How to Improve the Performance of Your HDMI Cables

There are some useful guidelines to improve your HDMI cables performance.

Use signal boosters. Depending on quality, most HDMI wires lost their signal in roughly 10 to 50 feet. With these devices, power is enhanced making them to continue on remaining powerful even on long cable runs. There are, however, HDMI cables which run for 75 feet and have already a built-in signal booster inside the cable.

Use signal equalizers. This is another device which can maintain the signal’s quality and strength even with longer cable runs. It can also be called a signal enhancer. Aside from enhancing the signal, it can also eliminate any superfluous noise disturbance. Losing the dynamics of the HD technology is not something to worry about as the device does not remove it.

Use signal extenders. It helps by extending the signal down the extent of the cable subsequent to receiving the signal.

Use signal restorers. They are minute gadgets where weak signals are re-harmonized to reach their HDMI quality to the fullest. It expands the distance to have the signal trek even for over a hundred feet.

Use fibre Optic Cable. This is the best but the most expensive alternative. Fibre optic cables are normally utilized after a maximum of 150 feet run length was attained. Likewise, HDMI cables can reach a maximum of 1,649 feet efficient run with its fibre optic.

The quality of the raw materials used dictates the maximum run length and efficiency of the cables. Thicker copper wires in twisted pairs are usually on the category of higher value cables, but spell add-on expense on the part of the consumer but still with no guarantee of efficiency. Even high quality HDMI cables strive to transmit better signals for more than a distance of 50 feet.

You still need to invest in other add-on devices to enhance the signal of your HDMI cable over long distance.

Using Serialization

A common problem in programming is moving the program data to another spot, such as a file on disk or another computer. For example, suppose a video game needs to store a saved file on the hard drive. Normally, the developer would have to write a method that takes all the game information and puts it into a format that can be placed on disk. Another method needs to be written to reverse this. The concept of serialization, used in some programming languages, bypasses this.

If a language has serialization libraries, this means that these functions are built in. You can input an object and have built-in language libraries convert the object to data. And of course, you can do the reverse. Instead of having to write code and create your own format for storing program information, you can just have the language do it. This has a wide variety of uses besides the video game save file mentioned in the intro. Suppose you want any program to store user-inputted data. You can simply put that data into a serializable object, that write it to disk. When the program starts up again, use the deserialization methods.

This can also be used for network communications. Consider the problem of writing client and server programs that can communicate with each other. Instead of having to process data, you can just serialize the object and transmit its data over the network. As long as the client and server know what class is being used, this works.

However, not all programming languages can be serialized. Generally, this is only a feature of higher-level languages. .NET has it with the Serializable attribute for a class. For Java, the java.io.Serializable interface is used. Classes that implement this interface can be serialized. Even low-level languages such as C++ have the ability, albeit not in the standard library. The popular Boost C++ library has functions that provide the serialization ability.

However, there are also problems caused by serialization. Many languages do not have backwards compatibility. So if you write a new version of the program and try to use it with existing serialized data, it can fail. Fortunately, some languages do have backwards compatibility features that avoid this drawback.

Serialization is a useful tool that all programmers should know about. It provides an easy way to store program data permanently and transmit it between multiple computers. For languages where serialization libraries are built-in, this is generally very easy.

Getting the Best Drain Unclogging Nearby Essex County NJ

If you have a backed up sink full of hair or food, you will need drain unclogging nearby Essex County NJ. Of course, you can try drain unclogging materials bought over the counter at your local grocery store or hardware store like Home Depot. However, for bigger clogs, you will need a professional such as a plumber or someone who specializes in drains. If it gets to the point that you need a professional, there are several things that you should make sure to get in order to have the best possible experience for both you and your family.

First, you should make sure to know what the hours of operation are for any professional. If their schedule doesn’t align with yours, that will be a problem. If there is a drain emergency on Saturday night at 1 AM, then you might have to find someone else to help you with the drains. Nights and weekend availability might be something that you should think about when selecting a professional.

Second, you should make sure you get an estimate of the work to perform. This way, you will have a good idea of the effect it will have on your household budget. Also, there is much less likely to be any huge surprises after the work agreed upon is completed. This is good for everyone involved to ensure that nobody is unhappy.

