SirBillybob

There are 3, and a 4th in development by Moderna. We all got MVA-BN which is one of the 3 but has 3 brand names according to global location, not to be confused with the trifecta of distinct products.

Just touched down in Stockholm, as case possibility beyond Africa was expected eventually. Clade I; the b now seems to be unnecessary given the phylogenetic tree structure. Person travelling from the endemic area. Contained thus far, Sweden reports. Public Health Agency of Canada had weeks ago estimated a 10% chance of arrival here by September, without the same expected spread that had been attributable to GBMSM network transmission of Clade IIb. Preparedness now an obvious benefit.

Theoretically, there’s also the population-level effects of Doxy prophylaxis, beyond self and intimate others. If the majority of higher at-risk GBMSM that go condomless simultaneously pursued uptake with high adherence levels over an arbitrary period of time it could attenuate two bacterial STIs, dramatically reducing incidence by controlling prevalence. To some degree that could compensate for poor control of the other two bacterial diseases. The latter would necessitate an arbitrary period of protected sex for the population majority; limited-time mass adjustment not abstinence. We cannot rule out that gaming Gonorrhea will eventually require such an intervention even though now would be ideal. It would cut incidence along with putting the brakes on AMR.

If you like your STIs in even-number clusters of four better than odd-number clusters of three, you might look up MGen (MG) infection and DoxyPEP as well as AMR associated MGen. It was included, for example, in the IPERGAY study and significant PEP protection did not occur. Another glossed over bacterial STI entity. Go to the party for Syphilis and Chlamydia reduction benefits, stay for the Gonococcal and Mycoplasma Genitalium shots. Do you want to live in a world where two highly problematic STIs become irrelevant factors in the prophylaxis research literature and are dismissed in subsequent guidance simply because they were included but no salutary benefit was found? I don’t.

An interesting read attached. So disappointed Aidsmap is done. Dissent on doxyPEP: recent guidelines becoming more cautious | aidsmap WWW.AIDSMAP.COM Two recent statements about taking the antibiotic doxycycline up to 72 hours after sex to prevent bacterial sexually...

Just the part about how that works out with Magnums, as well as the bioavailability of antibacterial treatment with all that cartilage. 😉

There is no Clade II 2nd wave affecting us. Portugal had a minor 2nd wave last summer that petered out. For upcoming Europe travel I track incidence trends. Up to early July; next review early Oct. ‘Circuit’ may elevate Spain incidence but I won’t know as early as I’d like. 965 De Maisonneuve East continues Imvamune offering on walk-in basis. I am single-dosed but likely will get 2nd dose soon. One reason is that impending pilots strike may strand me against booked return date and I’ll get more piggy over there being aggravated with sched disruption. It’s already in the past few days been a challenge to build a back-up flight plan to travel back home. I guess I’ll wing it and see what happens with my AC booking. NACI thoroughly updated guidance in May but 2-year booster recommendations have not been formulated yet for obvious reasons. PHAC constructed a complex algorithm for possible Clade Ib incursion and it’s unlikely anybody landing here and infected would not have it contained, diaspora households and whatnot. Jumping into GBMSM community a very remote possibility. If Canada officials could get their heads out of their asses there would be an attempt to donate some of our abundant MVA-BN supply to African LMICs.

I have enjoyable encounters without STI risk, so what I have done is fill in some of what I perceive to be missing elements in the decision-making process for DoxyPEP use. I don’t have much skin in this game. There is some interesting reading on other jurisdictions’ reviews and perspectives on DoxyPEP validity should you be interested, use search terms such as Europe, EU, Australia. Generally thumbs down from majority proportions of working groups. I test for STIs regularly, even though risk is negligible for me, because there tends to be openness with partners regarding status. I wouldn’t take DoxyPEP even if its current prophylaxis record were to be better for Gonorrhea, the reason being that any of the 3 infections would be detected early in the extremely unlikely event of acquiring one and, similarly, behavioural risk mitigation transfers into partners’ negligible risk from interacting with me. I would follow national guidelines for treatment if I ever acquired Gonorrhea: Ceftriaxone. AMR is creeping up for this drug but remains less than for Doxycycline. Test of cure is a possible contingency for following any treatment failure with a back-up medication. An anecdotal case of Doxy success is not surprising, in the same way that outright ineffectiveness of PEP is refutable, but does not figure prominently in guidance predicated on the broader picture of best GC treatment practice. Happy sex and ‘bonne chance’.

