How Serosorting Affects Your HIV Risk

Serosorting is a common practice among men who have sex with men (MSM). While it's perceived to lower the risk of getting HIV, it may actually do the opposite. Let's gain a better understanding of serosorting and why it might not be a good practice to adopt.

Serosorting is the practice of choosing sexual partners based on their HIV status. In other words, people "sort" their potential partners according to whether they are HIV positive or HIV negative. Serosorting is increasing in popularity among MSM.

Man holding HIV medication cocktail, close-up
Bruce Forster / Photographer's Choice / Getty Images

Effectiveness of Serosorting Challenged

According to a study in the American Journal of Preventive Medicine, men who serosort are more likely to believe that because they serosort their engagement in unprotected anal sex is less risky for getting HIV. Therefore, they are also less likely to be concerned with using condoms when having anal sex. So, because the fear of infecting a negative partner is removed, safer sex is often not used.

In fact, scientific data suggests that serosorting may actually increase the risk of HIV instead of decreasing it. This is especially true in areas where HIV testing is low, according to a study in Sexually Transmitted Diseases.

While an HIV positive and negative couple — a serodiscordant couple — would likely engage in safe sex practices to prevent infecting the HIV-negative partner, couples, where both partners are assumed to be negative, are less likely to use protection. In this case, the couple may not have considered the window of time between exposure and a positive HIV test.

Remember, the body takes some time to produce enough antibodies for an HIV test to turn positive. Therefore, if a test is done before there are enough antibodies to be detected, the result will be negative even though there is an HIV infection. Other variables that increase the risk of serosorting leading to an HIV infection include:

  • A partner being deceptive about their true HIV status, saying they are negative when they are not.
  • A person not knowing they are infected because they have not been tested recently for HIV.
  • A person assuming that their partner is HIV negative when in fact they are not.

According to the CDC, serosorting does not protect against other sexually transmitted infections either, including hepatitis B, hepatitis C, syphilis, and genital herpes.

A Word From Verywell

Because serosorting is used among men who have sex with men, the CDC recommends that MSM undergo HIV and STD testing at least once a year, with bigger stress on doing it every three to six months. Moreover, abstinence or practicing safe sex with condoms will help prevent HIV transmission. The bottom line: be smart about your sexual health and risks.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  • Centers for Disease Control and Prevention. Serosorting among Gay, Bisexual, and Other Men Who Have Sex with Men. October 5th 2015.
  • Eaton L et al. Serosorting Sexual Partners and Continued Risk for HIV Transmission among Men who have Sex with Men. Am J Prev Med. 2007 Dec;33(6):479-85.
  • Serosorting Sexual Partners and Continued Risk for HIV Transmission among Men who have Sex with Men
  • Wilson DP et al. Serosorting may increase the risk of HIV acquisition among men who have sex with men. Sex Transm Dis. 2010 Jan;37(1):13-7. 

By Mark Cichocki, RN
Mark Cichocki, RN, is an HIV/AIDS nurse educator at the University of Michigan Health System for more than 20 years.