SirBillybob

City-wide road infrastructure, construction, and repair involves about 5,000 kilometres, expected to continue another 8 years. This will not necessarily be evident for that length of time coming in from Dorval or in all sections of the downtown core. But it is long and painful, especially for cross-city commuters. I am back to the 747 Express bus rather than Über. $10 CDN, reliable, and often only 30 minutes. But I also live very close to one of the route stops that is easier to walk to-and-from ... a car takes much longer to traverse those same city blocks due to construction.

In general, people will often debrief with a trusted friend prior to going to a Clinic. If you have a confidante, they may help assess the decision to pursue screening. Many folks attend PEP screening with someone they know. A lot of guys paying for sex do not have a reliable non-judgemental "tribe" member. The forum may not be the optimal debriefing place, but in the absence of ... the above ... In addition, many guys hiring commercial sex providers are mortified about disclosing this practice, notwithstanding that a clinic is likely accustomed to serving this population. I still wince when transparently verifying this theme at PrEP follow-ups. The OP was cryptic, but readily invited private input as surrogacy for a real-world confidante. OK in my books. Some people have a lower threshold of anxiety and may experience an isolated transmission phobia following behaviour that others view as negligible or zero risk. Someone may have AIDS phobia, have some insight into their "panic" state, and be self-conscious about pursuing transmission assessment or psychological help. I am not saying this is the case, but there must be some reason for the vagueness. Let's face it, fear of transmission is a motivator for protection. Fear can thus be productive but also take on an extreme shape. I think that what kept this thread ticking along was curiosity about what really occurred. My sense is that the OP got some advice behind the scenes that was useful if not technically formal.

I think I have the answer. I checked Fugues magazine April edition online and saw a typed event listing for May 18th ... "Party District", an opening summer sorta circuit party on the strip with international DJs and 'beaux danseurs sexy'. I could find no banner ad on it, though. I believe it was formerly "Hot & Dry" on the Saturday of our Victoria Day weekend. I do not think it was strictly affiliated with Sky but likely similar to the Gay Pride parties in August, with loosening of venue boundaries in the interests of Village fest.

I just telephoned a staff member at Sky Complex. He has no knowledge of the sign you refer to. As I said, I saw no such sign myself. Their facebook page does not display any such feature for recent and upcoming nights. They neither had, have, nor will have dancers/strippers.

I do believe it is called 'screwnicorning'.

Hamptonn really bulking up ... NYC. Davisphysique was in DC following Boston. Perhaps he is now a Colombian attaché'd to some politician's tongue. He looked his best IMHO 6-7 years ago. Perhaps they have a Latin American competition coming up. Hamptonn is still short his pro card.

Having spent a great deal of time in Brazil, you cannot judge overall level of national attractiveness based on a slice of the population selling their attractiveness. My straight friends base their desire to visit Brazil on Victoria's Secret December TV show.

I went by Sky on Thursday night and saw no "danseurs" sign. Some of the venue's components are weekends only but I was busy. I went to Stock but forgot to ask if there was new competition (ie Sky) I may be proven incorrect, but I do not think Sky has strippers with private dance options. They upgraded one component to a bistro at street level, but I think the other components have not been altered to add a dancer stage, etc.

... after it has become engeorgi'd from sucking on it.

There is a little bit more info on earlier threads here. Search "Georgi". Besides, his surname Kiryakov is on his shirt and you can find him on IG, etc.

I never planned it, but had a huge crush, in my 50s, on an escort who also was a novice personal trainer who was also getting some expert mentoring on program design. We agreed on a short trial of training, ended up mixing the two roles for 30 months. I had obviously been working out poorly for decades because I peaked at a low-body-fat but rather skinny size, and low but healthy weight for my height. For years I had dreamed of getting just that extra 10% that would still bring me to a weight (still) more slender than a swimmer build. Slowly, steadily, with an approach more geared to high resistance less reps, changing the routine every 4-6 weeks, I got to 17% greater weight than baseline. About one pound max per month on average. Not big by any stretch but appropriate for my frame. Half of workouts with him, half on my own, never more than two at a time on my own. For me, bending to his rigourous programs was exciting and the additional treats were incentivizing. I agree in principle that it was training heresy but it worked for me.

