Riobard

The friend of your friend is your enema.

You haven’t seen 28 Days, Weeks, Years Later film series? Exile can be a succession bump. In addition to the cocaine one.

More likely a cocaine line in new digs Downturn Abbey.

Glad you’re seronegative and relieved but the story has an abrupt ending considering you were tested due to having been deemed at risk for infection. You must not be taking PrEP because you’d have been already required to determine HIV status regularly. Whether or not you ponied up cash for a clinical procedure you should have been informed about HIV prophylaxis options. I simply want to flag it because I’m not sure what your risk factors are or your degree of awareness for PrEP eligibility going forward.

No I haven’t, not in 11 years of several trips and countless fee-for-service appointments. I once mistakenly underpaid on one occasion by 20% the agreed amount to a guy at his place and he politely texted me later. He was correct as I knew exactly how much I had obtained and the balance I held. I had made it clear the amount I proposed would be in USD or BRL. I blame it on my rare use of US bills … why can’t that treasury get its act together and find some denomination dye? I was mortified. I arranged to have it physically delivered to him, with his permission to address it to him at his building, quite a hike even for an enthusiastic walker like me if I was to have repeated the trek, along with a generous tip consisting of reais to have available to him outside of exchange requirements. Had it been an outcall I’d have had to make different compensatory arrangements. Not that some don't coyly and sweetly put their palms together prayerfully if they witness you sliding their pay off a larger array of notes. I try to remember to avoid display.

Reports of traffic disruption having occurred in the southeastern city region may be overblown if not inaccurate. I think that main route vehicular traffic may be now normalized even where the greatest impacts in the northern zone were. Fallout from yesterday’s flashpoint in terms of disruption in conventional tourism zones may be negligible at face value.

I think it’s day to day following yesterday’s ‘war zone’ up near the main airport. I wonder about residual vehicular traffic blockades posed by one side of the belligerents: the alleged crime faction, that I believe were quite disruptive as an alleged retaliatory measure yesterday, including areas far from the shootout phenomenon. Of course this does not rule out the possibility of police-initiated barricades. At the very least, I would want to be familiar with Metro and Supervia rail options for contingency planning. I assume that the VLT light rail transit, a fairly limited circumscribed area relatively speaking, as well as BRT long haul trans-city bus routes could be comparatively more subject to blockades at a traffic flow structural level. These blockades apparently consist of dozens of buses commandeered (or leased?) by the civilian belligerent category. Those here with boots on the ground will know more. It’s all slowing my roll with respect to planning a trip in the upcoming weeks using up a relatively small amount of allocated visa-dependent days left over prior to my migratory year reset. Likely Europe instead now.

I assume you are basing the first 90% on an estimated percentage of circulating virus that would bypass the mutation. I haven’t drilled down too much but I think the ratio of R5-tropic strain (that which would be preferable in terms of infection escape for the relevant mutation discussed) to X4-tropic strain is deemed to be about 85:15, but X4 is more aggressive? So a lot of moving parts. If one applies the strain proportionality factor to the usually referenced transmission risk estimates that exist outside of consideration for the mutation protective factor, then the degree to which event risk, based on the mutation, for receptive anal (RAI) is reduced to about twice the risk for insertive anal (IAI). Accordingly, it is possible to compare and contrast the volume of true risk events that corresponds to arbitrary probability percentages of infection because number of events is key in infection potential over time. For example, in separate sexual position based calculations about 49 RAI events and 510 IAI events, respectively, for a 10% probability of infection. Escaping infection with the mutation is, as established, not due to absolute immunity but is predominantly due to not having enough sex for breakthrough infection, adjusted for sexual position. The notion of added protection equivalent to condom use is appropriate. The above factors might be considered for risk tolerance and subsequent choice of prophylaxis. Notwithstanding that I use condoms for bacterial STI prevention, I use them as well as PrEP for IAI HIV prophylaxis. It follows that in my case, if unambiguously possessing the mutation, I would certainly continue both condom use and PrEP for RAI. YMMV regarding tolerance and caution.

200 opening ask? Even 80 under duress? Much hotter dudes for 50. I would say the person in that image is defined, not so muscular.

IMHO the GPs will likely be celebrating a gayforpayness leg up more than gayness, and any indication of linear parade participation will be the usual traffic circuit from the spa amenities or darkroom thru the central bar to the back smoking zone and back ad infinitum. Avoid at risk of deprivation and being shortchanged expressivity of particular components of Thanksgiving season gratitude that week. Chances are that on the Saturday night at 117 there will be a festive nod to pride along with a celebration of birthdays of reception staff Claudio and barkeep Tiago.

