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The next problem is that most small online business owners usually have little money and not a lot of time to generate traffic and visitors to their site.... Many of them spend 6-8 hours every day just trying to generate some traffic to their site, product or service. And, at the end of each month, because nothing they seem to try ever works very well, they find themselves no better off than they were the month before. It doesn't take them long to realize what a big waste of time doing it that way really is. What we want to share with you today is one of the 'smartest' ways to generate an unlimited number of visitors to almost any site. It doesn't matter whether you are promoting a product, a service, a business opportunity or a content site. It doesn't matter how much your product costs ... It doesn't even matter if you are promoting your own products or someone elses via an affiliate program. If you want to promote ... need extra traffic or visitors ... want to increase your sales and monthly income, while automating 98% of it all - then keep reading. And while we can't cover ALL the different methods here, we would like to reveal 3 or 4 that we have found to be extremely inexpensive, relatively untapped, that have huge potential in bringing qualified traffic to your website. And, even more importantly ... regardless of whether you want 10,000 or 1,000,000 visitors, they only take about 30 minutes to set in motion! Why would you pay a lead-generation company $3 to $5 or more PER lead when you can generate your own at a fraction of the cost? So now instead of spending your entire day and your entire bank account trying to generate traffic to your site, what we are about to reveal should have you spending your time on more important things - like developing new products, growing your business, golfing, or whatever else it is that you really want to do. Isn't that the whole point of having your own web business ... so you can have more time and freedom to enjoy life and do as you wish? Wouldn't you agree, it's much better to spend 30 minutes or less on promotions, and to have the entire process automated? That's the difference between working SMART, and working HARD! You don't want to work HARD do you? The first thing we need you to know is that all website traffic is not created equal. There are plenty of sources out there and we can't speak for them all. However, we do use the traffic methods we mention below to successfully generate traffic and qualified leads to our business. And, as well as ones not mentioned below, they continue to work successfully to promote these types of online businesses with consistant success: Business Opportunities Network Marketing/MLM Franchise Opportunties Work-at-home programs Credit Cards/Repair Personal Finance Insurance offers Investment sites Computers, Software, etc Education, Jobs/Career "Free Stuff", Coupons, etc Internet/Web Services Shopping, Gifts, etc Sports/Sporting Goods Travel, Cars, Outdoors Pets, Hobbies, etc Mens/Womens Health Dieting, Fitness, etc Cooking, Gardening, etc Home Improvement Online Casinos sites Joke and Humor sites Online Games, Chat, etc Music, Sports, Movies, etc Pets, Hobbies, etc The traffic generation methods we are talking about are Pop-Ups, Pop-Unders, Keyword Targeted Pop-Unders, Expired Domain Traffic, AUDIO is OK traffic, and the different targeting platforms that can make them even more effective in promoting your business. It is important to note that these traffic generation methods are NOT spam advertising. All websites these methods take place with, have opted in to allow this to happen, are payed well to do so, and, there are tens of thousands of them participating). Let's start by taking a quick look at POP-UPS. I'm positive you've experienced "Pop-Ups" while surfing online. Pop-Ups are the irritating windows that suddenly "pop" out of nowhere, in front of what you were reading, interrupting what you are doing. We aren't going to spend a lot of time talking about Pop-Ups. They tend to get a lot of bad press; most people have software installed and most ISPs have blocking devices in place to eliminate them these day, which makes them not as popular a means of generating traffic. Nevertheless, because they are usually slightly cheaper than the other methods, some people still buy them in large quantities and use them to pull a small, but converting quantity of traffic to their websites. We want to spend more time talking about the other 3 types of promotion methods today. , and we will go next to the traffic method called Pop-Unders. POP-UNDERS - are pretty much what the name sounds like. The big difference between them and Pop-UPs is that Pop-Unders load **under** the current browser window. Because of that, they tend to not be as bothersome or interrupting to the web surfers as Pop-Ups. 99% of the time the web surfer doesn't even know the Pop-Under site is there until they move or close their main window, so they aren't in a "bad mood", from being