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.”

___

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.”

___

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.

___

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.

___

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.

_____

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.”

___

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

___

Online:

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

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

AP-GfK Poll: Americans want tighter Ebola screening, concerned government hasn’t done enough

By LAURAN NEERGAARD and EMILY SWANSON, Associated Press

WASHINGTON (AP) — Americans overwhelmingly want tougher screening for Ebola, according to a poll released as federal health authorities took new steps to do just that.

Many are worried about Ebola spreading here, and two-thirds say the government hasn’t done enough to prevent that from happening, according to an Associated Press-GfK poll.

Some things to know:

THE PUBLIC WANTS MORE TRAVEL SCRUTINY

The AP-GfK poll found 9 out of 10 people — unusually high agreement on any issue — think it’s necessary to tighten screening procedures for people entering the U.S. from the outbreak zone in West Africa, including 69 percent who say it’s definitely needed.

Some would go even further: Almost half say it’s definitely necessary to prevent everyone traveling from places affected by Ebola from entering the U.S. Another 29 percent say it’s probably necessary to do so.

The Centers for Disease Control and Prevention has warned since summer that an infected traveler eventually would arrive in the U.S., and it finally happened last month when Thomas Eric Duncan developed symptoms of Ebola a few days after arriving from Liberia. He died on Oct. 8.

WHAT IS THE GOVERNMENT DOING

While Duncan wasn’t contagious during his flight, his arrival spurred U.S. officials to begin checking passengers arriving from Liberia, Sierra Leone and Guinea for a fever, an early Ebola symptom, just like they’re checked before leaving those countries.

The AP-GfK poll suggested that wasn’t enough.

Wednesday, the CDC moved to fill a gap in that screening: Starting next week, all of those travelers must be monitored for symptoms for 21 days, the Ebola incubation period. They’ll be told to take their temperature twice a day and must report the readings to state or local health officials.

That’s not just for West African visitors. It includes U.S. government employees, who had been doing their own 21-day fever watches upon return from fighting the epidemic, as well as doctors and other workers for aid organizations, and journalists.

WHY NOT A TRAVEL BAN

The Obama administration says that’s not on the table. Already, there are no direct flights to the U.S. from the outbreak zone, and the airport with the most travelers from West Africa — New York’s Kennedy airport — has averaged 34 travelers a day since entry screening began. Health experts say a travel ban would prevent medical supplies and health workers from reaching West Africa, and could drive travelers underground and hinder screening of potential Ebola carriers.

AMERICANS FEAR EBOLA’S SPREAD HERE

Nearly half of Americans are very or extremely concerned that Ebola will spread widely in the U.S. After all, two nurses caught it while caring for Duncan.

Health experts had hoped that fear would start to dwindle, considering that people who shared an apartment with Duncan while he was sick emerged healthy from quarantine this week — showing the virus isn’t all that easy to catch.

FEAR VS. KNOWLEDGE

But despite months of headlines about Ebola, nearly a quarter of Americans acknowledge they don’t really understand how Ebola spreads. Another 36 percent say they understand it only moderately well.

People who say they do are less concerned about Ebola spreading widely in this country. Among those who feel they have a good grasp on how it spreads, 46 percent are deeply concerned; that rises to 58 percent among those who don’t understand it as well.

Ebola doesn’t spread through the air or by casual contact, and patients aren’t contagious until symptoms begin. Ebola spreads through close contact with a symptomatic person’s bodily fluids, such as blood, vomit, feces, urine, saliva, semen or sweat.

The AP-GfK Poll was conducted Oct. 16-20, using KnowledgePanel, GfK’s probability-based panel designed to be representative of the U.S. population. It involved online interviews with 1,608 adults, and has a margin of sampling error of plus or minus 2.8 percentage points for all respondents. Respondents were first selected randomly using phone or mail survey methods, and later interviewed online. People selected for KnowledgePanel who didn’t otherwise have access to the Internet were provided with the ability to access the Internet at no cost to them.

___

Online:

AP-GfK Poll: http://www.ap-gfkpoll.com


AP-GfK Poll: Voters see GOP win in the offing, but they aren’t too fond of their choices

By JENNIFER AGIESTA and EMILY SWANSON, Associated Press

WASHINGTON (AP) — Two weeks before Election Day, most of the nation’s likely voters now expect the Republican Party to take control of the U.S. Senate, according to a new Associated Press-GfK poll. And by a growing margin, they say that’s the outcome they’d like to see.

