, Cease, Detach, Disband, Disperse, Breach and Rift. Among others.
Therefore, through Serosorting and Safe Sex Serosorting we are finally able to PHYSICALLY BREAK THE CYCLE OF NEW HIV TRANSMISSIONS and stop the spread of HIV once and for all - GUARANTEED.
Respectfully
Robert Brandon Sandor
Question posted on thebody.com
http://www.thebody.com/Forums/AIDS/SafeSex/Current/Q202412.html
Dr. Bob, Can you explain about serosorting and whether or not it's a good idea? Peter
Response From Dr. Bob Frascino
Hi Peter,
Serosorting involves choosing to have sex only with partners who share your HIV status. It was initially criticized as a type of "viral apartheid." However, over recent years it has become more accepted and even encouraged by some safer-sex advocates and organizations. Online hookup sites can facilitate serosorting by allowing those hunting for sex to disclose their status ("I'm poz, UB2"). This certainly lessens potential disclosure trauma or rejection due to serostatus. What worries me is that many folks don't realize that serosorting is far from foolproof. Obviously some desperate and dishonest folks will outright lie. Others are misinformed, perhaps thinking their "undetectable" viral load means they are HIV negative. Some folks make false assumptions about their status. They've never really been tested but assume they are negative (or positive!) Also, one out of every five HIV-positive Americans has absolutely no idea he is infected with the virus! Finally I worry about the ever dreaded "window period!" HIV-infected folks in the window period are highly infectious but do not yet test positive. Also, I should point out serosorters often think that by serosorting they can forego the use of condoms. However, HIV is certainly not the only illness transmitted by unprotected hoochie-coochie! Gonorrhea, syphilis, chlamydia, genital warts and a whole host of other nasties are out there just waiting for their chance to make your life miserable. STDs can also cause a rise in HIV plasma viral load and drop in CD4 cells. And so if someone wants to serosort, fine, so long as they realize its limitations!
Discussion posted on http://www.medscape.com/viewarticle/584616_4
HIV Serosorting in Men Who Have Sex With Men: Is It Safe?
Using sexual history data collected during more than 10,000 visits by MSM to our STD clinic over more than a 6-year period, we evaluated the prevalence of serosorting, trends in its occurrence, and the protective efficacy of the practice. We found that our MSM patients acknowledged a behavior consistent with serosorting during more than a quarter of all clinical encounters; that the practice was increasing, particularly among HIV-infected MSM; that serosorting was associated with a lower risk of testing HIV positive than nonconcordant UAI, but a higher risk than universal condom use; that serosorting was associated with no decrease in the risk for bacterial STD; and that the protective efficacy of serosorting may be declining.
Our findings related to the protective efficacy of serosorting are consistent with previously published and presented findings. Two cohort studies of MSM have found that UAI with partners believed to be HIV negative was an independent risk factor for acquiring HIV. Similarly, a case-control study conducted in Seattle found that MSM who recently acquired HIV were more likely than MSM who tested HIV negative to report having UAI with a causal partner they believed to be HIV uninfected. All 3 of these studies suggest that HIV-uninfected men who serosort remain at risk for HIV. The Seattle case-control study did not observe an association between testing HIV negative and participants' report that they had decided not to have sex with partners because those partners were HIV positive, a direct measure of men's decision to serosort that we have used in a previous study. This finding casts some doubt on the protective efficacy of serosorting when it is adopted by HIV-uninfected men as a conscious effort to diminish HIV risk. Overall, our findings support the conclusion that serosorting offers partial protection from HIV; it is better than having nonconcordant UAI, but not as good as universal condom use.
However, that conclusion should be tempered by the realization that our approach to classifying serosorters was based on whether men had nonconcordant UAI and not whether they made a purposeful decision to serosort. Also, from both a personal and a public health perspective, the limits of serosorting seem to be profound. The practice appeared to reduce the risk of acquiring HIV by <50% compared with having sex with partners of unknown or discordant HIV status, and 32% of all MSM with newly diagnosed HIV reported that UAI with a partner they believed to be HIV negative was their most risky sexual behavior. This finding suggests that the population-attributable risk associated with serosorting may be high.
