Just as an aside, even if you are poz and barebacking only with other poz guys, you are still spreading strains of HIV, and more people having more multistrain infections will make it that much harder to develop a vaccine or a cure, either one of which could conceivably only be effective against a subset of the strains available.

So, although I agree with separating these people out in the statistics, they are still not the same as safe-sex folk as far as spreading HIV.

Your Serosorting comments are outdated, and needed revision. Here is some Safe Sex Serosorting scientific research findings. A question we gay Americans must ask ourselves is: Why are the HIV experts in America censoring the Safe Sex Serosorting data?

The findings:

For more than a decade, Serosorting has broken the cycle of new HIV transmissions, has made safe sex safer, and has reunited mankind to achieve a single, common goal – to reignite the excitement of HIV Prevention.

Serosorting – Having sex with your own HIV status. There are three forms of Serosorting, and two involve safe sex. Serosorting began back in the mid 1990’s as an HIV Prevention and Harm Reduction Strategy in New York City, NY and has now become an international phenomenon.

“The serosorting behavior our participants have reported could have reduced the number of new infections caused by people having random sexual occurrences by 99%,” says Jeff McConnell, project director of the Positive Partner Study at the University of California, San Francisco’s J. David Gladstone Institutes.

"There are other reasons why people may choose partners of the same serostatus beyond the risk of HIV transmission," Dr. William McFarland from the San Francisco Department of Public Health, California explained. "For example, HIV-positive persons may find more support in a relationship with another HIV-positive person because they share many more of the challenging aspects of living with HIV."

The investigator concluded: "Our observations and studies of serosorting may simply be documenting the rise of a community-generated HIV prevention strategy that is happening whether we have any control over it or not." Dr. McFarland said. (Sex Transm Infect 2006;82:461-466.)

“Does serosorting work? In some American cities, evidence of a “disconnect” between rising rates of sexually transmitted infections but steady or declining rates of HIV incidence has been seen as evidence that serosorting is working. Two things are necessary for serosorting:

1) A high rate of HIV testing and,
2) Disclosure of status.

A number of different posters looked at rates of disclosure by HIV-positive people all over the world. A poster from Uganda (King) found that of 1,092 HIV-positive clients of the country’s largest AIDS NGO, TASO, 45% of them men, 42% of them had been sexually active in the past three months and of these 69% had disclosed their HIV status to their partner. Encouragingly, higher rates of disclosure were associated with higher rates of condom use, showing that the two activities are linked.

Finally, in an upbeat presentation, Fiona Percy-de Korte reported on high rates of disclosure among recipients of antiretrovirals in the Botswana National Treatment Programme.

Among this cross-sectional survey of 275 patients in two districts, she said that 90% of ARV recipients had disclosed their HIV status to family members, 71% to their spouse or partner, 54% to friends, 26% to a church leader, and 20% to their employer.

Seventy-three per cent said they always used a condom during sex. And 48% said they had reduced their number of sexual partners since diagnosis.”(1)

There is plenty of evidence that serosorting exists as a behaviour. Jonathan Elford presented a poster showing that serosorting was common not only among HIV-positive gay men in the UK but also among Africans.”(2)

“Investigators from Sydney therefore looked at the serosorting behaviour of gay men known to be HIV-negative between 2002 and 2005. Although these men were not explicitly asked if they had “serosorted,” this behaviour was inferred from information they provided.

The practice of deliberately selecting partners of the same HIV status – often called “serosorting” – has been well described amongst HIV-positive gay men and even been credited with contributing to a fall in HIV incidence in San Francisco. Most investigators have looked at the serosorting behaviours of HIV-positive men and there are limited data on serosorting amongst HIV-negative gay men. There is also some evidence from the United States that HIV-negative men are increasingly avoiding sex with men who know they are HIV-positive. They also suggest that the internet may have a role in the apparent increase in serosorting.” (3)

Conclusion: For more than a decade, Serosorting has not only broken the cycle of NEW HIV transmissions and has made safe sex safer, but, Serosorting is the largest “word of mouth” HIV Prevention and Harm Reduction Strategy on the planet to date. And the Internet has played a key role in it’s success.

(1) Percy-de Korte F. Experiences of people living with AIDS (PLWA) following enrollment in the Botswana National Treatment Programme (BNTP). Sixteenth International AIDS Conference, Toronto, abstract WEAC0102, 2006.
(2) Elford J et al. Serosorting among Africans living with HIV in London. Sixteenth International AIDS Conference, Toronto, abstract WEPDC05, 2006
(3) Mao L et al. ”Serosorting” in casual anal sex of HIV-negative gay men is noteworthy and is increasing in Sydney, Australia. AIDS 20: 1204-1206, 2006.
Abelson J et al. HIV optimism does not explain increases in high-risk sexual behaviour among gay men of positive or negative HIV status in Sydney, Australia. AIDS 20: 1215-1216, 2006.