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: Americans support menu labeling in restaurants, grocery stores

By MARY CLARE JALONICK, Associated Press

WASHINGTON (AP) — More than half of Americans say they already have enough information at restaurants to decide whether they are making a healthy purchase. But they want even more.

According to an Associated Press-GfK poll conducted in December, most Americans favor labeling calories on menus in fast food and sit-down restaurants. Most favor labels for prepared foods in the grocery store, too.

The poll was conducted a little more than a week after the Food and Drug Administration announced new rules that will require restaurants and other establishments that sell prepared foods and have 20 or more locations to post the calorie content of food “clearly and conspicuously” on their menus, menu boards and displays. Companies will have until November 2015 to comply.

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MAJORITY SUPPORT MENU LABELING

A majority of Americans — 56 percent — favor requiring fast food restaurants to post calorie amounts on menus, while 54 percent favor the calorie postings at sit-down restaurants and 52 percent favor the labels at prepared food counters at grocery stores.

Slightly fewer approved of requiring the calorie postings in other dining locations. Forty-nine percent of Americans supported posting calories on coffee shop menus and 44 percent approved of the postings on vending machines and at movie theaters. Forty-three percent favored calorie postings in amusement parks. All of those establishments will be required to post calorie amounts under the new FDA rules.

Only about 1 in 10 Americans oppose labeling requirements at each of these places. The remainder said they neither favor nor oppose each requirement.

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WOMEN, DEMOCRATS MOST SUPPORTIVE

Women are more likely than men to say they favor labeling requirements at restaurants and prepared-food counters, though a majority of men support the labeling at fast food restaurants and around half support it at sit-down restaurants. College-educated respondents are more likely than those without a college education to favor labeling requirements at all of the establishments.

The support appears to be relatively bipartisan. Democrats are significantly more likely to support the calorie postings than independents or Republicans, but a slim majority of Republicans still support calorie postings at restaurants.

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PEOPLE CARE ABOUT CALORIES, SUGARS, FATS

The idea behind the rules is that people may pass on that bacon double cheeseburger if they know it has hundreds of calories — and, in turn, restaurants may make their foods healthier to keep calorie counts down. The menus and menu boards will tell diners that a 2,000-calorie diet is used as the basis for daily nutrition, noting that individual calorie needs may vary. Additional nutritional information beyond calories, including sodium, fats, sugar and other items, must be available upon request.

When they’re judging whether a food item is a healthy choice or not, 55 percent of Americans say how many calories it contains is very or extremely important to them. Same with sodium levels.

Sugar and fat were slightly more important to health-conscious diners — 61 percent said sugar was very or extremely important when deciding on healthy purchases and 59 percent said the same about the amount of fat.

Only 36 percent of Americans said they feel the level of vitamins and minerals is extremely or very important when making healthy purchases, and even fewer — 23 percent, less than a quarter — said the same about whether an item is organic. Women and people living in urban areas were most likely to make organic food a priority.

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AMERICANS ARE ALREADY INFORMED

Even though a majority favors more calorie labeling, most Americans say they already have enough information to decide whether they are making healthy purchases at restaurants.

Sixty percent say they now have enough nutrition information at sit-down restaurants and 56 percent say they do at fast food restaurants. That number drops to 48 percent at prepared food counters in grocery stores.

Around a third say they don’t have enough information to decide if they are making a healthy purchase in any of those places.

When it comes to the grocery store, 75 percent of people say they have enough information to make a healthy choice. Unlike restaurants, where nutritional information is often a mystery, nutrition facts panels have been required on packaged foods since the 1990s. The FDA included prepared foods at supermarkets in the menu labeling rules as grocery stores have increasingly sold restaurant-like offerings.

The menu labels were required by Congress as part of health overhaul in 2010. The FDA has said they are just one way to combat obesity, since Americans eat and drink about one-third of their calories away from home.

Michael Taylor, FDA’s deputy commissioner of foods, said the agency knows there is strong interest from the public in the labeling.

“It’s not a magic wand, but it will help people make better choices about their diets,” he said.