interrupted, when they do see it. When you advertise your site with "Pop-Unders", your site is loaded behind another website that someone has just arrived at or left. Once the person closes off that particular site they then see yours, hence the name "pop-under". This is obviously a very cost effective way to have your site seen by thousands or even millions of people. Obviously this type of advertising, as with most others has its pros and cons. The pro being people WILL see your site by the thousands and the cost is extremely low. The con being most people will close the pop-under without bothering to browse your website. That is a fact you have to be aware of. You are NOT going to see conversion rates of 10% or anything like that ... far from it. However, you can make a small fortune even with a horrible conversion ratio. This form of traffic generation is so cost-effective that even if you only get 1 sale out of every 10,000 Pop-Unders you're still a head of the game! Let me say this another way, because this is the key and you really need to understand this. Quite truthfully, from a response ratio standpoint, Pop-Unders aren't choice #1, however, because they are so inexpensive, they can be one of the BEST ways to promote your site from an ROI (return on investment) standpoint, and that's what matters! Pop-Unders are quite a popular means of generating traffic, especially since they can be targeted by topic into almost any specific niche your website fits into. For example, if you have a sports website, it can be targeted to "appear" behind sports websites. Or, if you have a casino site, it can be targeted to load behind casino websites. It's obvious that only the visitors who are actually interested in those topics, would be looking at that niche site in the first place, right? Here are some of the many categories that can be targeted: Advertising Media - Agriculture - Animals - Antiques - Arts - Associations - Astronomy - Auctions - Auto Rental - Autos - Babies - Bathroom - Beauty - Bicycles - Boats - Books - Bridal - Building - Business - Camping - Candles - Candy & Confectionery - Cellular Phones - Cellular Service - Career Counselling - Car Audio - Charity - Chatrooms - Christian - Cigarettes - Cigars - Childrens Products - Clip art - Clocks & Watches - Clothes - Collectibles - College - College Nightlife - College Students - Comics - Computer Advice - Computer Memory - Computer Peripherals - Computer Programming - Computer Related - Computer Software - Computer Virus - Consumer Electronics - Conventions - Cooking - Cosmetics & Perfume - Costumes & Uniforms - Crafts & Craft Making - Credit Cards - Dance - Debt Consolidation - Diet - Domain Names - Education - Employment - Entertainment - Exhibitions & Conventions - Eye Care - Fabrics - Family - Farming - Fashion - Fashion for Men - Fashion for Women - Finance - Fishing - Fitness - Flights - Flooring - Flowers - Food & Beverage - Free Stuff - Friends & People - Furniture - Games - Games for Consoles - Games for PC - Gardening - Genealogy - Geography - Gifts - Golf - Government - Hair - Handbags - Health - Health for Men - Health for Women - High Tech - Home Business - Home Electronics - Horoscopes & Astrology - Horses - Hotels - Humour & Fun - Income Opportunities - Industry - Information - Insurance & Banking - Internet Services - Investment - Jewellery - Jobs & Career Counselling - Kids Activities - Kitchen - Language - Law & Law Enforcement - Liquor & Alcohol - Loans - Magazines - Maps - Marketing for Internet - Marketing non-Internet - Media - Miscellaneous - MLM - Money Making - Mortgages - Motorcycles - Movies & Films - Music/MP3 - Musical Instruments - Nature & Animals - News - Office Supplies - Organizations - Personal Advice - Personal Computers - Personal Homepage - Pest Control - Pets - Photography - Posters - Printers & Supplies - Property (Commercial) - Property (Residential) - Real Estate - Religion - Safety & Security - Sales - Science - Seniors & Retirement - Services - Shoes & Foot Products - Shopping - Skateboards - Smoking & Tobacco Products - Software - Sports - Tax - Tea & Coffee - Telephones & Service - Television & Satellite TV - Tickets - Top Web Sites - Toys - Training - Transportation - Travel & Tourism - Trivia - Vitamins - Web Design - Web Hosting - Web Resources - Webmasters -Wedding/Marriage - Adult Casino - Adult Movies - Adult Toys - Gay - Live Webcams - Match Making/Dating - Paysites - Paysites Amateurs - Paysites Hardcore - Paysites Interracial - Paysites Softcore - Paysites Teens - Penis Enlargement - Shopping - TGP - Untargeted Adult - Webmasters - Adult Casino - Free Games - Horse & Dog Racing - Premium Casino - Sports Betting - Untargeted Gambling. There are some limitations to using POP-traffic that you should be aware of. You will find that most traffic resellers state these limitations in their Terms and Conditions; in clear view on their websites: No other window of any type can be spawned internal or external of the target URL. The sites you submit may not contain any pop window (i.e