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Fantasy likers Oral needs giveget into cut heavy cummers m4w Hello Ladies,Are you seeking for a man of distinction and composure.
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I like R B music. Cute chubby wants it tonight w4m Hi ya mans. But to explain further the role of count Octavian, it has to be sung by a mezzo soprano thus woman (I wonder what was on Strauss' mind when he wrote this part ;-) it does make the bed scene in the 1st act very erotic and lets your mind wonder.
You can keep moving your fingers down slowly until you reach the point where it feels deep enough inside your mouth. You can experiment with different tongue, mouth and head movements to see what works best but never use your teeth unless asked! Take your time to explore her upper thighs and the area around her vagina first, to help her get aroused. The most sensitive part of the vagina for a woman is the clitoris, which has more than 8, nerve endings. But the whole pelvic area is very sensitive.
Gently part the outer lips of the vagina and look for the vaginal opening, and the hooded clitoris just above it. Start off softly, using a relaxed tongue to make slow movements and work up to faster movements with a firmer, pointed tongue. You can experiment with making different patterns with your tongue and try different rhythms — taking cues from your partner as to what she enjoys most.
If you are concerned about hygiene, ask your partner to wash first - water and a gentle washcloth should do the trick. You could also bathe together as part of foreplay. You can begin by gently kissing and fondling the area around the anus including the perineum the area of skin between the genitals and the anus. You can then work your way in to the anus by circling your tongue around the outer area and finally inserting your tongue.
You can try licking, sucking, probing and nibbling gently — taking cues from your partner about what feels good to them. The risk of HIV transmission from oral sex is very low. The main risks arise if the person receiving oral sex has an STI or sores on their genital area, or if the person giving oral sex has sores in their mouth or bleeding gums.
However other STIs such as herpes , gonorrhoea and syphilis can still be passed on through oral sex. And some infections caused by bacteria or viruses can be passed on through oral—anal sex, such as hepatitis A or E. Infections can be passed on through oral sex even if there are no obvious signs or symptoms of the infection such as sores. You should definitely avoid having oral sex if either of you has sores around your mouth, vagina, penis or anus.
How do you translate that "1 into " into health risk communications? Well, let's look at it a slightly different way and then we are segueing into number three: What advice for providers? What public health communications would we give? Assuming the point estimate is 1 in There are a couple of options and let's sort of push it to the extremes. The one option is to say, "Yes, it is plausible.
Yes, it probably does occur. It occurs with relative infrequency. There are bigger fish to fry; there are more things to worry about. Are we basing that number on what Susan said and what Rick said? I've been following cohorts for 20 years and I still have yet to see what I think is really a documented case. He seroconverted--so I was never able to get what I thought was a plausible story out of him.
I think the best evidence comes from the cohort studies for the reasons Kim points out. The cases who present to various clinics for various reasons come along with various stories and histories whereas in the cohorts, they are being questioned, prior to their tests, so you at least have that working for you.
But you still have as everybody has mentioned a bias for underreporting risky behaviors, underreported risk. So I think even the 1 out of estimate is probably too high.
I would apply my usual clinical correction rule which is to double it and say 1 in I'm being a little fussy. You're saying that's the upper limit? That's one point of view. That's what I want to be on the record about. But aren't some of those individuals having protected anal sex? That's a very important issue. In some sense, we're talking about the ways that misclassification can happen, either over- or under-attributing HIV acquisition to receptive oral sex.
But what I have to say is that in every case where people have both kinds of sexual practice, we automatically ascribe it to receptive or insertive anal sex. In Eric's data, what you see is that actually insertive anal sex and receptive oral sex with ejaculation have about the same per contact estimates.
So I think there are situations in which we're probably underestimating the contribution of oral sex, as well as examples where we overestimate. We need to talk more about limitations. But remember that attributable risk is a combination of what the absolute elevated risk is and also how common it is. So while I certainly think that we want to move people away from having unprotected receptive anal sex, and certainly want to counsel people that even if they have protected receptive anal sex, condoms sometimes fail and so there is some risk associated with that, I don't know that on the flip side we really want to say, "Go and have as much unprotected receptive oral sex with ejaculation as you want and you don't have to worry about it.