Air Canada LAX to VIE in May thru Toronto is an outrageous $14,900USD long-haul with one of the Europe legs code-share Austrian. Looks like you got a good deal with United code-share Austrian considering all three are Star Alliance and you have the luxury of non-stop.

I walk from Renaissance to Lagoa all the time when there. It’s 0.7 miles. I often stop at Bella Paulista for a light bite on the way back, roughly the halfway point. I enjoy the hotel happy hour snacks and a bit of bubbly and panoramic view before heading out. The hotel rates my last two visits this year were $550 and $450, respectively USD, Madison Club Suite. I think lower price in the past but I cannot remember how much less. Metro and bridged distance on foot to Python out of curiosity about how to get around, but obviously Uber when was pouring rain. —— Found a Renaissance rate from a stay in 2023 in my screenshots. $310 for same room tier.

From the looks of it seems like deaf drivers stay on course without wandering, relatively speaking.

Although you fell short of one-week lead-in dosing I’m not sure whether you meant you missed doses within the abbreviated lead-in or within the on-demand sequence. Maybe both? There may be a better episodic salvage option for an abbreviated lead-in with or without consistent dosing, that being immediately adopting 2-1-1. Interestingly, while one-week lead-in dosing or 2 start-up doses in on-demand 2-1-1-… structure is recommended for adequate protection, updated on-demand guidance states that the subsequent on-demand prophylaxis sequence is satisfactory at 1–1-1-… dosing if the latest dose was no more than 6 days previously, but 2-1-1 if a week or more. Now that’s much more flexible than how we perceived it years back when on-demand was approved, no? This is not to say that one is restricted from 2-1-1-... in the subsequent sequence if the next occasion requiring protection is less than a week than the latest single dose. It’s your discretion and I certainly take 2 doses if merely a single non-dose day elapses from the previous sequence endpoint. If last dose in 2-1-1 is a Tuesday, my next 2-1-1 uptake the Thursday. Any toxicity concerns are assuaged by the rareness of such circumstances. If I needed to regularly double dose within short time frames I should be taking PrEP daily. However, my interpretation of how some interpret the guidelines is it is not recommended to compensate for a missed dose within the 7-day lead-in regimen by adding a second dose at any time, including 2-24 hours prior to activity as if you were initiating 2-1-1 given the notion of drug concentration absence or washout that renders you vulnerable. This seems rigid if strongly advised, and appears to be an artefact of the recommendation to not double-dose as compensation for a missed dose within a daily uptake regimen as long as uptake is generally very good at minimally 6 doses weekly. That said, it is deemed acceptable within a daily regimen plan to compensate for a missed dose within 12 hours past the typical uptake time, and the following dose as scheduled even though only an additional 12 hours or more elapses. There would be no reason to assume that failure to adhere to a full one-week lead-in would compromise the protection conferred by 2-1-1-… as called for when sexual activity imminently commences. The key is strict adherence once an on-demand sequence is initiated. The reason I put forward these ideas in detail is that you may have been unaware of your various prophylaxis salvage options in the context of missed doses that eventually created anxiety for you. In your shoes I’d have considered taking a lead-in category dose later than scheduled if I realized a dose was missed, or simply reverting to the established non-lead-in on-demand option depending on the details of less than optimal one-week lead-in uptake.

For sure, an injectable with effectiveness level such as Lenacapavir’s is a good bet, particularly if the proposed generic product drops to anticipated <$50 annually compared to Yeztugo’s current $28,000, but that is still a few years off and I believe the patent negotiation at this stage is that generic will be restricted to LMICs. Not sure where OP lives. I wasn’t putting forward 90% as any option’s efficacy compared to no PrEP. The way I set it up was the intention to indicate that depending on whichever Truvada-inclusive study’s cohort a research subject assigned to Truvada uptake found themself in could be at close to 10-fold greater risk for infection and that doesn’t add up. I should have emphasized It isn’t a true efficacy metric because it’s comparing the case incidence outcome in two studies. However, it’s no less valid to make such comparisons than to indicate efficacy relative to estimated background HIV case incidence in which PrEP or PEP uptake is baked in to an unknown degree. Lenacapavir efficacy was described by the researchers as conferring 96% less infection risk relative to background HIV incidence. As you indicate, no PrEP taken as prescribed confers reduced risk as low as 90%. What I was pointing out was that the Lenacapavir researchers, based on comparing with the oral … Truvada … reported that Lenacapavir injection conferred 89% less infection risk. That leads the reader to believe that Lenacapavir is way more effective in a head-to-head comparison. However, when HIV case incidence for Truvada recipients in the Lenacapavir study, .92 cases per 100 person-years, is compared to the Truvada alone observational cohort study I referenced, 1.1 cases per 1,000 person-years, the degree to which Lenacapavir is purported as being more effective drops to 0%. An explanatory argument for such a difference (.92 vs .11), coincidentally the same reduced relative risk 89% in case incidence as was indicated comparing Lenacapavir to Truvada, could be that an experimental group was considerably less adherent to oral uptake than an observational group. But seriously, I would find it hard to buy that assumption even considering that a randomized trial is obviously a different methodological animal than a single product cohort. I grasp the difference between HIC and LIC privilege and resource access but If I or my public coffers or insurers had to fork out $28,000 for an equally clinically effective option … and given some amount of wiggle room for less than 100% oral meds taken as prescribed … because I suck at remembering daily pills I might try to find a way to overcome such adherence limitations. You can put a price on health even if a price shouldn’t be put on it.