From 2024 CROI meeting, DoxyVAC efficacy for Gonorrhea adjusted down to 33% efficacy from interim 51%. But the incidence curves merge so it has to be even less. In contrast, you can see the incidence curves separating widely for Syphilis and Chlamydia. They omitted recurrent GC infection in the hazard ratio metric. Recurrence not uncommon due to high GC rates over time. They omitted these revisions from subsequent Lancet publication. The entire component was ghosted and, therefore, will be excluded from any meta-analytic synthesis of the small extant body of research. The incidence difference is statistically significant but of questionable clinical significance because 40% of study subjects allocated to PEP were infected with Gonorrhea over the study period and the curve direction portends higher cohort rates over time. 15% of subjects not taking PEP caught Syphilis.

Here’s the updated French IPERGAY/DOXYVAC research I mentioned wrt CROI meeting and an earlier post of mine. They actually omitted the Gonorrhea DoxyPEP results. I cannot access the full text without paying for Lancet subscription, so passing. Just a moment... WWW.THELANCET.COM

I see. Good point. I am only referring to PEP. I think “on” and “taking” can be interchangeable, even if regularly or prn. But I understand that for some “on” connotes taking regularly. The thing is that either DoxyPEP (theoretically on-demand) or DoxyPrEP (theoretically daily) can merge in regularity, obviously in contrast to HIV PrEP and HIV PEP. The caveat is Doxy dosage, never more than 200 mg in any 24-hr period. Technically, like HIV on-demand PrEP (a ‘before’ risk scenario) Doxy STI prophylaxis uptake quantity and frequency is variable in either a ‘before’, ‘after’, or blend of each. —— There is a fair abundance of Gonorrhea discussion, ‘up thread’ or ‘up topic’ as the kids say, under Health here, or a quick Google search will steer you to reputable summaries albeit a bit outdated on research developments. I had tried to fill in some of the gaps past while. The updated (downgraded) DoxyPEP effectiveness presented at the 2024 CROI conference seems to have not yet made it to journal publication. The integration of Ceftriaxone treatment failure reality has also fallen short in health entity summaries and there is more upthread on antimicrobial resistance (AMR). The only research on DoxyPrEP is a decade old and it was not effective for Gonorrhea. You can access that reference any many others from the CDC DoxyPEP guidelines simply by using the word search function for PrEP though you will see most of the yield relates to HIV PrEP.

And here’s the BBC piece that’s the next inner layer Russian doll for the Post piece, both referring to the actual paper I just appended above and whose data are buried deeper in the doll layers. Penile cancer: 6,500 amputations in Brazil in a decade WWW.BBC.COM "It's something you never imagine will happen to you," says João, 63, who under went a partial amputation.

I think The Post distorted some of the findings but here’s the paper and you can view for yourself, including perhaps implications for your geographic location. Global Pattern and Trends in Penile Cancer Incidence: Population-Based Study - PMC WWW.NCBI.NLM.NIH.GOV Penile cancer is a relatively rare genital malignancy whose incidence and mortality are rising in many...

