By LAURAN NEERGAARD, Associated Press

WASHINGTON (AP) – An AIDS-free generation: It seems an audacious goal, considering how the HIV epidemic still is raging around the world.

Yet more than 20,000 international HIV researchers and activists will gather in the nation’s capital later this month with a sense of optimism not seen in many years – hope that it finally may be possible to dramatically stem the spread of the AIDS virus.

“We want to make sure we don’t overpromise,” Dr. Anthony Fauci, the National Institutes of Health’s infectious disease chief, told The Associated Press. But, he said, “I think we are at a turning point.”

The big new focus is on trying to get more people with HIV treated early, when they’re first infected, instead of waiting until they’re weakened or sick, as the world largely has done until now. Staying healthier also makes them less likely to infect others.

That’s a tall order. But studies over the past two years have shown what Fauci calls “striking, sometimes breathtaking results,” in preventing people at high risk of HIV from getting it in some of the hardest-hit countries, using this treatment-as-prevention and some other protections.

Now, as the International AIDS Conference returns to the U.S. for the first time in 22 years, the question is whether the world will come up with the money and the know-how to put the best combinations of protections into practice, for AIDS-ravaged poor countries and hot spots in developed nations as well.

“We have the tools to make it happen,” said Dr. Elly Katabira, president of the International AIDS Society, which organizes the world’s largest HIV conference, set for July 22-27. He points to strides already in Botswana and Rwanda in increasing access to AIDS drugs.

But Fauci cautioned that moving those tools into everyday life is “a daunting challenge,” given the costs of medications and the difficulty in getting people to take them for years despite poverty and other competing health and social problems.

In the U.S., part of that challenge is complacency. Despite 50,000 new HIV infections here every year, an AP-GfK poll finds that very few people in the United States worry about getting the virus.

Also, HIV increasingly is an epidemic of the poor, minorities and urban areas such as the District of Columbia, where the rate of infection rivals some developing countries. The conference will spotlight this city’s aggressive steps to fight back: A massive effort to find the undiagnosed, with routine testing in some hospitals, testing vans that roam the streets, even free tests at a Department of Motor Vehicles office, and then rapidly getting those patients into care.

“These are the true champions,” Dr. Mohammed Akhter, director of the city’s health department, said of patients who faithfully take their medication. “They’re also protecting their community.”

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A few miles east of the Capitol and the tourist-clogged monuments, the Community Education Group’s HIV testing van pulls into a parking lot in a low-income neighborhood with a particularly high infection rate. An incentive for the crowd at a nearby corner is the offer of a $10 supermarket gift card for getting tested.

Christopher Freeman, 23, is first in line. He was tested earlier this year and says showing off that official paper proclaiming him HIV-negative attracts “the ladies.”

“Forget money, it’s the best thing you can show them,” he said.

But that test was months ago, and Freeman admits he seldom uses condoms. He climbs into the van and rubs a swab over his gums. Twenty minutes later, he’s back for the result: Good news – no HIV. But counselor Amanda Matthews has Freeman go through a list of the risk factors; it’s education to try to keep him and his future partners safe.

“Just try to get yourself in the habit of using condoms,” she said. “You say it’s hard to use condoms but what if you do contract the virus? Then you’ve got to take medications every day.”

Freeman waves his new test result with a grin, and walks off with a handful of free condoms.

At a nearby bus stop, counselor Laila Patrick encounters a little resistance while handing out condoms, when a woman says that encourages sex outside of marriage.

“Stopping AIDS is everyone’s business. You’re looking out for the next person,” Patrick said. “You might just want to help someone be safe.”

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About 34 million people worldwide have HIV, including almost 1.2 million Americans. It’s a very different epidemic from the last time the International AIDS Conference came to the United States, in 1990. Life-saving drugs emerged a few years later, turning HIV from a death sentence into a manageable chronic disease for people and countries that can afford the medications.

Yet for all the improvements in HIV treatment, the rate of new infections in the U.S. has held steady for about a decade. About 1 in 5 Americans with HIV don’t know they have it, more than 200,000 people who unwittingly can spread the virus.

Government figures show most new U.S. infections are among gay and bisexual men, followed by heterosexual black women. Of particular concern, African-Americans account for about 14 percent of the population but 44 percent of new HIV infections.

Your ZIP code plays a role in your risk, too. Twelve cities account for more than 40 percent of the nation’s AIDS cases: New York, Los Angeles, Washington, Chicago, Atlanta, Miami, Philadelphia, Houston, San Francisco, Baltimore, Dallas and San Juan, Puerto Rico. Many are concentrated in specific parts of those cities.