But the survey suggests many will cringe when they cast those ballots. Most likely voters have a negative impression of the Republican Party, and 7 in 10 are dissatisfied by its leaders in Congress.

The Democrats win few accolades themselves. Impressions of the party among likely voters have grown more negative in the past month. In fact, Democrats are more trusted than the GOP on just two of nine top issues, the poll showed.

The economy remains the top issue for likely voters — 91 percent call it “extremely” or “very” important. And the GOP has increased its advantage as the party more trusted to handle the issue to a margin of 39 percent to 31 percent.

With control of the Senate at stake, both parties say they are relying on robust voter-turnout operations — and monster campaign spending — to lift their candidates in the final days. But the poll suggests any appeals they’ve made so far haven’t done much to boost turnout among those already registered. The share who report that they are certain to vote in this year’s contests has risen just slightly since September, and interest in news about the campaign has held steady.

Among all adults, 38 percent say they’d like the Democrats to wind up in control of Congress, to 36 percent for the Republicans. But the GOP holds a significant lead among those most likely to cast ballots: 47 percent of these voters favor a Republican controlled-Congress, 39 percent a Democratic one. That’s a shift in the GOP’s favor since an AP-GfK poll in late September, when the two parties ran about evenly among likely voters.

Women have moved in the GOP’s direction since September. In last month’s AP-GfK poll, 47 percent of female likely voters said they favored a Democratic-controlled Congress while 40 percent wanted the Republicans to capture control. In the new poll, the two parties are about even among women, 44 percent prefer the Republicans, 42 percent the Democrats.

In all, the poll finds that 55 percent of likely voters now expect Republicans to win control of the Senate, up from 47 percent last month. Democrats have grown slightly more pessimistic on this count since September, with 25 percent expecting the GOP to take control now compared with 18 percent earlier.

What’s deeply important to likely voters after the economy? About three-quarters say health care, terrorism, the threat posed by the Islamic State group and Ebola.

On foreign affairs, Republicans have the upper hand. By a 22-point margin, voters trust the GOP more to protect the country, and they give the Republicans a 10-point lead as more trusted to handle international crises. Democrats have a slim advantage on health care, 36 percent to 32 percent.

Although handling the Ebola outbreak was among the top issues for likely voters, the poll shows little sign that either party could capitalize on fears of the virus as an election issue. More than half said either that they trust both parties equally (29 percent) or that they don’t trust either party (24 percent) to handle public health issues like Ebola. The remaining respondents were about equally split between trusting Republicans (25 percent) and Democrats (22 percent).

Same-sex marriage? Only 32 percent said that was an extremely or very important issue to them personally, identical to the percentage saying so in September, before the Supreme Court effectively allowed same-sex marriages to proceed in five more states.

The poll, which asked likely voters whom they preferred among the candidates in the congressional district where they live, found Republicans hold an edge in the upcoming elections. Forty percent said they would vote for the GOP candidate in their House district, while 32 percent said the Democrat. About a quarter backed a third-party candidate or were undecided.

Although likely voters appear more apt to take the GOP side in the upcoming elections, the poll finds little difference between those most likely to cast a ballot and others on negative perceptions of the nation’s direction and leadership. Among all adults as well as just the likely voters, 9 in 10 disapprove of Congress, 7 in 10 say the nation is heading in the wrong direction, 6 in 10 disapprove of the way Barack Obama is handling his job as president and 6 in 10 describe the nation’s economy as “poor.”

The AP-GfK Poll was conducted Oct. 16-20 using KnowledgePanel, GfK’s probability-based panel designed to be representative of the U.S. population. It involved online interviews with 1,608 adults, and had a margin of sampling error of plus or minus 2.8 percentage points for all respondents. Among 968 likely voters, the margin of sampling error was plus or minus 3.6 points.

Respondents were first selected randomly using phone or mail survey methods, and later interviewed online. People selected for KnowledgePanel who didn’t otherwise have access to the Internet were provided with the ability to access the Internet at no cost to them.

___

Associated Press writer Philip Elliott contributed to this report.

___

Follow Jennifer Agiesta on Twitter: http://www.twitter.com/JennAgiesta

Follow Emily Swanson on Twitter: http://www.twitter.com/el_swan

___

Online:

AP-GfK Poll: http://www.ap-gfkpoll.com