I think we do individuals a disservice if we don't present them with the data that's available, and I think the data says, "Performing fellatio without ejaculation is exceedingly low risk. With ejaculation carries some risk, albeit relatively low risk but you need to know that there's some risk associated with it. People draw their line in the sand in different places and I think they need to be armed with all of the information for them to make a personal decision about "How much is this particular practice worth versus the amount of risk that I take on?
Have we evolved, both in our public health messages and our individual counseling messages, from a point of view that I think we did hold at one point in time, that we really had to keep our safe sex messages simple, pure, clean--don't confuse people--to a position of saying, "Here's the information.
Draw your line where you feel comfortable"? I think it's patronizing not to do that. I think you don't want to make it exceedingly complex. I don't think you want to start throwing numbers and confidence intervals at people, but I think you can craft a fairly simple message that still doesn't dumb it down so much that you're not giving people the information with which they're going to make their decisions about their individual sexual practices. And I agree with Jeff that the goal from a public health standpoint is really to try to move people away from the highest risk sexual practices but I think that you want to do that by giving people all of the information, not just part of the information.
What you run into, though, is if you say to a guy who comes in, "Well, it's very low" and then the next guy, "It's very, very low," they go out and it's "Well, what's very low compared to very, very low" and they say "Two 'verys' and one 'very'", and you could say, "Very, very, very low" I mean, that's what people are hanging onto, which is a very difficult situation in terms of what actually happens in practice out there when people show up to get an HIV test and they want to know, how low is it?
Well, it's very low. Well, how low is it? I think that those are challenges but one key issue is: I don't think it's right to say that oral sex is no risk. We need to craft some sort of message along the line of what Susan was saying, that says it's low risk or very low risk-and that's one of the number one issues--and the second is, I think we have clear agreement that it's lower risk than, for example, unprotected receptive anal sex, and I think all of us would agree that you want to craft a message that says, "If you're trying to decrease your risk of getting HIV, it's definitely safer to have oral sex, even when someone comes in your mouth, than it is to be a bottom and not use a condom..
The more subtle things--how do you deal with that message about what the level of risk is--if you're going to get into that depends on whether people ask more questions about that. With the kind of data Eric has, you can give a ballpark.
You have to say that this is really uncertain but to give someone an idea. If you do this 10, times, about four times you get infected. Or out of exposures, you might get infected once. Or the other way of crafting it, which I'd prefer, is to say, "You know, it's somewhere around 10 times less risky than being the bottom. I've just gotta be sure that rd time I use a condom. Do you take it a step further in using Eric's data and say, "It's less risky than being a bottom with a condom"?
That's sort of what is being said, and I think my read of the literature agrees with that, that there is more risk just because of condom breakage. What's difficult about those estimates of higher risk with protected receptive anal sex is that these are probably a result of both condom failure and overreporting of condom use.
But I do think that part of the message is: So here are the things we know about how to use condoms so they don't fail but you also just have to know that sometimes they do fail, and we have demonstrated relatively high rates of condom failure in multiple cohorts of gay men. So I think a principle that's evolving here, though, is that we really need to approach the at-risk population with great respect in giving out the information and crafting a message that says, "Of course, this is the highest risk thing that you can do.
Best to avoid it because it does have a much higher risk of having you contract HIV. There are other activities that are much lower risk, such as unprotected receptive oral with ejaculation, or protected anal, that could be of around the same magnitude or the latter may be of somewhat higher magnitude. So you just have to know that if you're engaging in those practices, there are ways to use condoms that might make it safer but there are occasions in which transmission does occur.
You know, the principles on individual risk reduction have always been to move people along toward a safer part of the spectrum. So to move them from unprotected receptive anal, to receptive anal with a condom, to insertive, to insertive anal with a condom, to receptive oral with ejaculation, and if I was dealing on an individual level with a patient whose primary risk behavior was oral sex with exposure to ejaculate, I would counsel that individual to try to reduce their exposure to ejaculate.
I agree with what Jeff is saying, that from a population standpoint and from crafting public health messages, the focus should be on receptive anal sex. On an individual level, again, I think it's easy enough to say, "You know, the least risky thing you can do that's penetrative is to have fellatio and not let your partner ejaculate in your mouth.