“Maps tell the story,” said Brown University assistant professor Amy Nunn, who is beginning a campaign that will bring a testing van door-to-door in the hardest-hit Philadelphia ZIP code.

“It’s not just what you do, it’s also where you live. There’s just a higher chance that you will come into contact with the virus,” she explained.

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Prospects for a vaccine are so far elusive and health disparities are widening, so why the optimism as expressed by the Obama administration’s goal of getting to an AIDS-free generation?

Consider the potential strategies, to add to tried-and-true steps such as condom use and treating HIV-infected pregnant women to protect their unborn babies:

-Studies found treatment-as-prevention could lower an HIV patient’s chance of spreading the virus to an uninfected sexual partner by a stunning 96 percent. In the U.S., new guidelines recommend starting treatment early rather than waiting until the immune system has weakened. Abroad, the United Nations hopes to more than double the number of patients being treated in poor countries to 15 million by 2015.

-Other studies show a longtime AIDS medication named Truvada can prevent infection, too, if taken daily by healthy people who are at risk from their infected sexual partners. The U.S. Food and Drug Administration is expected to decide by fall whether to formally approve sale of Truvada as an HIV preventive.

-A study from South Africa found a vaginal gel containing anti-AIDS medication helped protect women when their infected partners wouldn’t use a condom, generating more interest in developing women-controlled protection.

-Globally, experts also stress male circumcision, to lower men’s risk of heterosexually acquired HIV.

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Testing is a key step in improving prevention. The AP-GfK poll found 57 percent of adults say they’ve been tested at some point, a bit higher than federal estimates, but not enough. The government recommends at least one test for adults, and that populations at higher risk get tested at least once a year.

Following those recommendations depends in part on people’s concern about AIDS. The poll found just over half of Americans consider HIV as much or more of a problem now than two decades ago. But less than 20 percent are worried about getting it themselves, and even populations at higher risk don’t consider HIV a big threat. Some 16 percent of black respondents said they’re very worried about HIV, compared with 4 percent of whites.

“We’ve become complacent about HIV in America, and it’s a real tragedy because hundreds of thousands of people in our own country aren’t getting the care they need,” said Chris Collins of amFAR, The Foundation for AIDS Research.

The drugs can cost up to $15,000 a year in the U.S., and overall treatment costs are rising as people with HIV live longer. In developing countries, those drugs can cost less than $400 a year.

The AP-GfK Poll was conducted June 14-18 by GfK Roper Public Affairs and Corporate Communications. It involved landline and cellphone interviews with 1,007 adults nationwide. Results for the full sample have a margin of sampling error of plus or minus 4.0 percentage points.

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In the U.S., the government is targeting the hardest-hit communities as part of a plan to reduce HIV infections by 25 percent by 2015, said Assistant Secretary of Health Howard Koh. Work is under way to learn the best steps to get people treated early, including in cities such as Washington, where 2.7 percent of residents have HIV, roughly four times the national rate.

Washington resident Zee Turner knows it’s hard to stick with care. She’s had HIV for two decades, learning the news when her baby was born sick. Health workers helped mom and daughter receive then-newly emerging treatments, and they’re doing well today.

“I felt that I should get out here and try to help somebody else, because somebody had to help us get into care,” said Turner, now 53 and a community health worker.

The city’s latest HIV count suggests progress, with a slight decrease in new diagnoses and a majority of patients being connected with medical care. Community workers such as Turner are called to try to help people stay on treatment when other problems intervene.

“If they’re on drugs, I take them to the drug program. If they need help going on Medicaid, I go with them to Medicaid,” Turner said. “Any problem they have, I’m going to try to fix it and get them back into care.”

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Associated Press Deputy Director of Polling Jennifer Agiesta and News Survey Specialist Dennis Junius contributed to this report.

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Online:

International AIDS conference: http://www.aids2012.org

Poll results: http://www.ap-gfkpoll.com

AP-GfK poll shows voter distaste for Putin-style leadership
WASHINGTON (AP) — Donald Trump has called Russian President Vladimir Putin “a leader — unlike what we have in this country.”

But most Americans don’t agree with Trump’s assessment of Putin’s leadership skills, a new Associated Press-GfK poll shows.

Only 24 percent of registered voters say Putin has leadership qualities that would be good for an American president to share, while 71 percent say he does not. In fact, a majority, 56 percent, said they have an unfavorable view of Putin, while only 10 percent said they view the Russian leader favorably.

