Sero-sorting: is it replacing safe-sex for gay men in Sydney?
Issues: Sero-sorting is the practice of choosing sexual partners of the same HIV sero-status to facilitate unprotected anal intercourse with casual partners (UAIC) whilst minimizing HIV transmission. Recent studies have shown an increase in sero-sorting amongst both HIV positive and HIV negative Sydney gay men.
Description: In Sydney rates of transmission among gay men have been relatively flat for the past 10 years.
Analysis of research among Sydney gay men conducted by Australia’s National HIV Research Centres since 2001 shows an overall decline in partner numbers and in UAIC in this population, an increase in disclosure of HIV status to sexual partners, and increased reporting of partners of the same sero-status. Disclosure of sero-status and negotiation around condom use often occurs in a context of trust and familiarity between players. This may indicate an increase in sero-sorting or simply a greater willingness to discuss HIV status.
Based on this evidence ACON developed a culturally appropriate, multi-faceted social marketing campaign to encourage gay men to reflect on the assumptions and beliefs influencing their decisions about condom use in the context of their presumed knowledge about the HIV status of their partners. This campaign addressed the different implications for HIV positive and negative gay men.
Lessons learned: In a sub-population highly educated about HIV, provision of information about risk may not be sufficient to sustain behaviour change. There is a complex analysis of relative risk versus potential pleasure being undertaken by these men, which requires greater understanding of motivation for effective interventions.
Next steps: Further research is required to better understand the relationship between sero-sorting and condom use including when and how a decision is taken not to use condoms and how gay men determine whether a potential sexual partner is of the same sero-status.
-Abstract available at link below-