Aqueerius saidWhat does sero-sorting have to do with barebacking?
It means I seek out other HIV+ men so as not to put HIV- men at risk.
Most guys won't sero-sort as you do. I see a danger in your message where guys will focus on the more convenient parts and forget the qualifying factors, which sounds secondary to the main message of "end stigma"
Most guys will do anything to get laid... there's also the danger where counting barebacking while undectable as "safe sex" will give some an excuse to not disclose their status. And I know you'll respond to that last part with assurances of what you do, but just remember what most guys are like
Confirmed by this study:
...viral sorting’ – men basing condom use decisions with HIV-positive partners on whether or not they have a detectable viral load....
...The researchers found considerable differences in condom use, STI risk and disclosure between men who adopted a 'viral sorting' strategy and other men with HIV. They found that 57.5% of viral sorters had had recent condomless sex compared with 36% of those who had not and that they were much more likely to say that they had had anonymous casual sex (70% versus 44%).
...The researchers were also concerned that the adoption of a 'viral sorting strategy' seemed to involve discussing and disclosing HIV status much less. Only 19% of 'viral sorters' said they had recently disclosed their HIV status versus 42% of others, and only 22% said they had discussed the topic of HIV at all, versus 44% of others.
This study can’t determine whether gay men living with HIV are using their viral load knowledge to reassure themselves that they do not have to discuss their status with partners, or are using it as a post-hoc rationalisation for not having disclosed.
Either way, they suggest that when the original "Swiss statement" was published in 2008, it was assumed that viral load would be discussed as part of HIV status disclosure between partners, rather than being used as a substitute for discussion.
"Without open serocommunication in these settings, other – potentially asymptomatic – STIs may be passed on,” the researchers comment. “Thus, a subversion of a basic condition of viral load sorting seems possible.”
Given, however, what the Seattle study reveals – that HIV-positive men may meet with a flat rejection of sex by over 40% of HIV-negative prospective partners if they do disclose – it is perhaps understandable if some HIV-positive men regard "undetectable equals uninfectious" as primarily excusing them of an obligation to disclose.
If people lie, it does not refute the effectiveness of medication.
Serosorting is a strategy that aims to limit condomless sex to people of the same HIV status. In order for this risk reduction strategy to be effective, men must not only know their own status but also the status of their partners.
Data from the Centre for Social Research in Health
(UNSW) obtained from the Gay Community Periodic Survey across Australia suggests an increase in limiting condomless sex to partners of the
same status, from 20% in 2003 to 24% in 2012 (2).
Furthermore, recent research using data
obtained from Sydney's 2014 Gay Community Periodic
Survey has found that 39.6% of PLHIV limit condomless sex to partners of the same status
(serosorting) (1), while 32.6% of HIV negative men actively employ serosorting as a risk reduction
strategy (1).ACON does not endorse serosorting in casual sexual encounters as an effective HIV prevention
strategy for HIV negative men, on the grounds that ascertaining the current HIV negative status of
even a familiar casual partner is inherently unreliable.
However, where this occurs between men of concordant HIV+ status, considerations of HIV
transmission are largely irrelevant.
Nonetheless, the risk of STI transmission is significantly increased in the absence of condoms. http://www.acon.org.au/sites/default/files/What-is-Safe-Sex-Position-2014.pdf
I've already posted about HIV POZ undetectable "super-infection" being a myth.