Finally, you should understand the payment options. Is financing available? If so, what is the interest rate and terms? Do they accept electronic payments such as VENMO or CashApp? Or can you PayPal it? Another possibility is a cash or check option but if you get that, make sure you get a receipt and/or ask for a discount. These are just a few of the things you should think about when dealing with your home plumbing system. Best of luck!

What Are Examples of Gourmet Foods?

The definition of gourmet food is food that a connoisseur would enjoy – a gourmet. This means that even food prepared with every day ingredients could be considered gourmet food if it is prepared with loving care by a chef who knows how to cook very well. For example, my husband cooks a chicken jal frezi which is simply superb, so can be classes as a gourmet dish. If I cook the same dish it can’t be classed as gourmet food as I am not very good at making this particular dish- I don’t have the patience it needs to make it to perfection. If you can take ordinary ingredients, say peas, carrots, potatoes and lamb and cook them in a way which makes the dish superb, then this is an example of gourmet food.

If you think about individual items that are categorized as gourmet food then Beluga caviar would be a contender for the number one slot. Beluga is a type of sturgeon which lives in the Caspian Sea where it is caught by Russian and Iranian fishermen for its eggs (unfertilized) as caviar is raw fish roe (eggs). If you are a true gourmet, then you will know that real black Beluga caviar can only be eaten with a spoon which is not made of metal as metal reacts with the roe and it doesn’t taste as good if this happens. It is eaten with mother-of-pearl, bone or tortoise shell spoons (these are now illegal so you have to find antique ones). Part of the mystique and caché of caviar is the rituals that surround the eating of it.

Wild smoked salmon is also considered a gourmet item and this taste very different to the ubiquitous smoked salmon found in packaged slivers on supermarket shelves. Oysters (raw) would also be categorized as a gourmet item. These seafood items are rich in vitamins and minerals and are very good for our health, and I often wonder if they became so highly valued because of their nutritional content as the peasants of Europe just couldn’t afford them.

Peasants could however find truffles, another highly prized item, in forests if they knew which trees to find them under. Black truffles are the best (so it is said) but white ones have a lot going for them too. In Italy in delicatessens you can buy a few slivers of truffle to go in a dish, which makes them less expensive that buying a whole truffle. They can be added to a dish to make it an extra special one as you don’t need to use very much of a truffle for it to impart its unique flavour to a dish. They are very good added to rice which is cooked in champagne (a truly gourmet risotto).

Cheeses which have been lovingly made from ewe’s and goat’s milk by small dairy farmers are also highly prized gourmet items, and you can, increasingly, find these online. Brie would not be classed as a gourmet item unless it is ripe and gooey and made by the French cheese makers. The type so often found on supermarket shelves is not a gourmet cheese.

Chanterelle mushrooms can be gathered in the woods as long as you know what you are looking for. These are certainly gourmet mushrooms with their meaty flavour and beautiful golden-yellow colour. They grow under (not on) trees and have very distinctive trumpet-shaped tops. Fresh porcini and morel mushrooms are also considered gourmet food items.

You don’t have to pay the Earth for a gourmet dish. All you have to do is have the patience and the understanding of the nature and quality of your ingredients to produce your own gourmet food. (Although Beluga caviar is wonderful!)

IPv4 Vs IPv6 (Advantages and Disadvantages)

We can see the rapid growth of internet users in last few years and this increase also create challenges for internet management groups, stake holders and service providers. Day by day infrastructure of internet is expanding and we can even enjoy the service of internet in villages and remote areas. Increased of usage also increase online devices. In start internet protocol addressing (a specific IP addressing for each online entity) was designed on 32 bit and this scheme IP version called IPv4.IPv4 addressing is like 203.128.076.001. decimal is used to make the IPv4 addresses more palatable for humans and a 32-bit address becomes 4 decimal numbers separated by the period (.) character. If we calculate these decimal values and we can get the total number of devices can be participate on this protocol (256x256x256x256) = allows for 4,294,967,296 addresses. It is about 4 billion of addresses and in early days of internet no one can think, 4 billion slot will be full. here we shall discus some disadvantages of IPv4 as we have seen addressing capability problem and after that we shall go through the solution which will replace IPv4 and addressing structure of the new addressing scheme. we shall go through some disadvantages of IPv4 and new features of IPv6.