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The AP-GfK Poll of 1,010 adults was conducted online Dec. 4-8, 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 3.4 percentage 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 access at no cost to them.

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AP Director of Polling Jennifer Agiesta and News Survey Specialist Emily Swanson contributed to this report.

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Online:

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

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Follow Mary Clare Jalonick on Twitter at http://twitter.com/mcjalonick

 

 


AP-GfK Poll: 5 things to know about the economy

By JENNIFER AGIESTA and EMILY SWANSON

WASHINGTON (AP) – Few issues in a presidential campaign come close to being as meaningful as the economy. The latest Associated Press-GfK poll offers a look at how the public feels about this issue, which touches nearly every aspect of American life. As the 2016 candidates get set to kick off their campaigns, here are five things to know about public opinion on the economy.

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THE ECONOMY ISN’T A MONOLITH

The economy, writ large, has been America’s top policy priority for the entirety of Barack Obama’s presidency, despite the slowly building recovery and the recent skyrocketing stock market. But focusing on this overall concern masks a distinction that matters to many Americans. Though negative perceptions of the economy overall are down compared with four years ago (57 percent describe it as “poor” compared with 83 percent who did in November 2010), Americans’ ratings of their own finances are actually a bit worse than they were back then (38 percent describe their household’s finances as poor, up from 30 percent in 2010). Young Americans, under age 30, have an exceptionally negative take on their finances, with nearly half describing them as poor.

Along the same lines, while a majority of Americans say the stock market and big businesses have mostly recovered from the Great Recession, just 16 percent think small businesses have, 27 percent say the job market where they live is mostly recovered and only 34 percent say their family is largely back to normal.

EDUCATION, LOCATION, INCOME LINKED TO IMPRESSION OF ECONOMY

For some in America, the economy is humming along. Majorities of college graduates, urban residents and people with incomes of $100,000 or more say the economy is in good shape. By contrast, just 28 percent of rural residents, 35 percent without college degrees and 35 percent with incomes under $50,000 say it’s in good shape. Half of those with incomes under $50,000 and 42 percent of rural residents say they and their families haven’t yet recovered from the Great Recession.

Rural residents feel the labor and real estate markets in their area have been particularly hard hit: 45 percent say their local real estate market has only recovered a little or not at all, while 53 percent say the same about their local job market.

EXPECTATIONS ARE SOMEWHAT BETTER

The poll finds an uptick in Americans’ hopes for their own finances and the nation’s finances in the coming year. In the new poll, 34 percent say they expect their household’s financial situation to improve over the next 12 months, better than the 27 percent saying so in October. And 38 percent think the overall economic situation in the country will improve in the coming year, up from 31 percent in October. On both measures, the share saying things would worsen dropped significantly. Still, 48 percent see stagnation ahead for themselves and 42 percent see sluggishness for the economy more broadly.

INCHING TOWARD RECOVERY

That expectation of stagnation may be because that’s what most Americans think the economy is doing now. Asked how the economy had changed in the last month, 60 percent said it stayed about the same. Nearly a quarter think it improved, while 14 percent say it’s gotten worse. Those figures are slightly rosier than in October, when 24 percent said things had worsened. But the majority saying things are staying the same has held over two years of AP-GfK polls, with one exception during the partial government shutdown in October 2013 when the share saying things got worse spiked to 45 percent.

LITTLE FAITH IN WASHINGTON TO IMPROVE THINGS

Who can turn things around? Very few think it’s Washington. Two-thirds of Americans say it’s unlikely that the newly elected Republican majority in Congress will be able to improve the economy in the next two years, and 6 in 10 say Obama won’t be able to either. Three in 10 say they don’t even trust either party to handle the economy.

But Americans don’t completely discount that Washington can help: 52 percent say the government generally did a decent job helping the country recover from the Great Recession. A scant 10 percent, however, say that Washington did a “very good” job lifting the economy out of recession.

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The AP-GfK Poll of 1,010 adults was conducted online Dec. 4-8, 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 3.4 percentage 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 access at no cost to them.

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Online:

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