exit pages, java pops, pop-ins, fly-ins, pop-unders, etc.). No redirectors, scripts that change the home page settings, message boxes, download boxes, are NOT allowed no hate/illegal/adult--All PG rated content. No warez, virus, trojan, auto-downloads, framebreakers, or browser-altering allowed. NO SOUND/NOISE on the page you are targeting. Before they start a campaign for you, they thoroughly check to see if any of these "traps" are on the site, and they do refuse service to any sites they determine are inappropriate for their network. Now while banning the presence of most of these "traps" listed above are valid, the NO sound/noise and the NO pop-up/under limitations that most traffic resellers enforce do stop A LOT of website businesses from using POP-traffic. Now there's a solution. AUDIO is OKAY! is a **new** mainstream form of traffic that ALLOWS you to have audio/sound and/or 1 Pop-Up or Pop-Under on your website's front page. What this means is that a lot of website businesses that have state-of-the-art movies, talking, or music presentations that start automatically on their front webpages, can now buy and use POP-traffic to generate visitors! This is new and this is in demand! Website promotion specialists can use POP-traffic to expose your business to millions of users with the most cost effective packages. They can deliver guaranteed visitors directly to your website 24/7. Whether you are looking to establish a presence on the Internet, or are just interested in branding your site, they can be your very own online advertising solution. does penis enlagement work com enlargement pennis pennis pump penile enlargement operation does penile enlargement work vimax free penis enlargement tip prosolution penis enlargement pill pennis enlargement before and after picture enlargement manhattan penile surgeon

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Cialis (Tadalfil) is in a class of drugs called phophodiesterase inhibitors. FDA approved Tadalfil – Cialis in 2003 for the treatment of men who experience difficulty having and maintaining an erection. Cialis (Tadalfil), an oral treatment for Erectile Dysfunction (ED) in men, is a selective inhibitor of cyclic quanosine monophosphate (cGMP) - specific phophodiesterase type 5 (PDE 5). Cialis is available in the form of tablets which contains 5, 10 or 20 mg of Tadalfil and inactive ingredients like croscarmellose sodium, hydroxpropyl cellulose, hypromellose, iron oxide, lactose monohydrate, magnesium stearate, microcrystalline cellulose, sodium lauryl sulphate, talc, titanium dioxide and triacetin. Recommended dose of Cialis in most patients is 10mg taken prior to sexual intercourse. Both Cialis and Viagra work in the same way, by helping blood vessels in the penis to relax allowing blood to flow into the penis causing an erection. Cialis is slightly different from the other ED drugs available in the market as it may work up to 36 hrs after dosing. Cialis is available online with various sites offering cheap Cialis. Forzest is the Indian answer to Cialis and is manufactured by Ranbaxy Laboratories Ltd. Forzest is same as Tadalfil and is also known as Generic Cialis. When a doctor prescribes and while buying it on the net there may be a choice between a brand – name medicine and the generic version of that medicine. Generic Cialis is available online and one can buy generic Cialis from these legal sites. There are variants of Generic Cialis available in the market – they are called generic Cialis or generic Tadalfil. They have the same composition as the branded Cialis. One can buy generic drugs as they only may look different because in the US, FDA does not allow it to look the same. Colors, flavors and certain other inactive ingredients may be different but the core ingredient remains the same. As most of the drugs fall under the patent law many companies are lining up to manufacture generic forms of the brand name drugs going off patent. Many Indian companies are in the race for regulatory approval to introduce medicines in the highly lucrative North American market. Many Chinese companies are also scaling up capabilities so that they could also foray into the generic market. All these companies need to file DMFs (drug masters file) before the US FDA detailing confidential information about manufacturing, processing and storing of drugs. They contain information about what is usually referred to as the active pharmaceutical ingredient (API), the core component of a drug. DMFs are also meant to support abbreviated new drug applications (ANDA). An ANDA approval is required to register generic versions of patented medicines that generate huge potential for what are often called ‘copycats’ of the drugs going off patent. best penis enhancement enlarement manhattan penis surgeon penile enlargment surgeon penis elargement surgeon plus vigrx vimax homemade penis enlargement enlargement manhattan pnis enlargement free penis pill sample safe pennis enlargement

