Serosorting, Barebakers and +'s- %'s Oh My!

Have you ever read an article about the rise or fall of HIV infection rates and when you reach the end you're either scared shitless, angry or have no idea what the hell is going on? Yeah, me too. All. the. time.

After reading this incredibly muddy article by 365gay.com entitled: "Study Suggests Shift In Attitude Among Newly Infected Men With HIV Regarding Partners" I again had that, "uhh, what?" feeling. But lately, do to having some incredibly bright and educated people around me I've grown skeptical of the way percentages and statistics are reported and thus my post-article freak-outs have declined.

Here's the dilly:
The article is saying that some poz men are barebacking or men who happen to be barebacking, are positive, but in some cities (like SF) they're beginning to only bareback with other positive men. This is otherwise known as "serosorting."

Serosorting, as defined by wikipedia is "the practice of seeking to only engage in sexual activities with partners who are of the same HIV status as you. In April of 2006, the Los Angeles Times reported that the practice of positive-positive serosorting is partially responsible for the decline in new HIV infections in San Francisco.

Serosorting is the reason why it is possible to see a simultaneous increase of barebacking stats with the decrease of HIV infection rates. Men who choose to not use condoms aren't changing their sexual acts but they are changing their sexual partners, and that in itself is a way to avoid spreading HIV. The trend here is that positive men are barebacking each other and not negative men.

Now listen up and listen up real good. I'm not advocating unsafe sex. I'm not saying that it's a good thing that poz on poz men are choosing not to use condoms (there's a TON of other health related issues with that alone.) I'm simply clearing up a hard-to-decipher article before we start stigmatizing the entire positive community as barebacking orgy-fueled deviants. Trust me, as I've reported before, a lot of gay men, even myself at one time, came spring loaded with that defense. And, yes. Yes. Yes. Yes we can talk about how this trend might make barebacking seemingly more acceptable, that it isn't foolproof and that negative men might get caught up in this, but it is none-the-less, an interesting trend and attitude shift to note.

I feel as though this is neither good nor bad news and proves how complicated statistics, percentages and HIV reporting can be.
Case in point- the article states:

Two separate studies presented earlier in the week at the National HIV Prevention Conference, however, found that more than 35 percent of men who have sex with men continue to have unsafe sex.

Everybody freak out, right?

Hold on a second. As a friend of mine pointed out when discussing this article:
How many of those guys are poz guys who have unprotected sex with poz guys only? In terms of HIV prevention, those guys should be counted out of the equation.
How many of those guys are in monogamous longterm neg couples? In terms of HIV prevention, those guys should be counted out of the equation.
How many of those guys were having non-penetrative or oral sex? In terms of HIV prevention, those guys should be counted out of the equation.

The real question is: How many NEGATIVE men fail to use a condom when they have ANAL sex with someone whose status was uncertain or POSITIVE? But nobody ever asks that question.

See that's just the thing. In many of the safe-sex surveys I take or the questions I answer when getting tested, I'm always asked, "Did you use a condom the last time you had sex?" The answer is almost meaningless without a follow-up question: "Were you and your last partner both already poz? Were you and your last partner both neg men in a longterm monogamous relationship? Was the last time you had sex a strictly oral/J.O. encounter?"

Hell yes. Complicated! But important.

I'd like to be clear about something. You can disagree with me all you want but I feel it is tremendously important that we do not look at postive and negative like black and white cards or a pass/fail on a college exam or a yes/no answer. In order to really begin combating this virus we need the ability to acknowledge and comprehend everything it involves. With anger and sympathy being both important factors, it is simple understanding that will eventually be the key factor winning out.