That's the easiest thing to do. If you're able to do that, that's the safest thing you can do. People don't necessarily just need to move one step in the continuum but you do want to craft the message for where that particular individual is in the continuum and from a public health standpoint, you do want to focus your resources on the major portion of infections. Similarly, if they were exposed to cum through oral sex, would we offer them PEP?
Would we offer them post-exposure prevention and post exposure prophylaxis with antiviral medications? So right now, at City Clinic, which is a public City STD clinic, we don't, because we have to prioritize our limited resources for the highest risk exposures and we don't have the resources to make available PEP for every possible type of exposure to HIV.
But I've been in a lot of discussions and dialogues with other advocates and they say, "Well, oral sex is clearly an important exposure. You really need to serve that population and offer them PEP. Again, I don't think we'll achieve consensus on that. Some would say yes, some would say no.
But I think our time is running out. But I think one of the things to consider there, though, and it is important, given what we know about people who underreported their risk, is that many people who come in and report a risk are actually seeking to confirm, they are looking for a way to get treatment or to get counseling about a higher risk exposure, which they don't feel comfortable disclosing and so it's always important for counselors to address the fact that even though people report only oral sex, many of them may have higher risk exposures and are not able to disclose those for one reason or another.
And so we have to continue to promote responsible sexual behaviors, using condoms and reducing exposure to infected semen, no matter what practice they're having. Well, let me see if I can summarize the conversation and if everyone can agree or comment on the following statements.
The first is that HIV acquisition by receptive oral sex without ejaculation is so unlikely, that we don't have any firm evidence even to show that it actually occurs. I'm not sure that I would say that. I think I would say that there are case reports--I can't really comment on the veracity of the reports--but they're on the order of case reports and it is exceedingly rare. There are cases for it but I don't know how many.
But you know, I think the thing also that we have to remember in thinking about counting case reports is that, after a certain point, people don't publish more cases of the same event. So I don't think you can count up the number of case reports and say that the number of cases reflects what's happening with the epidemic. I would just say, "While there are case reports, we think that the epidemiologic evidence such as it is suggests that that's a very rare event.
I think that second part is going to be problematic and even though I think that might be true in some populations. I think the issues are 1 when you're really getting a population attributable risk the data is not really good; 2 it depends on what populations you're talking about. If there's very little other risk behavior and a lot of oral sex, I can see that being a high number.
If there's a lot of unprotected anal sex, even with quite a bit of oral sex, it's not going to be as important a problem. So I think, again, it comes down to the kind of population that you're talking about and I think the data we have on that has weaknesses. Well, I agree with what Rick said. I think that the early studies don't necessarily reflect current realities because there was a lot more unprotected anal sex early in the epidemic.
As Rick points out, it doesn't necessarily reflect the current population attributable risk, which is driven by the relative prevalence of various risk practices. And to address Kim's concern, our cohort studies assessed risk behavior before HIV infection status was known. Some had and some hadn't, but that's what the multivariate models take into account.
Multivariate models look at the independent contribution of each of the practices. So I think the bottom line is that probably we're not going to agree on what the population attributable risk is, and that it is in part going to be driven by the frequency of particular contacts in particular populations. So I don't know that we're going to come to consensus on that. So we won't have agreement on that one. Copyright , Regents of the University of California.
Based on available scientific evidence, what is the risk of HIV transmission to an HIV-uninfected person who performs oral sex on an insertive male partner who is HIV positive? I would say extremely low risk. Extremely low risk, okay. At least based on self-report. The people who blacked out and can't be sure what happened to them, those are people that we didn't feel very confident were likely oral sex transmission cases.
From a public health perspective at a population level, oral sex is a lower risk activity and the promotion of it on a population level could result in fewer HIV infections. People draw their line in the sand in different places We do individuals a disservice if we don't present them with the data that's available, and I think the data says, "Performing fellatio without ejaculation is exceedingly low risk.
If you say to a guy who comes in, "Well, it's very low" and then the next guy, "It's very, very low," they go out and it's "Well, what's very low compared to very, very low? Yes, there are reported cases. Oh, you mean without ejaculation? I could count them! TheBody is designed for educational purposes only and is not engaged in rendering medical advice or professional services.
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