Not all barebackers are HIV-positive. Men who have bareback sex can be HIV-negative, HIV-positive or even unaware of their current HIV status. Some men who are HIV-negative and want to remain so may seek out bareback sex partners who believe they are HIV-negative also. Men who choose to have unprotected sex with other men who have the same HIV status as themselves are undertaking a process called serosorting. It’s important to understand that whilst taking care when serosorting, there’s no guarantee about its effectiveness and seroconversion can still occur.
Serosorting is the process of only having sex with a person who has the same HIV status as yourself. Some barebackers choose serosorting as a technique to help safeguard themselves from becoming HIV-positive. While the serosorting concept is excellent and a technique many barebackers find useful, the process doesn’t always work as intended. While two men can be extremely careful and honest when they serosort, what they honestly don’t know about their own health status or the health status of others can make serosorting ineffective. This is also the case when a person knows their HIV status, but may choose to lie about it to others to avoid missing out on an unprotected sexual encounter. Because serosorting relies on honesty and trust, its effectiveness cannot be guaranteed.
It’s not just HIV-negative men who serosort, both HIV-negative and HIV-positive men can serosort. Men who are HIV-negative and who want to stay HIV-negative will pursue bareback encounters with other men who believe that they are HIV-negative. HIV-positive men who want to avoid infecting HIV-negative men will seek bareback encounters with other men who are HIV-positive. While this all sounds great, those who are not aware of their current HIV status or those who are not honest about their HIV status reduce the effectiveness of serosorting. It is important to remember that HIV-positive men can also contract other strains of the virus from other infected partners.
Because the detection of HIV in the body involves a window period where it can be several weeks before HIV shows up in standard HIV tests, a person who is tested in the window period may appear to be HIV-negative, but they may actually be HIV-positive, even though it did not show up on their test results. This is a big problem with HIV detection and this can bring serosorting undone. While individuals who serosort may be completely honest, it may be other factors which impact on the effectiveness of the process. One person may be HIV-positive in the window period and not know it, then they may tell their perspective sexual partners they are HIV-negative (because they believe they are) and as a result they may transmit HIV unintentionally. HIV can then be spread to other sexual partners in the same manner and it’s disturbing to see just how quickly the virus can spread even when individuals are trying to have sex with others who have the same HIV status as themselves.
A major key to serosorting involves honesty, so if one person is honest and the other is not, then the effectiveness is instantly compromised. Serosorting is a great concept, but anyone who uses this process as a way of staying HIV-negative or not infecting anyone else needs to be aware that this technique is not 100% effective. Some men are not aware of their HIV status, so if this is the case, then serosorting will not benefit their situation, as they could be HIV-negative or HIV-positive. Serosorting requires both people involved (or more in a group setting) to know their current HIV status and be 100% sure about their health status.
Serosorting is mainly used to limit the transmission of HIV, but other sexually transmitted infections can still be transmitted whilst serosorting, even if a person is HIV-negative. The idea of serosorting could also be used to limit the spread of other sexually transmitted infections using the same process. In summary, while the concept of serosorting is excellent, barebackers who use this technique need to be aware that it is not a guaranteed way of preventing seroconversion, but it is one way of helping to reduce the spread of HIV.