Rapid Growth of the Internet and the Exhaustion of the IPv4 Addressing

IPv4 allows for 4,294,967,296 addresses which is about 4 billion and IP allocation limits the public IP addresses to a few hundred million. Cause of this limitation companies using NAT (Network Address Translator) to map single public IP to multiple private IP addresses.

IPv4 Security at IP Level

When we communicate at public medium we need to encrypt data to maintain security and privacy. After a passage of time we have now security for IPv4 packets. This security knows as internet protocol security or IPSec but this is an optional for IPv4.

Internet Backbone Maintaining Large Routing Tables

In IPv4 network IDs allocation is very critical and currently more than 87000 routes in the routing tables of internet backbone routers today. The routing infrastructure is based on flat and hierarchical routing.

Quality of Service Concern in IPv4

Now a days internet users are not only limited with browsing and searching data. Current users are well aware of text and voice and video chat and video conferences and online video libraries. This kind of communication need real time data transfer for quality of service. Normally for these kind of services we use UDP (User Data-gram Protocol) or TCP (Transmission Control Protocol).IPv4 TOS field has limited functionality and, over time, has been redefined and locally interpreted. Additionally, payload identification that uses a TCP or UDP port is not possible when the IPv4 packet payload is encrypted.

IPv6

As we can see we have some basic problems in practice of IPv4 now we will check some new features of IPv6. here I like to describe the some of basic features of IPv6. Deployment of IPv6 is a big challenge for internet management groups, stake holders and service providers. It is difficult but not impossible. We can see benefits of IPv6 here. Biggest upgrade jump from IPv4 32 bit to IPv6 128 bit.

IPv6 Header Format

New header is designed to minimize header overhead. by moving both nonessential and optional fields to extension headers that are placed after the IPv6 header. IPv6 header is more efficiently processed at intermediate routers and that generates efficiency. IPv6 is 4 time larger than IPv4 and its header size is twice than older version.

IPv6 Large Addressing Space

In IPv6 source and destination addresses is based on 128 bit. 128 bit addressing can produce over 3.4 x 1038 possible combinations. Currently we can say this is enough but who know about future may be it also face same problem like IPv4 after some decades. 128 bit addressing allow us multiple levels of sub-netting and address allocation. So we can say that we have plenty of address for use in future.

Addressing and Routing Infrastructure Efficiency in IPv6

IPv6 designed to create an efficient, hierarchical, and summarize able routing infrastructure that is based on the common occurrence of multiple levels of Internet Service Providers. It reduce the size of routing table of backbone routers. Which is can cause of efficient internet experience.

Security features is now built-in

IPv6 has been design to support IPsec (AH and ESP header support required) also support mobility version Mobile IPv6. IPSec based on two types of extension headers and a protocol to negotiate security settings. The Authentication header (AH) provides data integrity, data authentication, and replay protection for the entire IPv6 packet. It is better form developers who built-in security features in development of IPv6 rather we bolt on later.

Quality of Service (QoS) of IPv6

As we have already seen about the UDP and TCP protocols for streaming and other multimedia services on internet. Cause the usage of these services are increasing day by day IPv6 have a flow level field in its header which make better and special handling for packets from source to destination. Data traffic is identified in the IPv6 header, support for QoS can be achieved even when the packet payload is encrypted with IPSec and ESP.

How to Know If You Have Male Yeast Infection

Many males will be embarrassed by the fact that they have a yeast infection and will often not seek any medical help. A yeast infection is not something to be ignored and this article should help you to at least determine whether or not you have a yeast infection.

While, it is commonly said that a male yeast infection is a minor problem that can be eliminated by maintaining proper personal hygiene, the fact is that neglected male candidiasis can lead to severe health complications up to damaging the male reproduction organs. This is why it’s obligatory to learn about the symptoms of male yeast infection and ways to initially and properly diagnose the condition.

The following 5 categories will help you to know if you have a male yeast infection:

1. Painful

Things such a jock itch, burning sensations during sexual intercourse or urination. If the pain is server it is a good idea to see a doctor or seek out treatment immediately.

2. Visual

These include dry skin which may be flaky, redness of the penis head and in extreme cases a white discharge.

