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Not everyone will open a discussion about safer sex with a health care provider. For example, some people may not ask about safer sex because they do not perceive themselves to be at risk. Others may be too embarrassed to open the discussion. It is incumbent on health care providers to perform HIV risk assessment as an integral part of the medical history, and to provide HIV prevention counseling as an integral part of patient education and anticipatory guidance. Risk assessments and appropriate counseling should be performed periodically to facilitate not only initiation, but also ongoing maintenance, of risk-reduction behaviors.ĭevelopment of effective antiretroviral therapy (ART) has resulted in optimism for many HIV-infected patients. As efforts to develop even more effective treatments and preventive vaccines continue, it is critical to continue aggressive prevention efforts as a vital component of the battle against HIV. Although ART can result in dramatic reductions in HIV viral load, it is not a cure for HIV disease thus prevention should still be the first line of defense. In addition, although theoretical models have suggested that ART may combat the HIV epidemic on a population level, models that assumed steady or increased levels of safer-sex practices were more likely to predict reduction in new HIV infections than models that assumed decreased levels of safer sex.(2) ART may reduce, but cannot be expected to eliminate, the potential for an infected individual to transmit HIV to an uninfected individual.(3) Therefore, even individuals receiving effective ART should, at a minimum, initiate and maintain prevention practices with uninfected persons or persons of unknown HIV status. #CRYING IN PAIN DL GAY PORN PROFESSIONAL#.