Galactose is one of the 8 saccharides known as Glyconutrients. They are vital nutrients to the body and are: • Mannose • Glucose • Galactose • Xylose • Fucose (not fructose) • N-acetylglucosamine • N-acetylneuramic acid • N-acetylgalactosamine Galactose is found in sugar beets and dairy products. It is a sugar and is also known as brain sugar. Because it has food energy it is known as a nutritive sweetener. It is not very water-soluble and is less sweet than glucose. When joined with glucose it forms the disaccharide known as lactose found in milk. Alone galactose is known as a monosaccharide. Galactose is a vital nutrient in our body and deficiencies can cause serious metabolic disorders: • Mental retardation • Cataracts • A rare deficiency UDPgalactose-4-epimerase deficiency can cause nerve deafness • Galactose-1-phosphate uridyl transferase deficiency • Compulsive blinking disorder. Galactose is found in a number of natural products combined with other sugars, the most notable being lactose (combination of galactose and glucose). It is the galactose in lactose that causes an inability to digest dairy products known as lactose intolerance. It is also found in polysaccharides, carbohydrates and lipids. Lipids are found in the nerve tissue and the brain. Galactose is used in medicines and synthetic substances. A rare heriditary disease is known as Galactosemia can be found in infants. It occurs when there is too much Galactose in the body. This is caused by a liver enzyme deficiency. It is very important to diagnose this metabolic disorder early so that life long problems do not occur. This is a hereditary disease. It can only occur if one or both parents have this disorder. The disease will become apparent in the 1st days of life when the infant starts taking milk or formula. Jaundice, liver enlargement and vomiting are the usual signs of Galactosemia. However it can be further complicated by other infections. Blood tests will usually confirm diagnosis. If left untreated the disease can get serious and lead to kidney, liver, eye, and brain damage. The treatment is a glactose free diet. This is a long-term treatment and may have to be maintained for years and sometimes the whole of the person’s life. As an added precaution Expectant Mothers who are known to be at risk for this disease can also be placed on a glactose free diet during pregnancy. If diagnosed and treated early in life with an infant any liver damage will automatically heal up however if left untreated there can be irreversible damage. All jaundiced babies should be tested for Galactosemia. Galactose is also used for research into eye diseases. Consumption of yogurt and cottage cheese will produce more Galactose as the lactose in these 2 substances is easily broken down into the monosaccharide forms of glucose and galactose. Galactose can also be found in pectin, which can be obtained from fruits especially strawberries, and citrus fruits. penis enlargment review cheap penis enlargement pills homemade penile enlargment plastic surgery penis enlargment magna rx picture testimonials penis enlarement video vimax male penis enlargement manual penis enlargement safe pennis enlargement

Penis enlargement always seems like a good idea at first. Even those who don’t believe in the effectiveness of penis enlargement techniques and who dismiss all results as frauds, fakes and scams would certainly not mind to be proved wrong. There are few men on the face of the earth that are completely satisfied with the size of their penises. Still, the hardest thing about penis enlargement is to hang on to that initial feeling that you’re doing something good for yourself. Motivation is crucial to all human endeavors. It’s what makes the world turn around for humans. Properly motivated men and women can do things that may seem unlikely at first. Every person engaged in any activity that has tedious parts knows that maintaining motivation is the only way to get through and achieve results. Losing focus and allowing demotivation to creep up on you is the surest way to throw away a lot of hard work. Penis enlargement exercises suffer from the same problem. They are repetitive and can get to be downright boring sometimes. Just like gym, or professional athletic training, or piano lessons, penis enlargement exercises may seem tedious early on. Regardless of what you’re doing, routines are never fun. The trick is to keep your goal in mind and do whatever you feel necessary not to lose focus. The easiest thing to do is to keep thinking about your goal. Do you want those extra inches? Do you want to see “shock and awe” on the faces of ladies? Then you’d better quit bitching and start doing those reps. If necessary, write these questions on post-it notes and place them in your bathroom, or wherever you’re doing your exercises. The questions will help you focus on the positive results of penis exercises and strengthen your will to achieve them. You can make a workout chart and mark up every performed routine in blue and every missed routine in red. The fewer the red dots, the faster will those gains come. Remember that it