by Gus Cairns for aidsmap
Gay men attempt to reduce their risks of acquiring or transmitting HIV using information about HIV status, the Eighth AIDS Impact Conference in Marseille heard last week, but use a complex, fallible and sometime contradictory mix of guessing and rationalisation to do so.
As a result, said Peter Keogh of Sigma Research in London, who was one of the presenters in the session on ‘Risk Perception’: “The notion of who should be responsible for safer sex, and what responsibility consists of, becomes ever more fraught.”
Over the past few years there has been increasing interest in understanding what gay men do to avoid HIV infection and transmission when they know their own and their partner’s HIV status. This behaviour has been dubbed `serosorting` by some researchers, because it often involves choosing to have unprotected anal intercourse only with partners of the same HIV status.
Seroguessing in Australia
At last week’s conference Iryna Zablotska of the University of New South Wales in Australia introduced a new term – ‘seroguessing’ – for what a lot of gay men actually do.
She said that the proportion of Australian gay men, both with and without HIV, who both had unprotected sex and who attempted to serosort, in other words restrict it to men of the same HIV status, had increased between 2001 and 2006.
Read the rest here.
The continual difficulty we as Gay Men or Men Who Have Sex with Men in using condoms on a continual consistent basis can be read into all our prevention efforts; whether the prevention is for ourselves personally or another as our sex/love partner. Condom fatigue is out there.
ReplyDeleteHowever, serosorting into seroguessing is especially relevant in HIV negative men. Serosorting should be seen as a method of protection primarily among HIV positive men who have sex with other HIV positive men, and who wish to reduce the risk of infection outside the HIV positive experience. It can be a sound, compassionate and effective method in public health practice to combat condom fatigue amongst a world wide effort where gay men have been more than responsive in the 25 year old epidemic. Of course, HIV positive men who are diagnosed have a 3 year window where it is better practice for personal and community health to continue using condoms or other fluid blocking/rerouting methods to prevent possible super infection.
There is something almost unnamable yet intrinsic in our intimate needs which create a desire to touch the actual flesh of our partner(s). There can be a joy and certain pleasure in accepting the fluids of our love partners into our bodies. The flesh to flesh experience cannot be underestimated in its power to drive us all to create a dialogue which helps us find this satisfaction. Serosorting among HIV negative men should especially recognize this often unspoken basic drive. We as gay and transgender gay human beings desire the real time touch of our brothers almost like a life necessity. After all, many of us have been denied this human experience for far too long.
Acknowledging this fundamental hunger, may help HIV negative men identify the self talk which leads to seroguessing. Also, understanding this fundamental hunger can lead to better understand the original power HIV positive men found in honestly addressing their desires whilst acting within the confines of their own health reality. We must remember the origins of this public health behavior originated by HIV positive men for sexual activity amongst HIV positive men. We as HIV positive men were shedding the great burden to not infect our HIV negative gay and transgender gay brothers. This is an ultimately compassionate act for all of us. Under this point of view, serosorting is and amazing and self instigating public health strategy.
Much Love,
Adam’s Apple
What's interesting to me about the research Gus describes is understanding the types of gay men who are serosorting and how they go about it.
ReplyDeleteBuried in the research is a strong subculture of HIV+ gay men working very hard to reduce HIV-transmission-risk to others by selecting self-disclosed HIV+ partners. Certainly, assumptions about HIV status among some men results in high-risk activity. This is nothing new as assumptions about who is HIV+ and what behaviors can result in transmission have fueled the spread of HIV since the very beginning. We should also not be surprised that some HIV+ men with good intentions to disclose their status and learn their partners' status fail to do so effectively. HIV+ people as a group receive virtually no support obtaining the skills necessary to disclosure their status or mitigate the stigma and discrimination that such disclosures can undoubtedly produce.
I believe we cannot lump all serosorting into one large category as this over-simplifies a complex decision-making process gay men are attempting (with virtually no support from the HIV prevention establishment) to balance the desires for safety and sexual fulfillment. We should applaud those men who break the silence around HIV status with prospective partners. We should support HIV-negative men to better communicate and negotiate with their propsective partners. And we should also help HIV+ men with communications so they feel more comfortable talking openly about these issues and weighing the risks of condomless sex with other HIV+ people.
Demonizing serosorting ignores real lessons and opportunities to help prevent infections. Rather, we should segment the groups engaging in these practices, learn about their motivations, and capitalize on these motivations to help them acheive better sexual decision-making.
David Ernesto Munar
AIDS Foundation of Chicago