 Voters were split on whether Trump would be too close to Putin, with 42 percent saying they think Trump would be too close, and 41 percent saying his approach would be about right. Fourteen percent think he would not be close enough.
By comparison, most voters (53 percent) think Democrat Hillary Clinton’s relationship with Putin would be about right, while 11 percent think she would be too close and 32 percent think she would not be close enough.

The relationship between the Republican nominee and the Russian strongman began taking on new life when Putin praised Trump last December as “bright and talented” and “the absolute leader of the presidential race.”

The billionaire businessman hailed Putin’s regard for him as a “great honor,” brushing off widespread allegations that the Russian president has ordered the killing of political dissidents and journalists.

“Our country does plenty of killing also,” Trump told MSNBC’s “Morning Joe” in December.

Four in 10 Trump supporters and only 1 in 10 Hillary Clinton supporters say Putin has leadership qualities that would be good for an American president to have. Still, even among Trump’s supporters, just 16 percent have a favorable opinion of Putin. Only 5 percent of Clinton’s supporters do.

Marissa Garth, a 28-year-old stay-at-home mom from Smithfield, Utah, said she plans to vote for Trump this November because he exhibits the qualities of a strong leader — not to be compared with Putin.

“I think (Putin) is a strong leader for his country,” she said. “But at the same time I don’t think he necessarily has the qualities that I would want as a president.”

In fact, the poll finds that men are more likely than women to say that Putin has leadership qualities that would be good in an American president, 28 percent to 19 percent.

Among Clinton’s supporters, 69 percent say Trump would be too close to Putin. Forty-nine percent of those supporting another candidate share that view, but only 8 percent of Trump supporters say their candidate would be too close to Putin. Eighty percent of Trump supporters say his approach would be about right. Among conservatives, 20 percent say Trump would be too close to Putin.

There is nothing 54-year old Gary Sellers, of Homewood, Illinois, likes about Putin — or Trump. He called Putin a “dictator,” adding, “there are no qualities of his that I wish that an American president would have.”

A lukewarm Clinton supporter, he’s concerned that Trump shares Putin’s extreme views of governing. “I feel he has a dictatorial approach toward being president of the United States,” Sellers said of Trump.

Forty-seven percent of voters say they approve and 52 percent disapprove of President Barack Obama’s handling of the U.S. relationship with Russia.

Voters are divided over whether the next president should take a tougher approach to Putin (42 percent) or whether the current approach is about right (39 percent). Just 16 percent think the next president should take a friendlier approach.

Just under half of voters (48 percent) say the U.S. relationship with Russia is a very or extremely important issue, ranking it low on Americans’ list of priorities, far below issues like the economy (92 percent), the threat posed by the Islamic State group (70 percent), the U.S. role in world affairs more generally (68 percent) and immigration (60 percent).

There’s a generational divide over Russia. Two-thirds of voters age 65 and over and more than half of those between 50 and 64 call the U.S. relationship with Russia very or extremely important, while only 4 in 10 30-49 year olds and only a third of those under 30 say the same.

Generally speaking, voters are more likely to say they trust Clinton than Trump on negotiating with Russia, 40 percent to 33 percent. Nineteen percent say they trust neither and 7 percent trust both equally.

John Eppenger, 68, a retiree in Fairfield, Ala., said that when it comes to dealing with Russia, Clinton would “do a much better job than Trump. She’s not perfect, she’s not ideal, but she’s better.”

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The AP-GfK Poll of 1,694 adults, including 1,476 registered voters, was conducted online Sept. 15-19, using a sample drawn from GfK’s probability-based KnowledgePanel, which is designed to be representative of the U.S. population. The margin of sampling error for all respondents is plus or minus 2.5 percentage points, and for registered voters is plus or minus 2.5 percentage points.

Respondents were first selected randomly using telephone or mail survey methods and later interviewed online. People selected for KnowledgePanel who didn’t have access to the internet were provided access for free.

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Online:

Poll results: http://ap-gfkpoll.com


AP-GfK Poll: Majority of Americans fear Trump presidency

By JONATHAN LEMIRE and EMILY SWANSON

NEW YORK (AP) — More than half the country fears a Trump presidency. And only about a third of Americans believe he is at least somewhat qualified to serve in the White House.

In the final sprint to Election Day, a new Associated Press-GfK poll underscores those daunting roadblocks for Donald Trump as he tries to overtake Hillary Clinton.