Yes, the recent CDC DoxyPEP guidelines are specific to MSM/TGW that actually acquired a STI within the previous year. There is yet to be devised an official standard of care for those not in that category. But in Canada I believe either scenario is ‘off label’. Not surprised at the BC news because Grennan is running the DISCO trial out of there. Those results will be quite a while coming out. What accounts for non-USA jurisdictions’ reticence to emulate the current guidelines may be related to a different take on the efficacy evidence to date and to a different way of handling the risk behaviours that generate STI incidence. I read the news about BC and thought it was less than fully responsible. The majority of global Infectious Diseases entities are rightfully tentative. DoxyPEP efficacy against Gonorrhea is since revised downward when synthesizing the relevant data, and that update was available months before the final CDC summary. Moreover, along with low effectiveness is a high rate of Gonorrhea infection among recipients of DoxyPEP that would be expected to occur among populations with the same risk as study participants, that is, a previous STI infection essentially serving as a benchmark for sexual activity that supports statistical analysis comparing prophylaxis to placebo. The rates of Gonorrhea while on DoxyPEP are consistently greater than the rates of Syphilis and Chlamydia when not taking it. The guidelines gloss over the likelihood of breakthrough Gonorrhea in spite of attempted prophylaxis. Similarly, the growing rate of Gonorrhea antimicrobial resistance to conventional treatment (i.e., Ceftriaxone) is downplayed. The takeaway from the guidelines among some Infectious Diseases stakeholders is that prospective candidates for DoxyPEP are unfairly considered to be poorly equipped to process information related to differing efficacy data across the targeted infections and that it is futile to educate about problematic incidence rates because transmission will occur anyway. In fact, as seen with MPox for example, folks can and will adjust behaviour when given accurate information, while maintaining self-determination. The few jurisdictions endorsing DoxyPEP are telegraphing cynicism while virtue-signalling support for importance of personal sexual autonomy. You can also detect this in a recent conference rapporteur summary when referencing the recent disappointing updates about Gonorrhea. They are falling short of a transparent rendering of the advantages and liabilities of DoxyPEP. Be an ally fully, not half-measured. I wouldn’t say to anybody that DoxyPEP is a legitimate 3-for-1. Subtracting to 2-for-1 essentially calls for condom protection or other harm reduction with respect to Gonorrhea specifically. If you are not fine with trading off avoidance of Gonococcal infection, that is regrettably refractory to treatment, for the irrefutable benefit of pharmacological protection from Syphilis and Chlamydia (both of which are treatable) then Doxycycline prophylaxis is already obsolete. It is virtually impossible to stratify behavioural approaches to STI prevention according to the above differences among bacterial infections due to commonality in the routes of transmission. Gonorrhea is the more problematic STI but unfortunately evades prophylaxis.

!!?? Is that a random pseudonymous handle, formal legal Elon-ian adoption papers name, a test of our cognitive function recall, or a link to CP3O’s etiquette’n’protocol manual?😉😘

Why thanks 😊 but could you provide a Thesaurus for translation by any chance? What it might not clarify given your little side word salad, however, is that propensity by definition is static. The qualifier works semantically, for example courtesy of one of your photo subjects whose privacy was rudely invaded, if I were to say you have an occasional capacity to make a bit of sense. 😘

So I live a few blocks from Atetekan and Ste-Catherine and had a week’s break from the cottage, primarily for commitments and Olympics viewing. The zenith of Pride Weekend today was fun, cooperative weather, although some may know torrential rains almost shut down the city Friday along with power outages. l had occasion to attend Bar Stock and Bar Campus frequently. They were both worth it. I saw no evidence of any female customer example reflected similar to an earlier illustrative intent by another poster. I value inclusivity but also note the diversity in people types that makes life interesting. I had taken that entry as an inflammatory dig to body shame somebody that had dropped in to the club to enjoy a drink and socializing. There were many seats over the substantial space occupied by patrons where the customer might not have stood out as much. Random or bitchy photo choice? You be the judge. Visual hyperbole for the sake of showing off is tiresomely manipulative. I might add that the same poster also inserted slick illustrative representations of the club he seemed out to malign. He had also provided a photograph populated by men having a good time viewing a cute dancer. In a situation like this I typically say “Pick a lane.” A picture says a thousands words and inserting an array of contradictory photo takes is simply absurd and time-wasting. All strip clubs have their ups and downs. I don’t favour any one in particular so my summation is that the potential to enjoy your time in Campus or Stock is certainly there. It takes a village in The Village. If this topic had not been initiated the opportunity for a balanced and objective overview might not have occurred. So all are welcome. If a club visit makes you unhappy and you want to Yelp about it that’s OK too. The city has a lot of lucrative tourism going. One frustrated private dance seeker doesn’t make or break the scene. The dancers prefer local men and women over from-away drop-ins for repeat event earning reasons, understandably, but will be hospitable to anybody that knows how to behave and keep trash talk from spouting from their pie-holes (here we call it poutine-holes). I had an off-putting run-in with an unwell person in an otherwise empty MARTA station this Spring of an early dawn while minding my own business with suitcase ready to hop on a train to the airport. One unwell person does not represent the whole.

