Serosorting

When it comes to sex, knowing your HIV status (and your partner’s!) can help you make decisions that feel safer and more comfortable. Sero-sorting is a strategy where guys choose sexual partners based on HIV status. Some guys use it to reduce the risk of HIV transmission, while others use it to feel more in control of their sex lives. It’s one of many ways to manage risk, alongside PrEP, PEP, condoms, and undetectable viral load (U=U).

Sero-Sorting for HIV-Negative Guys

If you’re HIV-negative, sero-sorting usually means choosing to have sex only with other HIV-negative partners. So a guy who’s HIV-negative contact another guy whose online profile says he’s HIV-negative, so they have sex without a condom. 

But this strategy isn’t doesn’t always work. Why?

In Ontario, about 11% of people who have HIV have not been diagnosed with HIV. They may think they are HIV-negative, but sometime since their last test, they acquired the virus.

Also, when someone’’s HIV is untreated, their viral load is probably really high, which makes it more likely to pass on to a partner. For these reasons, two guys who think they are HIV-negative may have a very high likelihood of passing on HIV if they choose to fuck without condoms or without using another strategy such as PrEP.

Modern research shows that many new HIV infections between guys are happening when one of the guys has HIV but has not yet tested positive for HIV. 

Why might guys not know that they have HIV? There are lots of possible reasons.

• They may assume they do not have HIV, because their most recent test came up negative.
• People who have recently acquired HIV may experience no symptoms, or may not recognize the symptoms they experience as HIV infection.
• It is common for guys to underestimate the likelihood of HIV infection.
• It may be because they haven’t tested since they got HIV, but have had condomless sex.
• They may be so afraid of the stigma they might face if they test positive for HIV that they just don’t get tested. We all have a role to play in fighting stigma, so we can all stay healthier.

Research has shown that sero-sorting to favour HIV-negative partners is less effective than when guys combine other strategies: condoms, PrEP, and having sex with HIV-positive guys who have low and undetectable viral loads.

It also creates stigma against guys who know they are HIV-positive. In 2020, 97.8% of positive guys on treatment in Ontario were undetectable, but 11% of HIV positive guys didn’t know their status. 

Guys who have an undetectable viral load can’t transmit HIV through sex, but guys who haven’t been diagnosed, and therefore think they are HIV-negative can. 

Even so, some HIV-negative guys avoid HIV-positive guys regardless of their viral load or the kind of sex they’re having.

If you choose to sero-sort, combining strategies works best. Using condoms or PrEP adds extra layers of protection. If you’re considering condomless anal sex, being on PrEP or making sure your partner is undetectable dramatically reduces your risk of HIV transmission. Remember, regular STI testing is also important, because HIV-negative partners can still get other infections like gonorrhea, chlamydia, or syphilis.

Sero-Sorting for HIV-Positive Guys

Some HIV-positive guys may decide to only have sex with other guys who know they are HIV-positive. There are a few things to keep in mind about sero-sorting for poz guys.

For poz guys, only sleeping with other poz guys can be a relief, since there’s less misunderstanding and stigma, and no worrying about the transmission of HIV to an HIV-negative guy. Maybe you’re waiting to get linked to treatment, or in the middle of switching medications, so you’re not undetectable right now. Some guys are willing to accept the possibility of getting other STIs if they can have sex without condoms.

Two guys who know they have HIV choosing to have sex with each other is a reliable form of “sero-sorting” because HIV status is known to be the same.

Still, there are a few things to keep in mind if you’re an HIV-positive guy who is sero-sorting:

• Getting tested and treated for STIs regularly can help to reduce rates of STIs in gay men’s sexual networks.
• STIs are worth avoiding, which you can do by using condoms. The rates of STIs like syphilis are a big problem right now for gay men. They are particularly high among HIV-positive guys. Some STIs can be hard to manage, especially if left untreated.
• Talk to your partners — it’s possible that one of you is getting treated for an STI or that something about their approach to sexual health has changed.
• Even if you’ve hooked up with a guy without using condoms before, you may feel differently later on. You can let him know that you’d be more into it using a condom this time.

Making Sero-Sorting Work for You

Sero-sorting isn’t about judgment — it’s about making informed decisions that suit your sex life. Here’s how to make it effective:

First, know your status. Getting tested regularly gives you up-to-date information about your HIV status and other STIs. Testing isn’t just a responsibility — it helps you and your partners enjoy sex with confidence.

Second, communicate openly. Talk with your partners about your HIV status and ask about theirs. Some people are shy about disclosure, and that’s okay, but honest communication builds trust and makes it easier to decide what kind of sex feels safe.

Third, combine strategies. Sero-sorting works best alongside other risk-reduction strategies. PrEP protects HIV-negative guys, condoms protect against HIV and other STIs, and undetectable viral load protects HIV-positive guys and their partners. Using multiple strategies together gives the most protection and reduces anxiety during sex.Sero-sorting isn’t a magic solution, but people are doing it all the time already. Whether you’re HIV-negative or HIV-positive, it can help you reduce HIV risk, build trust with partners, and feel confident during sex. Pair it with other sexual health tools for the safest and most worry-free experience.