SirBillybob

Oh. That episode.

OK, now I’m confused …

Since convenience is a main driver in regimen selection, wise to consider lab burden, often contextually unique and nuanced, for regular HIV testing for injectables format. For example, all-in-one testing + drug admin at point-of-care versus separate lab attendance requirement. You can stop a given supply of oral meds if your lab test is positive the next day but you obviously cannot remove injected drugs that risk medication resistance if infected. Though the two current injectables don’t require regular kidney function assessment. A lot of this might depend on whether you attend a specialty clinic or pharmacy program versus family physician. Your program may want greater testing sensitivity than a rapid test. TDF/FTC oral regimen calls for venipuncture for kidney function … creatinine and eGFR via blood draw … so it makes sense in that case to have the routine blood draw test for HIV at the same . My advice is to assess these trade-offs and the degree of streamlining you prefer rather than be blind-sided by schedule demands. Where when and how you will get PrEP. My local dedicated no-fee program is very poorly functioning; I think the demand is overwhelming. I dropped them. Instead I pay hundreds of non-reimbursed dollars annually for private lab testing for HIV and bacterial STIs, renal etc, and my primary care physician prescribes the PrEP. He is also opted out of the provincial health care program and I pay him. Fortunately, my pharmacy can access my HIV and kidney function results online. For on-demand PrEP I’m certainly not going to switch to, say, Apretude (now covered in my Canadian province), and HIV testing every 2 months when my HIV testing pattern is based on behavioural risk, therefore less frequent; access to self-admin rapid testing for reassurance purposes not pharmacy dispensing; iterations of 90-day drug refills that require lab draw yet I only stock up about 3 months supply annually; and my kidneys are challenged by about one-sixth the burden of daily TDF/FTC PrEP.

And while we are clarifying “confidence interval” meaning, the lower 95% confidence interval bound for efficacy was 96.6% for Yeztugo in the PURPOSE 1 study; 82% in the PURPOSE 2 study.

Worry that replacing daily oral PrEP with an injectable might sacrifice protection as the injection concentration declines toward the next dose is understandable but isn’t supported by the clinical results. The approved intervals were deliberately set so that drug levels remain adequate through the end of the interval; the downward concentration curve is expected and already built into the regimen. There is no demonstrated end-of-cycle falloff in protection when injections are received on schedule. However, against perfectly taken oral PrEP, the biological advantage, in spite of statistically demonstrated superiority, may be small or unknowable because both approaches are already extremely effective. That said, Yeztugo trials were open label and there is no way to determine whether research subjects adjusted exposure risk towards dosing cycle finish lines. None of these methodologies are flawless. The idea suggested upthread, as basis for caution held by some making decisions, is confidence in a pharmacokinetic dosing protective buffer … “Confidence interval” does not refer to the degree of confidence in protection based on dosing intervals. In this context, confidence attaches to an estimated trial effect, often a hazard ratio or incidence-rate ratio, describing sampling uncertainty around the overall comparative incidence of infection, for example Apretude compared to TDF/FTC (aka Gilead’s pre-generic Truvada), or Yeztugo compared to background subpopulation incidence. To illustrate, one trial with Apretude compared to TDF/FTC: about 66% lower HIV incidence; hazard ratio 0.34 (95% confidence interval 0.18-0.62). Not to be confused with time windows and waning protection. My preference for oral PrEP, even if no out-of-pocket for injectable versions were possible, is based on my capacity for 100% adherence, but it’s moot because I apply that capacity to on-demand uptake.

I suspect it’s still searching for the lost plot😏

It’s in my genes. Your eugenics may cull me out.

This has been tabled before. If it had legs the lexicon would have a happy ending. “Two providers, both alike in dignity …” See how that worked out?

And he had a ball too. But shouldn’t this be in What’s Cooking?

Especially upside down … as welcoming as it is, I’d be walking pretty painfully to retrieve my keys from the ashtray.

#1 in petty officer rank

Aug 27th, but just watching the meet today without spoilers. Zürich. Not particularly expected. M 400m hurdles, Brazilian Dos Santos W 100m hurdles, American Russell

Exsssscuuuze me? O honey, I simply cannot. Voyooons donc, chéri, je t’en prie!

#1 OF is, categorically, erotica unless the consumer morphs it into an ad platform through gaming the firewalls. It’s typically more “Will I pay for this version of porn”? Sometimes but rarely, “Do you meet?” #2 Strip clubs obligate payment for cover and drinks only. Uncovering optional. I think the internal question there is more “Do I pay for this version of commercial sex work?” Sometimes, “Is there a booth available?” #3 The third option referenced is clear and may proceed from Part 2 of #2 or be sourced independently of #2. Sometimes, “How much, and how much do I get?” For 1-on-1 in-person I will 99% of the time have interacted a bit in-person, so obviously strip clubs or similar venues trump ad platforms, their inherent mystery, and associated detective work. So … Bachelor #2.

The character of King Harald as a little boy was featured in the recent PBS drama series Atlantic Crossing.