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-WE tv Poll: As women earn and learn more, traditional gender roles still drive dating scene

By JENNIFER AGIESTA, Associated Press

 WASHINGTON (AP) — Who ever said the dating game was logical?

 A new Associated Press-WE tv poll turns up all kinds of contradictions when people lay out their thoughts on dating, especially when it comes to money and gender roles.

 Seven in 10 of those surveyed say it’s unacceptable to expect a date to pay for everything. But most still say it’s a man’s job to pay for the first date.

Most say it’s OK to ask someone out because he or she seems successful. But even more say it’s unacceptable to turn down people because they haven’t had much success.

One-third think it’s OK to search for online clues about a potential first date’s success in life. But very few say daters should pay attention to each other’s finances before they are exclusive.

Overall, the traits that men and women rate as important hew to traditional gender roles.

Men and women agree that personality is the most important trait to consider when deciding whether to go on a first date with someone, and very few say money is a top consideration. Yet for men, a sense of humor outweighs intelligence, and they are more apt than women to prioritize looks. Most women place greater emphasis on a suitor’s financial situation and career ambitions.

It’s not just older people who feel that way. The differences are amplified among younger singles. About half of single men under age 45 say looks are a priority, while 70 percent of single women under 45 call career ambitions key.

There’s a clear gender gap on finances.

Men are less likely than women to say they’re comfortable dating someone who makes significantly more money than they do. Seventy-one percent of women would be comfortable in that situation, compared with 59 percent of men. Women are more wary of dating someone who earns less. Forty-three percent of men would be OK dating someone with a significantly lower salary, but just 28 percent of women would.

More broadly, uncoupled Americans are squeamish about dating those whose financial situations may not equal their own.

A shaky financial past is generally acceptable, and more say they’re comfortable dating someone who grew up in a poor family than in a wealthy one. But a questionable present inspires doubt.

Just 16 percent say they would be comfortable dating someone who is unemployed, and 23 percent say they would be comfortable dating someone with significant student loan debt.

Once dating turns to commitment and love, money is a bigger consideration for women when deciding whether to wed.

Among men who aren’t married or living with a partner, 84 percent say they’d marry someone they love regardless of whether she or he could provide financial security. Women are more cautious, with 61 percent would choose marriage for love without regard to financial standing.

Over time, Americans’ views on how women ought to balance family and career have shifted in favor of greater choice for women. But the poll also finds a more restrictive view on how men with a family ought to view their career, suggesting the rules many apply to dating continue once families are formed.

A Time/Yankelovich survey conducted in March 1978 found that about three-quarters of Americans felt women ought to put their husbands and children ahead of their careers and felt women with young children shouldn’t work outside the home unless it’s financially necessary. Now, about half hold those views.

But the AP-WE tv poll also found that half of Americans believe a man with a family has a responsibility to choose a higher-paying job over one that is more satisfying, compared with 42 percent who felt that way in 1978.

The poll was conducted in conjunction with WE tv ahead of the launch of the show “Mystery Millionaire.”

The poll was conducted May 16-19 using KnowledgePanel, GfK’s probability-based online panel designed to be representative of the U.S. population. It involved online interviews with 1,354 adults, including an oversample of 310 adults who have never been married. Results for all respondents have a margin of sampling error of plus or minus 3 percentage points.

Respondents were first selected randomly using phone or mail survey methods and were 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.

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AP News Survey Specialist Dennis Junius contributed to this report.

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Online:

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


AP-GfK Poll: Sign-up success fails to translate into broad approval for Obama’s health law

By RICARDO ALONSO-ZALDIVAR and JENNIFER AGIESTA, Associated Press

 WASHINGTON (AP) — President Barack Obama celebrated when sign-ups for his health care law topped 8 million, far exceeding expectations after a slipshod launch. Most Americans, however, remain unimpressed.

 A new Associated Press-GfK poll finds that public opinion continues to run deeply negative on the Affordable Care Act, Obama’s signature effort to cover the uninsured. Forty-three percent oppose the law, compared with just 28 percent in support.

 The pattern illustrates why the health care law remains a favored target for Republicans seeking a Senate majority in the midterm elections.

 The poll does have a bright spot for the administration: Those who signed up for coverage aren’t reeling from sticker shock. Most said they found premiums in line with what they expected, or even lower.

But even that was diminished by another finding: More than one-third of those who said they or someone in their household tried to enroll, were ultimately unable to do so. For the White House, it’s an uncomfortable reminder of the technical problems that paralyzed the HealthCare.gov website for weeks after it went live last fall.

The example of business owner Henry Kulik shows some of the cross-currents of public opinion.

Kulik is disabled as a result of Lou Gehrig’s disease, a condition that destroys the brain’s ability to control muscle movement. His family runs several stores that sell ice cream and other summer refreshments in the Philadelphia area.

Kulik says he doesn’t believe the federal government should require people to carry health insurance, as the law does. And he can understand worries about the cost to taxpayers. On the other hand, he’s been able to slash what his family pays for health insurance by purchasing coverage through the law’s new insurance markets and by taking advantage of tax credits to lower the premiums.

Before the law, his family was paying $2,400 a month. Now it’s several hundred dollars. And Kulik says the insurance for himself, his wife, and three children is comparable to what they had before.

‘‘I think there is a lot of misinformation,’’ he says.

Obama’s health care law offers subsidized private coverage to middle-class people who have no health plan on the job, and it expands Medicaid to pick up low-income uninsured adults. But last fall’s launch of new health insurance markets was paralyzed technical problems. The debacle contributed to the departure of health secretary Kathleen Sebelius.

After Congress approved the law in 2010, a political backlash over its Medicare cuts, tax increases and new regulations helped Republicans win the House. This fall the GOP is following a similar strategy with the Senate at stake.

‘‘Republicans hold an advantage on this issue among people who feel strongly about it,’’ said Robert Blendon of the Harvard School of Public Health, who follows opinion trends on health care.

Still, just 17 percent of poll respondents said the law will be completely repealed. While that represents an increase of 5 percentage points from March, the poll found that 67 percent believe the health law will be implemented with changes, whether major or superficial.

In Walhalla, South Carolina, digital publisher Greg Freeman says he’s no big fan of the president. But now into his late 30s, Freeman thought it would be a good idea to get health insurance through the new law. It took several tries to navigate the federal enrollment website, but Freeman says he’s generally satisfied. His main complaint is that his new doctor is about an hour away, in a bigger town to the east.

‘‘I can see if some of the kinks can be worked out this could be a very positive thing in the long run,’’ Freeman said. ‘‘We should be in a position to be healthiest country in the world.’’

The poll found that sign-up success translated into higher approval for the health care law. Among those who succeeded in purchasing coverage, 51 percent back the law, compared with 30 percent among those who tried to sign up and weren’t successful.

In the tiny coastal Oregon town of Reedsport, locksmith Marvin Plunkett says he’s disappointed that public opinion about the law remains so negative. He was able to gain coverage through the state’s expanded Medicaid program.

Plunkett recalled former Alaska Gov. Sarah Palin’s discredited charge that the law would set up ‘‘death panels’’ to judge whether seniors should receive medical care. ‘‘The truth about it is pretty mundane,’’ he said. ‘‘But the lies are really exciting and emotional.’’

The AP-GfK Poll was conducted May 16-19, 2014 using KnowledgePanel, GfK’s probability-based online panel designed to be representative of the U.S. population. It involved online interviews with 1,354 adults, and has a margin of sampling error of plus or minus 3 percentage points for all respondents.

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Associated Press News Survey Specialist Dennis Junius contributed to this report.

Online:

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