Thoughts On Serosorting

[Guest guest]

So, to summarize, serosorting is a potentially a good thing, but

doesn't come without risk. Serosorting between positive men means you

can't infect someone (at least sexually) who's negative, though it

doesn't necessarily mean that that negative person cannot be infected

by someone else, nor does it mean that positive persons cannot be

re-infected/super-infected. Incidence of re and super-infection is

practically anecdotal, as is evidenced that it does not commonly

occur. Above and beyond all that, other STDs will lower immune

response, so it's important to know that barebacking while serosorting

does not come without risk. Many STDs are off the radar screen,

coming up as " undetermined urinary tract infection " or similar

condition. The common response to this from a health perspective is

simply: don't bareback.

The part that doctors are only slightly conceding is that a large

number of men just don't care about the risks. It's not that they

think less of themselves, or that they don't care about their health,

however. Many people bareback as a way of being more closely

connected. Others do it because they believe the risk is less than

the reward (sex that feels better.) I'm reminded of a joke I once

heard that goes something like this:

A 50 year old man goes to see his doctor for a routine physical exam.

His doctor asks him, " Do you smoke? " The man says " no. " The doctor

asks, " Do you drink? " " no. " " Do you have multiple sex partners. "

" no. Actually, I haven't had sex in a long time. " " Do you take smoke

marijuana or take illegal drugs. " " Of course not! " " Do you speed? "

" no. " " Do you hike, sky dive, or do anything risky? " " No.. doctor.. I

don't do any of those things! Am I going to die? Why are you asking

me all of this? " The doctor pauses for a moment, then sets his

clipboard on his bedside and says " Tom... What does it matter? You're

not living anyway. "

The point is simply this: yes, there's risk. Anecdotal evidence

suggests to me that while doctors talk about re-infection and

super-infection, I know many gay men who continue to bareback and

remain healthy. I'm quite sure if doctors have come across one case,

it probably does, indeed, happen, however. Common sense tells me that

if you're already on meds, the likelyhood of becoming re-infected with

another strain is neglible, unless of course, that person is carrying

a resistant strain that's resistant to the meds you're on. But, how

many here could jump up and say " I have the K20 mutation.. anyone else

here have that, too, so we can bareback 'safely?' " My suspicion is..

not many. But, if re-infection and super-infection were really pretty

common, it'd make sense to me that we'd rapidly be approaching the

point where regimens fail pretty much across the board - but they're

not. Common wisdom also tells me if you choose to bareback between

HIV+ partners, it's healthiest to still limit the number of partners

you bareback with to lower any potential risk of

re-infection/super-infection. Ultimately, I'd like to see more

research to get a better feel for the risk of barebacking between poz

men, but it would seem to me that even " re-infection " is difficult to

prove as the cause for someone's failing health. It's highly possible

the other person was carrying another virus that was not tested for,

or perhaps there is no test for. Medicine is largely a complicated

game of guesswork. After a long time, we get better at making

guesses, however. Personally, I think I'd choose to bareback if my

partner were poz, since I am too. I understand the risks, but I think

so long as we're limiting our sexual partners, it probably doesn't

hold too high of an additional risk, yet the rewards are worthwhile to

me, personally (spontaneity, better feel, more intimate, etc.)

That said, I found an HIV- partner. Initially, I thought I'd be one

of those poz for poz people out there, only looking for HIV+ people to

date. But, the community had a limited pool to choose from, and

ultimately, the way things worked out it just didn't end up that way.

As a result, protection isn't an option for me - it's a must. I still

worry about it more than he does, and I think that's why I have a hard

time staying.. hard.. when having anal sex. Our relationship has

ended up mostly oral, and I'm okay with that. 3 years later, he's

still negative, and I couldn't have picked a better partner to be

with. I feel loved, supported, and healthier than ever.

Serosorting is a good option for controlling the spread of HIV,

however it's far from the answer to the problem of infection.

Serosorting and barebacking are highly personal decisions. As long as

we're well informed, I think it's up to the individual to make that

choice, regardless of what the rest of the world thinks. We ought not

to be judging, but rather educating people so they can make informed

decisions.