AFAIK none with on-site private dance structure.

With that Québécois penis nudging against your uvula he realizes and accepts that you have to place your hands somewhere.

Doesn’t fit on the licence plate, but “Eh bien je me souviens que je viens entre les reins des reines.”

More than one is usually discreet.

In contrast to oral finasteride where sexual function change findings lean towards a conclusion of detrimental side effect for some patients, topical finasteride (the OP’s written not oral topic) compared to topical placebo studied in research to date based on most recent available systematic review does not convincingly impact sexual function. Endocrine factors explain the academic receipts difference between oral and topical. Interestingly, some degree of both improved hair growth and deterioration in sexual function has been reported for placebo study arms, the two factors depending on oral vs topical product methodology. Finasteride assignment arm hair growth is usually a multiple of placebo arm hair growth because the latter group’s is not nil. Anecdotal reports of decreased sexual function among men using topical finasteride would be considered an artefact effect of unrelated variables affecting sexual function. Human nature goes for a concrete explanation, however specious. Science-based assumptions of causality not met satisfactorily. Due to unique sexual function demands a provider would not be deemed the most favourable candidate for assessing the effects referenced above.

Your question relates to the existence, application, enforcement, or breach of regulations that is irrelevant to the discussion about Montreal strip clubs because the venues’ acceptance of all genders is of their own volition and the venues do not pander or capitulate to the handful of objectors to ‘all walks of life’ inclusiveness. A double standard must contain a contradiction, like one party has the privilege of gaslighting the other but not vice versa.

Gay Pride, and a parade if there is one, culminates in a weekend … next weekend. Why should a club accommodate anyone’s arbitrary expectations according to specific dates anyway? Naturally, however, a commercial establishment’s marketing around key seasonal events is designed to upregulate interest. Irony: the expression of one’s meaning by using language that normally signifies the opposite. Example, somebody regularly attending Gay Pride lacking awareness of its typical 10-day structure. Or my single lifetime weekend visit to Atlanta this year qualifying a blanket impression about that scene that shouldn’t be taken with a grain of salt; of course it doesn’t, and I had the worst time ever, hookups so very inhospitable. 😉 The number of male customers in a photo that represents a few square feet in a large complex appears to be nil, that is so in this isolated case. As I said, it does and did not represent the ratio of men and women across the entire weekend’s evening span. Fake can be manipulation and reaching for influencer status exceeding grasp, with selective bias, not necessarily outright mendacity. Obviously, a photo such as the one posted is what the lens captured and is not doctored. It does not make it the penultimate receipt to defend a claim of steady female encroachment, Bridezilla theme notwithstanding. I similarly witnessed a gaggle of females there with flower wreaths in their hair this weekend. It was not problematic and my inclination to adjust my panties behind the curtain far exceeded that of getting them in a knot. Nor did a measured assessment of the scene lead to their ignition. The next time that you are in Stock or Campus I suggest hearing from the staff’s point of view the policy on taking photos in a strip club. You can always stomp your feet and assert it is your prerogative. That should go over well.