takes some time before the first results are visible. Muscles, tissues, bones and other parts of the body do not grow over night. The penis, too, needs time to respond to your program of exercises. Talk to other people of forums. This will help you understand the penis enlargement process and get first hand accounts of successful enlargement stories. Every forum user will also tell you that a lot of patience is required and that results come only to those who work hard and show a lot of persistence. Give yourself small rewards for a day, a week or a month of steady exercising. You’ve been a patient man and trained hard and you deserve a reward. Buy yourself something nice, invite a good-looking girl to dinner or do something you’ve been wanting to do for a long time. And remember to refrain from measuring yourself every day. Penis measurements should only be done every 3 or 4 weeks. Otherwise the results will simply be disappointing and your motivation to continue will suffer. The bottom line is: don’t give up. The road is long, hard and tedious, but worth every minute. Always remember that your goal is to have men look at your bulging crotch with respect and women falling over themselves to see if that penis is really the monster it promises to be. And if you put enough effort and persistence into it, nothing can stop you. top penis enlargment pills penis enlargment before and after pnis enlargement pills review vimax home penis enlargement home penis elargement herbal penis enlargment cheapest penis enlargement pill penis enargement traction device safe pennis enlargement

Dial 1-800/AIDSNYC Every Monday and Wednesday morning, promptly at 10 a.m., I leave behind my daily life and turn to volunteering as an AIDS Hotline counselor at New York City’s GMHC [Gay Men’s Health Crisis], the nation’s largest social service agency for AIDS. For the next four hours, my co-volunteers and I sit in front of a bank of constantly-ringing telephones, talking to men, women, and teens who call in from across the nation with urgent questions about AIDS, the ravaging disease that has left 13.9 million people dead worldwide. After almost 20 years, a whole generation, families are still facing the heartache of tending the sick, while scientists continue to be confounded by this stubborn, ravaging virus. Although the federal government currently spends$4 billion per year on AIDS research, and $15 billion worldwide, there is no cure in sight for the viral infection and no vaccine available. Small wonder that the GMHC AIDS Hotline, the nation’s first, is flooded with more than 40,000 calls each year. Listening to callers 8 hours each week, I often think the Hotline is actually a direct link to the soul of callers--an anonymous forum that allows each to reveal secrets and fears that they might otherwise never discuss with anyone. A Morning in May This is the way it began: “Good morning, GMHC AIDS Hotline, can I help you?” “Yes...I have a question...[hesitantly] My son...he’s 21...and he just found out...he’s HIV-positive [voice breaking] I’m.....alone, divorced. And I need some help...someone to talk to...” “Of course....happy to talk to you...it sounds like this has been devastating for you....” “It’s terrible. He told me two nights ago....he’s...he’s so young....I don’t want him to die. He’s my only child....why did this have to happen?” [crying] Her son, she explains, had sometimes neglected using condoms, convinced he wouldn’t contract HIV infection from his female partners. “How could he be so stupid?” she now asks angrily. “Why didn’t he know how to protect himself? I don’t understand. What am I going to do?” We talk for 35 minutes, and by the end of the conversation, I notice I’m barely breathing. The distraught woman’s anguish is palpable. Her situation is every mother’s worst nightmare.The life of her child is in jeopardy and she feels helpless and afraid. I can’t imagine anything worse. During the call, I do my best to employ the GMHC Hotline protocol of “active listening,” which involves using silence, empathy and gentle probing with open-ended questions. I’m also having my own emotional reaction to the panic in her voice, and I’m worried about whether I’m doing enough. Toward the end of the clal, when she exclaims: “I don’t want my baby to die,” my heart plummets: “I know....I understand that, but there is hope,” I tell her. I find myself on the verge of tears. The Bad News This mother’s story is too common. According to the Centers for Disease Control in Atlanta, Ga., 40,000 Americans (half of them under 25) are newly infected with the AIDS virus each year. Unprotected sex and intravenous drug use remain the principal modes of transmission. “Teenagers,” notes AIDS activist Elizabeth Taylor, “are being very hard hit.” She refers to the three million adolescents who contract a sexually-transmitted disease annually. “Heterosexual teenage football players who are healthy and drink milk can get it too!” says the 71-year-old actress, who has singlehandedly raised $150 million for AIDS research. “But teens are very ignorant and feel invincible. They believe there’s an invisible shield protecting them from the virus, when it’s actually aimed right at them.” Taylor believes in addressing the problem head-on: “Tell your teenage son: ‘Maybe a condom doesn’t feel as good, but if it saves your life, it’s better than being six feet under.’ Intelligence must replace random sex.” Although a new generation of AIDS-fighting medications is prolonging the lives of thousands, nearly half of the 900,000 people infected with HIV in the U.S. cannot afford these drugs. Since the virus was discovered in l981, 410,800 Americans have died from AIDS-related complications, and the disease has left 13.9 million dead worldwide. Who Calls a Hotline? Not long ago I took a call from a 15-year-old boy living in a small town who said he feels guilty about his sexual attraction to other boys and is scared to discuss this with his parents. I ask him if there’s a school counselor or relative he might talk to, but he says he’s too afraid to confide in anyone. Being a teenager is hard enough, I thought, without the pressure of keeping this kind of secret. I felt angry and saddened that this child can’t comfortably discuss his feelings with his own parents. I encourage him to call the Gay Community Center Youth Program in a nearby city. In the meantime, I assured him that he could call our Hotline anytime, that we’d be there for him. This call was typical of the many we get from teenagers,whispering from their parents’ homes, confiding their blossoming sexual feelings and concerns. Our Hotline also receives calls from married men who phone from their offices, worried about extramarital sexual encounters; gay men suffering side effects from medications; mothers caring for a sick child or grieving for one lost to AIDS; even health care professionals themselves confused and requiring burnout support. One particular morning, I’m struck by the number of single women who turn to our hotline for help. At 10:15 a.m. a distraught young woman calls, explaining that she had been dating someone “very charismatic,” after a two- year period of sexual abstinence. “At first we used condoms and I was taking the pill to avoid pregnancy,” she says. But after her partner assured her he was HIV-negative, the couple began having unprotected sex. A few months into the relationship, she recounts, his behavior became “unpredictable,” until he finally admitted he was sleeping with other women and was addicted to heroin. Now she has to withstand the “terror” of waiting 3 months before getting an HIV antibody test. To help her cope, I give her the names of three terapists in her area. The call lasts 43 minutes. At 11:15 a.m. I take a call from a woman who is breathing heavily. She says that four months earlier she’d had a brief affair with a limousine driver, “not out of passion, but because I felt lonely. This was so totally unlike me,” she continues. “I come from a traditional Orthodox Jewish family...” Although they used condoms, and she has since tested negative for HIV, she feels deeply ashamed, and has stopped seeing him. And because she has both a persistent vaginal yeast infection and a rash on her neck, she’s convinced she must be infected by HIV. Although rashes, high fever, swollen lymph glands, heavy night sweats, sore throat, or other flu-like symptoms may indicate HIV, they can just as easily accompany the common cold or flu, or other type of infection. I encourage her to seek medical help and counseling, but the calls ends on a down note. “I must have it [AIDS],” she moans. I’m exasperated because it doesn’t sound that way to me, yet I can’t get through to her. The call lasts 22 minutes. It’s 11.38 a.m. when a well-spoken woman, who says she’s an attorney, calls from her office, asking for the names of anonymous testing sites. At first very businesslike, she calmly takes down all the information. I ask her why she’s considering a test. Total silence. Then she begins to cry: “I....I can’t talk....I’m sorry...you see, I have swollen lymph glands....[crying]....And my doctor wants to rule out HIV...I feel overwhelmed...” Then, abruptly: “Where can I send a donation?” She thanks me and hurries off the phone after just 3 minutes. These were one-time callers, but, as in any epidemic, an element of panic prevails, and our hotline also attracts an army of “chronic” or repeat callers who are intensely fearful no matter how benign their risk, many revealing continued misconceptions and paranoia about a disease that can be effectively prevented. We do our best to help them, but often they’re impervious to counseling. Most poignant are calls we get from AIDS patients, phoning from their hospital beds, attempting to navigate the exhausting labyrinth of insurance and health care matters. One man, in hospice care, said he craved companionship and missed the “good old days” when he was handsome and healthy. That call was a tough one for me as just the day before a close friend of mine, Joe, who had battled HIV for 16 years, had finally succumbed. Although