Living with HIV: Is Serosorting Safe?

Written by Ann Pietrangelo | Published on July 24, 2013
Medically Reviewed by George Krucik, MD, MBA on July 24, 2013

What is Serosorting?

If your blood has detectable antibodies to human immunodeficiency virus (HIV), you are said to be seropositive. If no antibodies are present, you are seronegative.

Serosorting is the practice of choosing a sexual partner who has the same serostatus as you. Usually, serosorting is used as a method of engaging in unprotected sex. It is thought to reduce the risk of contracting or transmitting HIV, the virus that causes acquired immunodeficiency syndrome (AIDS).

About HIV Testing

The most reliable way to test for HIV is with a blood test performed in a medical setting. A laboratory will determine if your blood contains HIV antibodies.

Rapid home-use tests involve taking a sample of mouth fluids and placing the swab in developing solution. Results are available the same day.

Home test kits can result in false negatives or false positives. Both the World Health Organization (WHO) and the U.S. Food and Drug Administration (FDA) caution that home tests are not always reliable. Additional laboratory testing is advised for confirmation.

Knowing Your HIV Status

Who’s been tested and how recently? Was it a laboratory test or a home-use test? If you’ve contracted HIV since your last test, you don’t always know you’re infected, and neither does your partner.

Assuming your partner’s HIV status is risky. A 2007 University of Connecticut study of men who have sex with men concluded that those who serosort and identify as HIV-negative aren’t any more likely to know their HIV status than men who don’t serosort.

False Negative Results

If you’ve been infected with HIV, there is a period during which antibodies may not be detectable. This is true of rapid-home tests and even some of the most sensitive blood tests. For some people, it may take as long as three to six months to detect HIV antibodies. This is a leading cause of false negative testing. It’s also a good reason to repeat testing on a regular basis.

False Positive Results

Some laboratory tests are so sensitive that they can actually misidentify other antibodies as HIV. That’s known as a false positive. All positive-result HIV tests should be confirmed by a second test.

If you suspect you may be infected with HIV or believe you are at high risk of HIV infection, repeat testing over the course of several months is necessary to accurately confirm the results.

Condom Versus Serosorting Alone

When compared to those who always use condoms, people who engage in serosorting are at higher risk of HIV transmission. Serosorters are also at risk of a host of other sexually transmitted infections (STIs), including syphilis, herpes, and hepatitis.

The CDC advises that when used correctly and consistently, latex condoms are highly effective in preventing transmission of HIV and other STIs.

Is Serosorting a Safe Practice?

Serosorting may be associated with a slightly lower risk of HIV transmission than not serosorting combined with lack of condom use. However, serosorting for the purpose of engaging in unprotected sex is not a safer sex practice, according to the U.S. Centers for Disease Control and Prevention (CDC). Serosorting is based on incomplete information. This can leave you vulnerable to transmission of HIV and other serious STIs.

If You Practice Serosorting

The problem is that in most instances, there simply isn’t enough reliable information. You can’t tell someone’s HIV status based on appearance, age, gender, or sexual orientation. Some people may incorrectly believe themselves to be HIV-negative. It’s a good idea to ask for proof of testing. Both parties should be tested on a regular basis.

It is also important to remember that serosorting offers no protection from other STIs. Serosorting works best within a long-term, mutually monogamous relationship. 

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