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 prefer low prices to items ‘Made in the USA’
WASHINGTON (AP) — The vast majority of Americans say they prefer lower prices instead of paying a premium for items labeled “Made in the U.S.A.,” even if it means those cheaper items are made abroad, according to an Associated Press-GfK poll.

While presidential candidates like Donald Trump and Bernie Sanders are vowing to bring back millions of American jobs lost to China and other foreign competitors, public sentiment reflects core challenges confronting the U.S. economy. Incomes have barely improved, forcing many households to look for the most convenient bargains instead of goods made in America. Employers now seek workers with college degrees, leaving those with only a high school degree who once would have held assembly lines jobs in the lurch. And some Americans who work at companies with clients worldwide see themselves as part of a global market.

Nearly three in four say they would like to buy goods manufactured inside the United States, but those items are often too costly or difficult to find, according to the survey released Thursday. A mere 9 percent say they only buy American.

Asked about a real world example of choosing between $50 pants made in another country or an $85 pair made in the United States — one retailer sells two such pairs made with the same fabric and design — 67 percent say they’d buy the cheaper pair. Only 30 percent would pony up for the more expensive American-made one. People in higher earning households earning more than $100,000 a year are no less likely than lower-income Americans to say they’d go for the lower price.

“Low prices are a positive for US consumers — it stretches budgets and allows people to save for their retirements, if they’re wise, with dollars that would otherwise be spent on day-to-day living,” said Sonya Grob, 57, a middle school secretary from Norman, Oklahoma who described herself as a “liberal Democrat.”

But Trump and Sanders have galvanized many voters by attacking recent trade deals.

From their perspective, layoffs and shuttered factories have erased the benefits to the economy from reduced consumer prices.

“We’re getting ripped off on trade by everyone,” said Trump, the Republican front-runner, at a Monday speech in Albany, New York. “Jobs are going down the drain, folks.”

The real estate mogul and reality television star has threatened to shred the 1994 North American Free Trade Agreement with Mexico and Canada. He has also threatened to slap sharp tariffs on China in hopes of erasing the overall $540 billion trade deficit.

Economists doubt that Trump could deliver on his promises to create the first trade surplus since 1975. Many see the backlash against trade as frustration with a broader economy coping with sluggish income gains.

“The reaction to trade is less about trade and more about the decline in people’s ability to achieve the American Dream,” said Caroline Freund, a senior fellow at the Peterson Institute for International Economics. “It’s a lot easier to blame the foreigner than other forces that are affecting stagnant wage growth like technology.”

But Trump’s message appeals to Merry Post, 58, of Paris, Texas where the empty factories are daily reminders of what was lost. Sixty-eight percent of people with a favorable opinion of Trump said that free trade agreements decreased the number of jobs available to Americans.

“In our area down here in Texas, there used to be sewing factories and a lot of cotton gins,” Post said. “I’ve watched them all shut down as things went to China, Mexico and the Philippines. All my friends had to take early retirements or walk away.”

Sanders, the Vermont senator battling for the Democratic nomination, has pledged to end the exodus of jobs overseas.

“I will stop it by renegotiating all of the trade agreements that we have,” Sanders told the New York Daily News editorial board earlier this month, saying that the wages paid to foreigner workers and environmental standards would be part of any deal he would strike.

Still, voters are divided as to whether free trade agreements hurt job creation and incomes.

Americans are slightly more likely to say free trade agreements are positive for the economy overall than negative, 33 percent to 27 percent. But 37 percent say the deals make no difference. Republicans (35 percent) are more likely than Democrats (22 percent) to say free trade agreements are bad for the economy.

On jobs, 46 percent say the agreements decrease jobs for American workers, while 11 percent say they improve employment opportunities and 40 percent that they make no difference. Pessimism was especially pronounced among the 18 percent of respondents with a family member or friend whose job was offshored. Sixty-four percent of this group said free trade had decreased the availability of jobs.