at the end Joe was a mere skeleton, he was nonetheless at peace. “I’ve done what I wanted to,” he told me on our last visit. An avid gardener, he insisted on a final trip to his country house to see his garden one last time. For a moment the caller’s reality and the memory of my deceased friend blurred in my mind and I was overcome. Time for a break. Face to Face One of the most and unique services GMHC offers is called “A-Team Counseling,” a one-time, in-person session that’s free and anonymous. Recently, I was on an A-Team counselling a 26-year-old HIV-infected mother from the Midwest. She had traveled to Manhattan by bus to find her estranged boyfriend, who, she recounted tearfully, had kidnapped her 7-year- old son. Disheveled, painfully thin, the woman was a disturbing sight. She’s learned that the two had already returned home where the boyfriend was, and the child put in his grandmother’s custory. custody of his grandmother. Meanwhile she’d run out of money for the return trip, been refused a loan by her family, lost her ID, gone hungry and spent two nights on the street. Fortunately, this woman was registered at a local AIDS organization in her town. I telephoned her caseworker and persuaded him to buy her a one-way Greyhound bus ticket for $115.00. I also gave her subway tokens, a basket of food, juice and coffee. Smiling shyly, she thanked me for caring. Shaking hands good-bye with this woman was a bittersweet farewell. What will happen to her? I wondered will her health deteriorate or improve? Will she gain control of her life and be able to provide for her son? I’ll never know. One thing I do know: She’d appeared with the sorrow of a difficult life in her eyes, but when she left, she was elated at the thought of being reunited with her child. It seems that with faith and a helping hand, almost anything is possible. * * * * * 10 BIGGEST MISCONCEPTIONS ABOUT AIDS AND HIV (This list would probably be most effective when presented in a vertical chart, the misconception on the left, the correct answer on the right.) 1)The AIDS virus can be transmitted through saliva, sweat, tears, urine or feces; also through deep kissing. 1) HIV can ONLY be transmitted through four bodily fluids: blood, semen, vaginal secretions and breast milk--and can also be transmitted from a mother to her child before birth, during birth, or while breast feeding. The exchange of saliva through kissing is no-risk, unless the saliva has blood in it and both you and your partner are bleeding in the mouth simultaneously. 2) HIV may also be transmitted through casual contact with an infected person. 2) You can’t get infected from toilet seats, phones or water fountains. The virus can’t be transmitted in the air through sneezing or coughing. You can’t get HIV from sharing utensils or food or from touching, or hugging. HIV dies after being exposed to the air. Therefore, touching dried blood on a shaving blade, a toothbrush or a bathroom counter top is no risk. In any case, unbroken skin is impermeable, like a rubber raincoat, and cannot absorb the virus whether it’s alive or dead. Blood transfusions and medical procedures in the U.S. are safe. Giving blood is completely risk-free. The chance of getting HIV from dentists or other health care providers is too low even to measure.You can’t get it from mosquitoes or other insect or animal bites. 3) Oral sex is just as risky as vaginal or anal intercourse. 3) Although not 100% risk-free, oral sex is considered a low-risk activity,except if: you have bleeding gums, recent dental work, open sores such as a herpes lesion, any cut, blister, or burn in the mouth, or if you’ve just brushed or flossed your teeth. Also, oral sex with an infected woman is riskier if she is having her period, since menstrual blood can contain HIV. Overall, latex barriers, (such as condoms or dental dams) used during oral sex reduce the transmission of not just HIV, but other sexual transmitted diseases. 4) Animal skin, latex and polyurethane condoms are all equally effective in preventing HIV infection and you can use ANY lubrication on the condom desired. 4)Only latex or polyurethane condoms may be used, as HIV can pass through an animal skin condom. With latex condoms, only water-based lubricants--like K-Y jelly or H-R jelly--may be used. No lubricants with oil, alcohol, or grease are safe.Petroleum jelly,Vaseline, Crisco, mineral oil, baby oil, massage oil, butter and most hand creams can weaken the condom and cause it to split. However, with polyurethane condoms, petroleum-based lubricants can be used. 5) Women have to rely on men using condoms during intercourse to protect themselves against HIV. 5) Women may employ the “female condom,” a plastic sheath that can be inserted in their vaginas and used for protection against HIV. It can be inserted up to 8 hours before sex, has rings at both ends to hold it in place and can be lubricated with oil-based lubricants that stay wet longer. In addition, women can carry conventional condoms for their male partners’ use. 6) If a woman is HIV-positive, her offspring will automatically be born infected with HIV. 6) With no medical treatment taken, about 25% of HIV-positive women will give birth to infants who are also infected. However, the use of anti-HIV medications has resulted in a significant decrease of mother-to-child transmission of HIV in utero and during delivery to less than 5%. (NYT 10/19/ 99]. 