SirBillybob

Aren’t there two platforms for which posters insist on using the same abbreviation?

I get very close, and then some.

There might not have been a thread emerging, but at the very least a floss.

And do you have an elderly lady embedded in your drilled out cavity?

Anybody else almost wishing for a GoFundAli?

And just like that, …😏

But the one-eyed snake gives everything away anyway.

And if that’s not enough on the nose …

Aidsmap’s Pebody and I share the same fault, that of incorrectly stating that the risk metrics are predicated on the assumption of an HIV-positive partner. In fact, the risk estimates data are limited by the fact that infectivity is unknown due to already existing modifying factors. The fault on my part is more grievous because I had already been aware of the distortion. Therefore, because variables such as per act seronegative status of both partners; per act HIV-negative status of one partner in tandem with close to negative status equivalency of the other partner due to extant infectivity modification; non-ejaculation; and circumcision are baked into the risk metrics at unknown proportions, my examples based on the assumption of poz partner with unsuppressed viral burden are underestimated, but to unquantifiable degrees, in the context of absence of TasP, PrEP, and condom use. The reason that factors that inflate risk and attenuate risk are presented separately is that one cannot easily mash them up with values in which the mix of infectivity is unknown.

It doesn’t really matter what assumptions about partners back the application of infection prevention options. Many people employ maximum protection, short of abstinence, in spite of assuming it won’t always have been necessary. To assert that they are incapable of measured nuance is absurd.

Use a condom if you’re mile-high. No, I’m not discounting anything. I am only applying the concept to the actuality of unprotected sexual intercourse with one or more partners HIV-positive with unsuppressed viremia, using those risk metrics. Believe it or not, that is how insertive partners are seroconverting, acquiring infection, even today in a world where better prevention options in combination nevertheless exist. If he had fucked 100 times over any previous period his cumulative risk of infection will already have been 10.4%. Another 100 added prospectively … 19.8%. I had applied it to a scenario of evaluating the appropriateness of PrEP when working with an inquiring patient whose sexual position was insertive, where he might assume that past experiences in which he evaded infection did not count towards cumulative risk due to false assumptions of a risk reset to 1/909. Those experiences could include time frames prior to the widespread clinical option of PrEP and the concept of TasP. But in my scenario the idea of TasP is irrelevant because, yes, the best estimate of transmission is zero (while mathematically > 0) due to sustained undetectability. The cumulative experiences with a poz partner with unsuppressed viral load are not precisely quantifiable unless one knows every partner’s viral load status, but the risk ratios are measurable if you compare tops and bottoms using each respective stationary setpoint of event risk and assuming the same proportions of partners’ categorical viremia status.

Per-act risk accumulates nonlinearly and repeated exposures compound differently because the number of risk acts is applied as an exponent to the probability of non-infection. This doesn’t mean that you cannot take an arbitrary probability of infection and calculate the number of insertive acts that it takes to achieve risk equivalency to the number of receptive acts. That there is no absolute guarantee of infection is an artefact of the impossibility of non-infection probability reaching zero because there is no exponent applied to either .9862 or to .9989 that can yield absolute 0. It just makes sense to round up to 100% probability of infection for high cumulative amounts of risk acts because the inverse of none is not none … one or more. Of course, in this context one is all it takes and more is superfluous unless re-infection complicates the clinical picture.

I’ve always explained to patients that the risk from unprotected insertive anal is lower than from receptive anal but depends on the more elusive variable of how much of a debt is owed to past good luck because the cumulative risk events for a top can be equivalent in probability of infection to that of a bottom with lesser number of events in which infection from a poz person with unsuppressed virus is evaded. This concept of the past catching up is as relevant as the idea of prospective encounters in terms of the decision to PrEP or not.

What exactly are you asking or should be asking your physician? People respond to being upset in many ways. In contrast, specific sexual behaviours are associated with different levels of infection risk.

Though it will be TV/streaming for me, for the closed-caption English, as I'm somewhere between upstairs and downstairs. 😏

Demurstibation is the new shrinkflation.

Well said, Granny.

How does ChatGPT interpret the family being from Public Relations?

Where you’ll receive countless tempting offers to flip what you purchase in a hot market.

Before this topic is locked, let me just add that this type of scenario, for obvious reasons, should be especially filtered through MA prostitution law.

Diagonally, so it’s all good.

The only good reason for his extended gym time is that you would be gazing up at his bulging crotch while he spots your bench press.

Add a little somethin’ somethin’ and you have an hors d’oeuvre.

I thought overnight is a one night stand.