Dr. Bob, Can you explain about serosorting and whether or not it's a good idea? Peter

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!

Dr. Bob