7) AIDS is fundamentally a gay disease contracted by white males. 7) Recent data compiled by the Centers for Disease Control and Prevention indicate that young gay Hispanic and African-American men and heterosexual women are the fastest growing segment of the population being infected with HIV. Women now account for 43% of all HIV infected people over age 15. [NYT 11/24/98] African-American and Hispanic women account for more than 76% of AIDS cases among women in the U.S. 8) Heterosexual men are not really at risk for contracting HIV, even if they don’t use condoms. 8) The inside opening of the penis is composed of highly-absorbent, sponge- like mucous membrane tissues, which can provide a route for HIV-infected vaginal secretions or blood to enter the bloodstream. Proper condom use protects men from infection. 9) The AIDS epidemic is largely over because new AIDS medications like protease inhibitors and others have turned AIDS into a chronic, not a terminal disease. 9) In the U.S., AIDS is the fifth leading cause of death for people 25-44 years old. Roughly half of all those infected with HIV in the U.S. are not receiving any medications or medical care. AIDS now kills more people worldwide than any other infection, including malaria and tuberculosis.[NYT 11/24/98] In 1998 alone, 2.5 million people died of AIDS worldwide. 13.9 million people have died since the virus was discovered in 1981. 10) If you think you’ve been exposed to HIV through unprotected sex, you can take an HIV antibody test 2 weeks later and get an accurate result. 10) The standard “window” or waiting period remains a full 3 months. However, because the widely-used HIV antibody tests (The ELISA and Western Blot) have become so sensitive, about 95% of people will procure an accurate result 4-6 weeks after a possible exposure to the virus. * * * * [Note:The information stated above was reviewed for medical accuracy by Dr. Todd J. Yancey, an infectious disease specialist practicing in New York City and affiliated with New York Presbyterian Hospital, NY, Cornell Campus.] THE CHILD LIFE PROGRAM “Mommy takes a lot of medicine and Mommy’s really tired sometimes and she can’t take you to the park as much as she used to. It’s not that I don’t love you...and that I don’t want to...but Uncle Jack’s going to take you to the park today.” --A mother living with AIDS, a client at GMHC, talking to her 6-year- old son. In New York City alone, 28,000 children have been orphaned by AIDS since the epidemic began [NYT 12/13/98] GMHC’s unique Child Life Program serves HIV-infected parents and their children--who may, or may not, be infected with the virus. “We help families strengthen their ability to cope, relieve the pressure of parenting with support services, and teach parents how to talk to their kids,” says Child Life Program Coordinator Alison Ferst. “Unfortunately, should a parent or child be sick enough to be facing death, we also help them walk through it with grace and dignity---as opposed to feeling alone, isolated and frightened. “We also encourage sick parents to make stable legal plans for their children who may be left behind,” adds Ferst, “and to have disclosure conversations with the children in advance, so you don’t have a child standing at her mother’s funeral, not sure where she’s going next.” When an HIV-infected Mom arrives at GMHC to have lunch, attend a support group, consult with a lawyer, or access the acupuncture clinic, she can leave her children in a spacious playroom, decorated with fanciful murals and a giant tree hand-painted by the famed children’s story writer and illustrator, Maurice Sendak, who donated his art. [see photos] The program provides: child- sitting, nutrition services, a food pantry, art and magic classes, and recreational trips--church picnics, seasonal apple-pumpkin picking, amusement parks, zoos, museums, beaches. Also: homework help sessions, holiday parties, hospital visits, summer sports and weekly support groups for HIV- positive parents and their HIV-negative children. This unique program also features: Cooking classes for kids who sometimes prepare meals for sick parents; Pediatric Buddies, GMHC adult volunteers who play with sick children and also assist with family chores; Fun With Feelings Support Group, Friday Evening Family Time, Birthday parties, and a Holiday Gift Drive. “Children infected or affected by AIDS,” concludes Ferst, “want to be like other kids: They want to play with their friends, want to know that someone will always take care of them, want to know they’re not alone, and often wonder if it’s their fault when Mom or Dad gets sick.” These children need a helping hand and any of us can provide one.