Moreover, most voters oppose the hard-line approach to immigration that is a centerpiece of the billionaire businessman’s campaign. They are more likely to trust Clinton to handle a variety of issues facing the country, and Trump has no advantage on the national security topics also at the forefront of his bid.

Trump undoubtedly has a passionate base of support, seen clearly among the thousands of backers who fill the stands at his signature rallies. But most people don’t share that fervor. Only 29 percent of registered voters would be excited and just 24 percent would be proud should Trump prevail in November.

Only one in four voters find him even somewhat civil or compassionate, and just a third say he’s not at all racist.

“We as Americans should be embarrassed about Donald Trump,” said Michael DeLuise, 66, a retired university vice president and registered Republican who lives in Eugene, Oregon. “We as Americans have always been able to look at the wacky leaders of other countries and say ‘Phew, that’s not us.’ We couldn’t if Trump wins. It’s like putting P.T. Barnum in charge. And it’s getting dangerous.”

To be sure, the nation is sour on Clinton, too. Only 39 percent of voters have a favorable view of the Democratic nominee, compared to the 56 percent who view her unfavorably. Less than a third say they would be excited or proud should she move into the White House.

“I think she’s an extremely dishonest person and have extreme disdain for her and her husband,” said one registered Republican, Denise Pettitte, 36, from Watertown, Wisconsin. “I think it would be wonderful to elect a woman, but a different woman.”

But as poorly as voters may view Clinton, they think even less of Trump.

Forty-four percent say they would be afraid if Clinton, the former secretary of state, is elected, far less than say the same of Trump. He’s viewed more unfavorably than favorably by a 61 percent to 34 percent margin, and more say their unfavorable opinion of the New Yorker is a strong one than say the same of Clinton, 50 percent to 44 percent.

That deep distain for both candidates prompts three-quarters of voters to say that a big reason they’ll be casting their ballot is to stop someone, rather than elect someone.

“It’s not really a vote for her as it’s a vote against Trump,” said Mark Corbin, 59, a business administrator and registered Democrat from Media, Pennsylvania.

Roughly half of voters see Clinton at least somewhat qualified, while just 30 percent say Trump is.

Even when it comes to what may be Clinton’s greatest weakness, the perception that she is dishonest, Trump fails to perform much better: 71 percent say she’s only slightly or not at all honest, while 66 percent say the same of Trump. Forty-nine percent say Clinton is at least somewhat corrupt, but 43 percent say that of Trump.

“Whatever her problems are, they don’t even come close to him,” said JoAnn Dinkelman, 66, a Republican from Rancho Cucamonga, California, who will cross party lines and vote for Clinton. “Everything that comes out of his mouth that is fact-checked turns out to be a lie.”

Trump finds no respite with voters when it comes to what he vows to do as president, either.

Nearly 6 in 10 oppose his promise to build a wall along the U.S. border with Mexico, and only 21 percent of his supporters and 9 percent of registered voters overall are very confident he would succeed at fulfilling his promise that Mexico would pay for the construction.

Six in 10 believe there should be a way for immigrants living in the country illegally to become U.S. citizens — a view that Trump opposes.

“The wall isn’t the answer. It’s not feasible and Mexico won’t pay for it,” said Timothy Seitz, 26, a graduate student at the Ohio State University and a Republican. “We should be leaders. We shouldn’t cower from others and cut ourselves off in the world.”

Beyond immigration, voters say they trust Clinton over Trump by wide margins when it comes to health care, race relations and negotiations with Russia. She also narrowly tops Trump when it comes to filling Supreme Court vacancies, as well as another of the billionaire’s signature issues: handling international trade.

Trump is narrowly favored on creating jobs, 39 percent to 35 percent, while in general, voters are about equally split on which candidate would better handle the economy. Voters are slightly more likely to trust Trump than Clinton on handling gun laws, 39 percent to 35 percent.

Voters are closely split on which candidate would better handle protecting the country and evenly divided on which would better handle the threat posed by the Islamic State group. And Americans are much more likely to say they trust Clinton than Trump to do a better job handling the U.S. image abroad.

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The AP-GfK Poll of 1,694 adults, including 1,476 registered voters, was conducted online Sept. 15-19, using a sample drawn from GfK’s probability-based KnowledgePanel, which is designed to be representative of the U.S. population. The margin of sampling error for all respondents is plus or minus 2.5 percentage points, and for registered voters plus or minus 2.7 points.

Respondents were first selected randomly using telephone or mail survey methods and later interviewed online. People selected for KnowledgePanel who didn’t have access to the internet were provided access for free.

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Online:

Poll results: http://ap-gfkpoll.com