We also observed that the proportion of HIV-infected men who could be classified as serosorters is increasing, though this trend seemed to primarily affect HIV-infected MSM. This finding is consistent with observations from London, where researchers have observed an increase in serosorting among HIV-positive men, but not HIV-negative men. In contrast, public health officials in San Francisco and Sydney have reported findings they believe to be consistent with a trend toward increased serosorting among HIV-uninfected MSM. We cannot say the extent to which differences observed in these studies reflect true variations in behavior versus differences in how the studies recruited their populations or defined serosorting. Serosorting among HIV-infected men may place them at risk for HIV superinfection and, as shown by our study, does not protect them from bacterial STD. On the other hand, serosorting among HIV-infected MSM does not pose the same risk for inadvertent HIV transmission as serosorting among HIV-uninfected men. Insofar as the trends we observed also included a decline in nonconcordant UAI among HIV-infected MSM, one could speculate that the rise in serosorting among HIV-infected MSM decreased HIV transmission and increased the protective efficacy of serosorting for HIV-uninfected MSM. Unfortunately, we found that the risk of acquiring HIV among HIV-uninfected serosorters may be increasing.
The fact that serosorting seems to have become more risky for HIV-uninfected MSM is surprising and concerning. In a separate study, we recently found that the period between HIV tests among MSM testing HIV positive in STD clinics in Seattle and 3 other US cities declined between 2001 and 2006. Like the decline in nonconcordant UAI we observed in this study, one would think that such a change would make serosorting safer for HIV-uninfected MSM; the period during which men are unknowingly infected should decrease and, with it, the risk of inadvertently transmitting HIV to partner should be reduced. These disparate trends merit additional study and highlight the complexity of trying to understand HIV transmission trends based on limited information about behavioral risks. Although we believe our findings merit confirmation, from a practical perspective, the observation that the protective efficacy of serosorting may be declining should prompt additional caution related to serosorting.
Our study population was comprised of clinical evaluations of MSM who sought care at a single STD clinic in Seattle, WA. The self-selected nature of this sample, the geographical focus of the population, and the need to exclude some visits from the analysis because of missing data all may limit the generalizability of our findings. Also, we did not have data on patients' number of sex partners of different HIV status or number of sex acts with partners of each HIV status, information that would have permitted us to conduct a more detailed analysis. We did not routinely collect data on how patients knew a partner's HIV status, and some infections we attribute to serosorting failure may reflect patient's assumptions about partners' HIV status rather than inaccurate explicit discussions between men before sex. As in other studies of sexual behavior, our data are based on self-report, which may be inaccurate. Finally, as in most previous studies, we defined serosorting based on patients' reports of their partners' HIV status and their condom use. In many instances, decisions to have sex or use condoms with partners were probably not based on an active decision to serosort; people form sexual partnerships based on myriad factors (age, race, socioeconomic status, social connections, emotional bonds, etc.), many of which may affect the likelihood that their partner is HIV infected or wants to use condoms. These factors could affect whether we classified a person as a serosorter and might be independent of whether that person made a conscious decision to serosort. As a result, our analysis may not accurately represent the true prevention efficacy of serosorting as an active prevention strategy.
In summary, we found that serosorting is common and that it seems to be increasing among HIV-infected MSM. It offers some protection against HIV, but a large proportion of persons with newly diagnosed HIV report UAI with partners they believe to be HIV uninfected as their highest risk sexual behavior. We also observed what may be a decline in the protective efficacy of serosorting over time. Whether trying to increase serosorting is a good idea depends on what behavior it replaces. To the extent that men adopted it as an alternative to more consistent condom use, it is undesirable. Insofar as it replaces nonconcordant UAI, it should be encouraged. Clinicians and counselors should be able to discuss serosorting with their patients and clients, making clear that it is not an optimal strategy for avoiding HIV but that it may be a good step toward safety for some people. Unfortunately, the complexity of serosorting makes it difficult to craft simple, clear, and accurate public health messages about the practice. We believe that widespread efforts to promote serosorting, particularly among HIV-uninfected persons, should be undertaken with caution and, if adopted, should be accompanied by rigorous evaluations to assure that they do not increase the population's HIV risk. Beyond this, our findings highlight the need for HIV-uninfected men who serosort to test for HIV frequently using the most sensitive available tests (ie, HIV RNA or HIV antigen tests) and to honestly discuss their HIV status and testing history with sex partners.
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Many HIV poz gay men still do not know what serosorting is about. There are also quite a few HIV+ gay men, and others, who are just as quick to make...