---- I went to Thermas about 8 times this month over a few weeks visit. Tried to hit every night of the week. There was no real difference among the nights. It was generally awful for selection or for doing a few guys consecutively. There was 1 max 2 guys each time worth hiring. Otherwise, the dozen or so escorts were surprisingly unattractive and out of shape compared to my previous visits 2012-2016, and compared to Rio, Salvador Bahia, São Paulo, etc. If it had not been for the few guys who appealed to me ... a stroke of luck that there was one each time (otherwise I'd have been flushing cash down the drain for the entrance) ... it would have been a total bust. The VIP room (€15) was decent. Junior (mentioned), a newbie friend of his from Rio Grande do Sul state, and an in-demand stud from Paraguay were highlights and made the trip worth it.

Yes, I realized that after having boned up on some of the reading this week. You have a good eye. I might have walked off with misinformation or misinterpretation. In any case, I now stick to Tylenol. I am going to go over it again with a walk-in to the PrEP clinic pharmacist soon because my PrEP follow-up with the nurse is a few months away.

Part 3 Consumer Information - see the paragraph on "do not take with ... NSAIDS". Gilead Sciences Product Monograph for Truvada, July 5 2018 Me: Ibuprofen may perhaps be a NSAIDS with lower nephrotoxicity than some others but it can be easily switched out for Tylenol or Aspirin? Some people pop such pills like candy, and my health care providers may be framing taking Advil (or Methocarbamol with Ibuprofen for muscle relaxation) as a prohibition rather than a caution?

Hi, TruthBTold, I still think that what you described in more detail remains inconsistent with the guidelines for on-demand as I understand them. I say this in the spirit of longstanding townhall-type sharing traditions for gay men since the onset of HIV, traditions that have made their way into current fora such as this one, and are like an unstoppable train. The explicit proviso being such contributions do not stand in for properly sourced medical advice. Not to be controversial or out-of-turn authoritative, or erode your confidence in your health provider. The product monograph or pharmacist's instruction sheet is another means of ascertaining the correct regimen based on whether it is continuous daily PrEP or a current on-demand option endorsed in your particular country.

I understand what you are trying to say, josh282282. My impression reading the OP was that has his physician was describing the now widely accepted on-demand PrEP regimen. That was my assumption because the OP had described enough features of that regimen that lined up with the instructions accompaning the Tenofovir-Emtricitabine bottles dispensed to me and thousands of others in several parts of the world. The OP's description fell short of the details of this IPERGAY research-supported regimen. However, he did not suggest that he was going to take PrEP willy-nilly without following the instructions for the version of PrEP he would ultimately select. I will risk a paradoxical bind at this juncture. You suggest that I did not elaborate on my on-demand PrEP preference, yet if I now describe that regimen you may be inclined to assert that I am trying to endorse it without the solid research underpinnings you seem to dismiss or be unaware of. But here goes: 2 pills 2 to 24 hours prior to first sexual activity, followed by 1 pill taken daily until 48 hours following the last sexual activity. My most recent course equalled 14 doses for 10 days of expected activity. Such cycles of usually similar length occur, in my case, a few times within the year. You rightly weighed in out of concern that the OP and others would not take PrEP properly. You described a consumption standard, 7-days preparatory PrEP, that remains consistent with the elective option of continuous PrEP uptake .... 7 days of consumption prior to having or resuming intercourse at a level of frequency supporting continuous (as opposed to on-demand) is not an imposition because it is likely going to be a one-time basis, or a less frequent but longer wait-period requirement in the context of sustained cycles of high-risk sex. On the subject of motive, you are imputing to me irresponsible or reckless intent. Unfortunately, this is just an example of WYSIATI bias ... what you see is all there is. Embellishing your point by needlessly conflating my rendering of the description of my physician's instructions with the proffering of amateurish clinical advice. I had already clarified that I was not giving a personal opinion but that I was following the guidelines that emerged from on-demand PrEP research. I am not the only forum member, by the way, that applies the principle of 'caveat emptor' to all consumerism including health care. A physician incapable of drawing on more sophisticated processing in order to temper cognitive bias and short-sighted impressions of me would not pass my 'acid test' for patient-centred care.