Showbar is at Carvalho de Souza 278F, equidistant from two very close Madureira stations on different Supervia lines that fan out westerly but converge at Central Station easterly. You need to nose around at the building complex to discover what would be Unit or Loja F as there is no apparently overt signage. Also see X.

Simply landing, by misfortune it seems, in the Lenacapavir research was unhealthy for the comparison group assigned to daily FTC/TDF and LEN placebo. The oral PrEP incidence rate was 10 times that of the well-known previous observational cohort study (ANRS PREVENIR), for similar population parameters, in which the incidence rate for either daily or on-demand Truvada trended at the same level as for the more recent Lenacapavir study injection recipients. Thus, having been, by happenstance, in the study evidently better for one’s HIV infection incidence outcome would yield similar efficacy as the relative efficacy purported by Lenacapavir compared to conventional oral PrEP … about 90%. You don’t have to pre-establish an agenda of meta-analysis to objectively reference apparent contradictions in outcome. No academic attempt to responsibly synthesize PrEP would omit the outcome difference This is what happens when researchers are so biased and disingenuous that they are keen to introduce the background of their aims, yet in discussion stages omit reference to the enormous differential between the findings for the comparison group they wish to describe as deprived by virtue of not accessing the “favoured” (bias source) product and previous research findings that document what could realistically be expected when sticking to oral uptake. Here we have a marketing thrust that asserts that a vastly more expensive PrEP option is substantially superior to a comparative generic oral product, the latter at pennies to the dollar, when it is merely noninferior at the level of breakthrough infection incidence by person-years denominator when you drill down into the reasonably manageable breadth of PrEP research. In fact, the HIV seroconversion rates are virtually identical … 0.11 cases per 100 person-years for LEN in PURPOSE 2; 1.1 cases per 1,000 person-years for oral PrEP in ANRS PREVENIR.

The ratios were actually 2:2:1 for PURPOSE 1 (LEN : F/TAF : F/TDF) the cis-gender women population sample study; and 2:1 for PURPOSE 2 (LEN : F/TDF) the men and gender diverse population sample study. The latter more relevant to most of us. What catches my eye most for PURPOSE 2 are the supplementary bacterial STI data, not packaged in the original NEJM paper eleven months ago, but soon afterwards shown in the manner appended below, depicting the consequences of not using condoms. Not that it isn’t consistent with what we already know about STI incidence in the context of HIV PrEP. One way to interpret person-years is that if the LEN trend for the entire study sample were to be theoretically reflected in any one individual study subject, that person would acquire a combined total of gonorrhea or chlamydia infection on approximately 8 separate occasions going forward 10 years. Bear in mind that condom use is not restricted or tracked in the research, so the incidence rates are actually higher, to an unknown degree, among persons consistently not using condoms.

Well, cuz you rag on select others with text but have nothing intelligent to say other than a lazy emoji when you anticipate digging yourself into a deeper hole. I’m supposed to be impressed with your meagre motley crew of alliances when the readership is several thousand members? Even then, the low single digit subgroup that you just stated you rely on for backing seem to be subpar relative to your own intelligence. You’ve just served up a big nothing-burger of a response and you hardly exemplify gay rights advocacy other than the very deterioration to which you attempt to call attention . 🥱🥱🥱

Yet you are one of the top ranked board scolds, persistently squabbling with gay men and downvoting them at every turn.

Oh the old my personal experience stands in for rational science argument.

Oh … come on.

For every cumulative 1,000 suffocated less frequent posters there’s an overregular poster whose ruling the roost obsession never peters out.

February 1945 is underway? OK then whatevs you say.

How will he wade through all the recycled news posts?