The overarching challenge is how to communicate risk without confusing or discouraging people.
One challenge is trying to communicate risk without putting a number on it. The public often wants risk to be communicated as a percentage (such as 2%) or a ratio (such as a 1 in 50 probability of HIV transmission). However, it’s very difficult to communicate risk as a number and these ratios can easily be misunderstood. For example, a person could understand this ratio to mean that they can have anal sex without a condom 50 times before they get HIV when, in fact, they could be the guy who does it once and gets HIV or the guy who does it 600 times and doesn’t get HIV.
Another challenge is how to communicate the many variables that need to be considered, such as the viral load of the HIV-positive partner, whether either partner has sexually transmitted infections (STIs), the window period, how often someone is getting tested, and how much one partner trusts the other(s). All these things can affect transmission significantly but are not easily measured or quantified. The information is complicated and can discourage someone from trying to reduce their risk.
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