3. Indigestion

These will include problems such a constipation, diarrhea, intensive gas an in extreme cases even bad breath.

4. Fatigue

A simple lack of energy and mood swings.

5. Sexual dysfunction.

The inability to get or maintain an erection without pain occurring.

6. Dietary preferences changes

Most common of which are cravings for sweets and refined carbohydrates, etc. This is a bad thing because if you have a male yeast infection these types of foods should be minimized

Note that the last four male yeast infection category symptoms are associated with almost any other yeast infection subtype as well. This fact supports the widely accepted alternative medicine philosophy that claims that candida balanitis is first and foremost an internal problem that needs to be addressed holistically rather than a local or external condition.

If you are able to identify any of these symptoms then it is very likely that you have a male yeast infection. Many men are not very forthcoming about seeking help but this is a dangerous approach because a yeast infection should be looked at and treated as soon as possible.

Auto Mechanics Curriculum – Preparing for the Job of the Future

While taking driver’s education class in high school, for part of the curriculum, a man insisted his daughter take a basic auto mechanics class. They fought for weeks about this class. It was unnecessary. It was ridiculous. After all, she was a girl. After much verbal sparring, she took the class and enjoyed it, using her knowledge many times.

Years later, it became clear why the man wanted his daughter to take this class. Someday, her car would break down. The auto club would not always be able to come to her aid. Roadside assistance is not always available. Especially when the breakdown occurs in the middle of the desert. A person could wait hours for help. That could be dangerous. It was important to know how to fix the basics on her own.

When she became a parent, and her teenage daughter was ready to learn to drive, it was their turn to fight about taking the class. The mother insisted and her daughter relented. As it turns out, after much arguing, the student really enjoyed it. Since she did not have a “head” for business, or fashion, or mathematics, or English, or any other subject for that matter, it seems the one thing she excelled at was fixing cars.

After taking all of the basic classes the school had to offer, the student’s instructor suggested a transfer to the local high school that offered full vocational technical programs. The transfer took place, and for the next two years she took a number of classes like basic tune-ups and trouble-shooting, tire rotation and balancing, transmission repair, engine repair, fluid transfers for oil changes and transmission fluid, and air conditioning, among others. Upon graduation from high school, the student became a licensed auto mechanic.

For this young lady, that was not enough. She wanted to specialize in foreign cars. That required a whole new set of classes. Thus began her enrollment in the local college vo-tech. Another two years and she earned her A.S. Degree in Auto Mechanics. She was able to fix anything on wheels. However, as with any industry, evolution takes place. The new hybrid vehicles are already on the market, and the electric car is just around the corner. She continues with her education to maintain the high level of expertise necessary for the cars of the future.

Auto mechanic classes can help a student with their future. To become a mechanic, one must learn problem-solving skills. Mechanics is a process. So is life. One cannot put gas in a car that has no engine. Such is the same with life. One step at a time.

For students that struggle in school, vo-tech classes and auto mechanic classes have historically been extremely challenging. Their opportunities for success were once unlike the mother and daughter that both took auto mechanics classes and flourished.

Building A Custom Chopper Motorcycle, Where Do You Start?

So you want to build a custom chopper? I do too, so the first question I asked myself, is where do I start. Should I make a business plan, a schedule, a financial statement, or should I just buy my wife some flowers and blindly proceed? I guess I should do all of the above but not necessarily in that order.

I will start by trying to justify this purchase and or endeavor, to do this I will make a list of my reasons for building a Chopper. 1) I want to ride a custom chopper, a totally cool stretched out, fire breathing, gas eating, pavement pounding, old lady scaring, 2 wheel monster. 2) I want to be able to say “I built that” when someone asks me where I got that totally sick bike. 3) I want to be able to customize the bike beyond the standard add on parts I can get for my current bike a Harley Davidson Fatboy. 4) I want to be able to make this dream come true, meaning I need to be able to pay for it. A $35,000 chopper is out of my current budget. 5) I have been talking about this for 5 years so why don’t I get to it and stop doing all the talking and start doing some building.

Now I have a few reasons on paper a will look at my options, then make a plan, a schedule, and find some extra money.

