A new study suggests that HIV infections among men having sex with men in San Francisco may be occurring at about half the rate previously calculated (1.2% per year, down from 2.2%). While speculations abound about what accounts for this great success (and about whether the data are conclusive), an excellent article in today's New York Times points out one possible contributor: a new form of Internet dating known as sero-sorting.
Sero-sorting refers to the practice of choosing sex partners based on a common sero-status (positive or negative HIV status). Internet dating allows people instant access to others of the same sero-status, something that is difficult to achieve in more traditional meeting places. Aside from the possibility of offering HIV-positive people the opportunity to find sex partners with the same status, Internet sero-sorting may also help foster a sense of community and belonging for HIV-positive people.
Internet dating based on sero-sorting is a great example of a harm reduction strategy. Harm reduction strategies seek to reduce the risks of certain behaviors when it is impractical or undesirable to eliminate them entirely. Rather than shy away from acknowledging the risky behaviors that people engage in, harm reduction seeks to discourage those behaviors but at the same time make them less risky for people who will simply not give them up. Each time you drive a car you are (hopefully) practicing harm reduction: recognizing that driving is risky but not willing to ban it entirely, the government forces you to wear a seatbelt and obey a speed limit in order to reduce that risk.
Just as driving can never be entirely risk-free, dating by sero-status does not erase the risk of sexual transmission of HIV. Two partners who believe themselves to be negative should not forgo protection based on this belief. In addition, there are risks associated with sexual contact even when both parties are HIV-positive, especially if that sex is unprotected. However, Dr. Jeffrey Klausner, who oversees sexually-transmitted disease prevention at the San Francisco Department of Public Health, maintains that the risks of re-infection or infection with a second strain are very low and pale in comparison to the risks associated with sex between partners of differing HIV-status. Finally, websites designed to help people find partners with the same HIV sero-status may not necessarily deal with other sexually transmitted infections: it is still important to discuss sexual health with prospective partners, and it is still important to practice safer sex. In other words, dating by sero-status may reduce risk of transmission and may help people feel more comfortable, but it is not a license to abandon safer sex practices.
Internet dating by sero-status may hold great promise for reducing the number of sexually transmitted HIV infections, and not just in the gay community. However, sero-sorting is only possible when prospective daters know their HIV status. For information on HIV testing visit http://www.hivtest.org.
Mara Burney is a research associate at the American Council on Science and Health (ACSH.org, HealthFactsAndFears.com).