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The AP-GfK Poll of 1,076 adults was conducted online March 31-April 4, 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 3.3 percentage points.

Respondents were first selected randomly using telephone 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:

http://ap-gfkpoll.com

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On Twitter follow Emily Swanson at @EL_Swan and Josh Boak at @joshboak


AP-GfK Poll: Public wants Senate action on court, but interest is modest

WASHINGTON (AP) — Nearly 2 in 3 Americans back Democrats’ demands that the Republican-run Senate hold hearings and a vote on President Barack Obama’s pick for the Supreme Court. But an Associated Press-GfK poll also suggests that GOP defiance against considering the nominee may not hurt the party much because, to many people, the election-year fight is simply not a big deal.

Just 1 in 5 in the survey released Wednesday said they’ve been following the battle over Obama’s nomination of federal judge Merrick Garland extremely or very closely.

That included just 26 percent of Democrats and 22 percent of Republicans expressing intense interest, along with a scant 8 percent of independents. That aligns with the political reading of the issue by many Republicans that while it motivates each side’s most committed partisans, people in the middle consider it a yawner — making the fight essentially a wash.

Another clue that voters not dedicated to either party find the court fight tiresome: While just over half of Democrats and Republicans said the issue is extremely or very important, only around a third of independents — and half of Americans overall — said so.

About 8 in 10 said that about the economy and about 7 in 10 took the same stance about health care and the threat posed by the Islamic State group. Immigration and the U.S. role in world affairs both attracted slightly more intensity of interest than the court battle.

“It gets me irritated, the bickering and all that kind of stuff,” Julie Christopher, 49, a Republican and flight attendant from Fort Worth, Texas, said in a follow-up interview, describing her modest attention to the issue.

Christopher said that while she agrees with the GOP’s refusal to hold hearings on Garland, when it comes to backing candidates in November, “That’s not going to be my only thing, like boom, I’m not going to vote for them.”

Hours after Justice Antonin Scalia’s death in February, Senate Majority Leader Mitch McConnell, R-Ky., said his chamber would not consider an Obama nominee and would instead wait until the president elected this November makes a pick. With the remaining justices split 4-4 between those leaning conservative or liberal, most GOP senators have lined up behind McConnell.

Democrats have been spewing outrage ever since. Along with liberal groups, they’ve been using television ads, news conferences, public demonstrations and Senate speeches to ratchet up pressure on GOP senators, especially those facing re-election this fall in swing and Democratic-leaning states like Illinois, New Hampshire, Wisconsin, Pennsylvania and Ohio.

Democrats’ theory is that the public wants Republicans to end their obstruction and let the Senate do its job, forcing GOP senators to relent on Garland or risk defeat in November. The AP-GfK poll has some data backing that up.

The 64 percent who favor hearings and a vote this year on Garland include an overwhelming proportion of Democrats and a sizable minority of Republicans, 40 percent. Independents, who can be pivotal in closely divided states, back action this year, 52 percent to 36 percent.

“I’d rather see at least deliberations, and see Congress do its job,” said Marc Frigon, 33, a high-tech worker from Beverly, Massachusetts, who leans Republican and wants the Senate to reject Garland’s confirmation. “I feel like that’s why we elected them in the first place.”

Just over half of moderate and liberal Republicans want the Senate to hold hearings this year, while fewer than 3 in 10 GOP conservatives say that.

Overall, people say by 59 percent to 36 percent that they want the Senate to approve Garland should a vote be held. Nearly 9 in 10 Democrats favor confirmation and independents tilt slightly that way, while 69 percent of Republicans favor rejecting him.

In another sign that the public tips toward Obama on the issue, 57 percent approve of the way he’s been handling the Garland nomination. That’s more than the number who gave the president positive reviews on any other issue in the poll: the economy, health care, Islamic State militants, immigration and world affairs.

The AP-GfK Poll of 1,076 adults was conducted online March 31-April 4, 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 3.3 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:

http://ap-gfkpoll.com