Let’s start with a my build options, and plan on a slow and steady approach. I realize I will need to do a lot of research before I start. I have 4 basic options, a kit bike, a rolling chassis, a start from zero build, or an extreme makeover of a current motorcycle.

Option 1) If I start with a motorcycle kit I maybe the farthest ahead from a mechanical perspective, and farthest behind from a financial point of view. What do I mean by this, well a kit bike has all the parts it just needs paint, labor, gas, oil and some love. The problem a complete kit bike will cost me $12,000 dollars right up front. This is a bit out of my spend a ton of money now then not be able to ride a bike for a year or two thinking. If I get a kit, I maybe able to get it together faster, as I will be motivated and have all the parts ready to go. As a first bike I think this is a very good option, when you consider all the expensive mistakes I may make along that way. One drawback to this option is the amount of customization I can do to the bike as it is put together. Because all the parts are in the kit, I may resist the urge to get new bars or different sheet metal, or other parts.

Option 2) Start with a Rolling chassis, this is the middle of the road option, spend a lump sum of money, about 1/2 of what the overall bike will cost and get a basic setup that all works together.

A Rolling chassis kit consists of a Frame, 2 wheels, the forks, and triple clamps and bars, all build and configured to work together. Add a motor and a transmission and all the major workings of the bike are in place. This setup helps avoid some of the major work needed to mix match and fit these items together. This option also allows for a ton of customization in the parts that people see and the parts that give a bike it’s personality. For me this is a very serious option to consider. I would only have 1/2 the cost and 1/2 the parts sitting around and gathering dust until I get time to get it together.

Option 3) Find each and every part one at a time and build a completely custom motorcycle. I know I could do this, but I also know I will encounter more unexpected and possibly expensive issues with this type of build. This option would give me a bike that no one would ever duplicate. This could be very good or this could be very bad. What if some possible combination of frame, motor, forks, or wheels didn’t work together? It would not be discovered until the motorcycle was all together. I think this option is better left to the serious professional who build bike all night long, as the are working on other peoples bikes, and running businesses during the day. I may consider this for my second custom chopper.

Option 4) Take an existing bike and start cutting and changing it. This is maybe as involved as chopping and re-welding the frame to create a new rake and angles. Or it could mean just getting a new frame and using the engine, transmission, and various other part to build a new machine. I like this idea, and I think it would be a lower cost alternative to all new custom parts. With this option you are also able to keep the current registration and title if the frame is not replaced. This is also a lower cost option because a lot of the miscellaneous parts can be reused.

I know that in one page all the possible combinations of Custom Chopper build can’t be completely explained, I just hope this information give you something to start with and build on. It has help steer me in the direction of a rolling chassis, so I better get shopping.

Herpes and Pregnancy

Herpes, both oral and genital, are highly communicable diseases caused by the two strains of the Herpes Simplex Virus: HSV-1 and HSV-2. Genital herpes is transmitted sexually and is rarely transmitted from a pregnant mother to her unborn child, but could prove fatal for the unborn infant if it is transmitted.

It is possible, though unlikely that someone can transmit the virus through the placenta during pregnancy. If this happens, chances of the baby being born with a defect or a miscarriage increase.

The   transmission  also depends upon the stage of pregnancy in which the primary episode of herpes sets in. If the women had primary genital herpes during the first trimester, then there are less chances of the baby being infected. This is because it usually takes the body three to four weeks to buildup antibodies against the virus.

So if herpes happens at the onset of pregnancy, the body gets enough time to build up the immune system. As a result, these antibodies are also passed onto the baby. Generally, mothers can have a normal vaginal delivery.

But this is not so if the woman gets the infection in the second or third trimester of pregnancy. If the blood tests confirm that the women has never had herpes before the experts will recommend a caesarian delivery. This is because at these stages, the body does not get enough time to build up the immune system and the chances of  transmission  are extremely high.

It is easier to prevent herpes than it is to cure it. The highest risk to an infant comes from an infected mother who contracts HSV-1 or 2 during pregnancy and the best way to avoid this is by preventing this situation. Since Genital Herpes is a sexually transmitted disease, steps should be taken to ensure that you don’t transmit herpes during this crucial time.

A Fragile Lifeline: Lessons I Learned Answering The Aids Hotline

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.