The International Antiviral Society -USA panel is accepting of the on-demand 2 pill 24 hours prior to RAI uptake standard based on the Ipergay study. I believe the reference is in JAMA and easily accessed. For intermittent semi-spontaneous anal intercourse, 7-day blood plasma loading is unrealistic for many fellows at a practical level. Postponing a rare fuck opp don't work that way. We tend to want it and to want it stat. And as mentioned, PrEP is not intended to replace condom use. I do consult my ID specialist and switched a year ago from the 7-day single dose to 24-hour pre-coital double dose, even though I always know 7 days or more ahead of time when sex is going to occur, and even though cost is a non-issue for me. Granted, I neither expect readers to follow my decision nor the advice of a physician not in their care cascade. If IAS-USA and CDC want to duke it out on behalf of American MSM, fine with me. I am neither American nor USA-centric. CDC guidelines, while reputable and respect-worthy, are not global guidelines.

Oh, right. Thanks. On demand PrEP was 86% more effective for drug (.9% infection over average 9 months, with acknowledgement among the 2 subjects they had stopped the pills) compared to placebo (6% infection rate; n = 14 infected). Essentially, PrEP taken properly was very effective.

Sorry, I do not know why you cannot find this info. NSAIDS add to the extreme workout that Truvada confers [sorry, should be "imposes", not confers] on our kidneys. My follow-up PrEP team at a top-drawer clinical research centre always says: remember, drink lots of water and do not take any Advil. Try googling 'truvada nsaids' and follow the trail.

Help me out, please. A poster wrote in these related PrEP threads quoting an 86% something-or-other. I was skimming, then could not find the post during a more detailed read. Where is that post? Was it removed? Please tell me the thread name and the date of that specific contribution.

Some of the confounders comparing daily versus demand related to the reduced distinction between the sexual patterns of the two groups. More frequent sex among some in the demand group amounted to up to an average of 25 doses per month. This is analogous to taking continuous PrEP substandardly in the context of a frequency of anal intercourse that would ordinarily call for the daily regimen. Therefore, a lot has to do with taking the chosen course appropriately ... not news. In contrast, in the substudy of demand PrEP compared to demand placebo, each group's average pill dose frequency was about 15 per month ... equivalent to about 3-4 sex cycles based on, give-or-take, two simultaneous pills before followed by one pill on each of two subsequent days.

Ibuprofen is contraindicated while taking Truvada. I switch to Acetaminophen or ASA for occasional headache use (unrelated to ARV meds) as needed during my on-demand PrEP cycles. Psyllium husk is food and is water soluble. There are no food adjustment requirements for tenofovir/emtricitabine. I do not alter my psyllium consumption when taking PrEP because it does not affect the pharmacokinetics/bioavailability of the drug. The most challenging requirement is increased water consumption for renal protection, because I have never felt particularly thirsty and I have an "urgent bladder". When taking PrEP I always need to be conscious of where I can pee if out doing some activity.

There is a lot of easily accessible research on comparing both the effectiveness, and MSM consumer reasons/preferences, for daily versus OnDemand/intermittent/pericoital PrEP. The guidelines for on-demand are a little more specific than the OP represented, based on his summary of his MD's description. This option is far more commonly utilized in Europe and Canada compared to USA. I take the on-demand course, though I have the same very low cost burden for either method. I think somebody mentioned donating their unused/stockpiled Truvada to a poz person that might be in need. NEVER make this call. Truvada is not used as a solo agent for HIV treatment. That is why routine testing is recommended for PrEP users. If seroconversion occurs, a different standard of medication is used for viral suppression and to prevent the complexities of drug resistance.

"George" is apparently now in HCMC Vietnam, while one of his escorting wingmen is in Melbourne. A very hot muscular 6'2" Mineiro workout buddy "Pedro" or "Pablo" or something like that, training with George end of April and posted on his IG feed, worked a shift recently at BCN Thermas, turning tricks for €50-70.