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: Most say filing tax returns is easy; few willing to pay more for simpler forms

By STEPHEN OHLEMACHER and JENNIFER AGIESTA, Associated Press

 WASHINGTON (AP) — Struggling to figure out your federal tax return? You’re not alone, but you’re in the minority.

With the tax filing deadline looming next week, a majority of Americans say completing a federal tax return is easy, according to a new Associated Press-GfK poll.

The findings defy conventional wisdom in Washington, where politicians have made careers out of promising a simpler tax system. In another blow to advocates of tax reform, almost no one is willing to pay higher taxes in exchange for a simpler code.

“If you’ve got the equivalent of a high school degree and you know how to do math, it’s very simple,” said Sara Thornton, a small business owner from East Granby, Conn.

Only 7 percent of those surveyed say they would be willing to pay more in federal taxes if the process of filling out a tax return were easier. Some 90 percent say “no, thanks.”

“No, because I don’t know that it is that difficult,” said Alicia Brown of suburban Des Moines, Iowa. “We already pay outlandish taxes because we live in Iowa. We have very high real estate taxes.”

The tax-writing committees in Congress have spent the past several years trying to build momentum for the herculean task of simplifying the tax code. One reason it’s so difficult is there are bound to be winners and losers. Sweeping changes to precious tax breaks will undoubtedly leave some people paying more, while others pay less.

One selling point for tax reform has been a simpler tax form. Ever hear a politician say you should be able to fill out your taxes on the back of a postcard? You’ll probably hear it again during this fall’s elections.

The National Taxpayer Advocate says filers spend a total of 6.1 billion hours a year preparing tax returns, at a cost of $168 billion. According to the IRS, 90 percent of filers either pay a tax preparer or use computer software to help them fill out their returns.

But 58 percent in the AP-GfK poll say completing a federal tax return is easy. Thirty-eight percent call it hard.

Fully 86 percent who have completed their tax forms say they are extremely confident or very confident that they filled them out correctly.

Not surprisingly, higher income taxpayers are more likely to say that filling out tax forms is difficult. Wealthy people tend to have more complicated taxes because they often have multiple sources of income and they are more likely to itemize their deductions, making them eligible for more tax breaks.

Forty-five percent of those with incomes above $100,000 said it is hard, compared with 33 percent among those making less than $50,000.

Through March 28, the IRS has processed 89 million returns. About 82 percent have qualified for refunds, averaging $2,831. That’s about $207 billion in tax refunds. Almost 91 percent of returns have been filed electronically.

Americans think most of their fellow taxpayers are honest, but not all of them. On average, poll-takers estimate that about one-third of Americans intentionally cheat when filling out their tax returns.

Erma Pierce of Poplar Bluff in southeast Missouri said she thinks about half of people cheat on their taxes, and she takes a dim view of it.

“You’re not supposed to cheat, lie or steal,” Pierce said. “It’s against the Bible.”

Thornton, the small business owner in Connecticut, said her estimate depends on the definition of cheating.

“People think of cheating as a case of, I reported I have nine children and I only have two. Or I reported I only made $20,000 this year and I actually made $50,000,” Thornton said. “They think of those forms of cheating, the absolute blatant, extravagant forms.”

Thornton’s definition of cheating is broader, which is why she thinks 80 percent to 90 percent of people cheat on their taxes.

“The minor forms of cheating are things like, well, I can increase my charitable deduction by $200,” Thornton said. “Most people consider, quote, unquote padding their income tax reporting or shaving it off a little bit, they don’t necessarily view that as cheating.”

“I define that as cheating only because it really is.”

The AP-GfK Poll was conducted March 20-24, 2014 using KnowledgePanel, GfK’s probability-based online panel designed to be representative of the U.S. population. It involved online interviews with 1,012 adults, and has a margin of sampling error of plus or minus 3.4 percentage points for all respondents.

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

Follow Stephen Ohlemacher on Twitter: http://twitter.com/stephenatap


AP-GfK Poll: Election indicators suggest GOP edge

By, JENNIFER AGIESTA, Associated Press

(AP) – The latest Associated Press-GfK poll holds bad news for President Barack Obama, but as the November elections draw closer, there are ominous signs for congressional Democrats as well.

A look at the key findings from the March poll on this year’s election and the burgeoning 2016 presidential field.

GOP GAINING GROUND

Preferences for control of Congress are tight, but Republicans have gained on Democrats since January. Thirty-six percent in last month’s poll said they would rather see the Democrats in charge of Congress and 37 percent chose Republicans.

Democrats held a narrow advantage on that question in January, when 39 percent favored the Democrats and 32 percent the Republicans.

Democrats are in the majority in the Senate while Republicans run the House.

The shift stems largely from a change among those most interested in politics.

In the new poll, registered voters who are most strongly interested in politics favored the Republicans by 14 percentage points, 51 percent to 37 percent. In January, this group was about evenly split, with 42 percent preferring Democrats and 45 percent the Republicans.

That’s not the only positive sign in the poll for the Republicans.

Favorable views of the GOP have improved, with 38 percent overall now saying they hold a favorable impression of the Party. Republicans’ positive view of their own party has increased from 57 percent in January to 72 percent now.

Even impressions of the tea party movement have shifted more positive in recent months. GOP favorability still lags behind that of the Democrats, however, with 43 percent holding a favorable view of the Democratic Party.

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CONGRESSIONAL APPROVAL STAGNANT

Congressional approval is stagnant and negative, with just 16 percent saying they approve while 82 percent disapprove. Among those who have “a great deal” or “quite a bit” of interest in politics, 90 percent disapprove, including 61 percent who strongly disapprove.

Nearly 4 in 10 (39 percent) would like to see their own member of Congress re-elected, an improvement since January. Among registered voters who say they pay a great deal of attention to politics, 44 percent say they would like to see their current member re-elected, compared with 33 percent in January.

Here, there’s a glimmer of hope for Democrats. Those who consider themselves Democrats are now more likely than Republicans to say their own member of Congress ought to be re-elected. Not all Democrats live in districts represented by Democrats, of course, but it represents a shift in opinion since January.

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WHO’S IN CHARGE

With control of Congress divided between the parties, most Americans say Obama has a lot or quite a bit of control over what the federal government does, outpacing the share who say the Democrats or Republicans in Congress are in control.

Partisans tend to see the opposition as the controlling force, with Republicans more apt than Democrats to see Obama in charge, and Democrats more likely to say the Republicans have the upper hand.

Six in 10 (62 percent) of those with a great deal or quite a bit of interest in politics say Obama has a lot or quite a bit of control of what the federal government does. Just half (51 percent) of those closely attuned to politics say Democrats in Congress exert a similar influence over what the federal government does and 40 percent say the same about Republicans in Congress.

There’s little change since December in which party Americans trust more to handle major issues.

Democrats’ strong points are on handling social issues, including same-sex marriage (31 percent prefer Democrats, 17 percent the Republicans) and abortion (30 percent prefer Democrats, 22 percent Republicans). Republicans have the edge on protecting the country, 34 percent to 16 percent, a slightly wider margin than they held on the question in December.

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LOOKING TO 2016? NOT SO MUCH

The poll measured impressions of 19 potential 2016 presidential candidates, and found that a majority of those surveyed offered an opinion about just seven of them. The other 12 have quite a lot of introducing themselves to do if they are to make a run for the White House.

Most people said either they hadn’t heard of them or skipped the question.

Hillary Rodham Clinton generated the most positive response of the bunch, with 46 percent viewing the former secretary of state and first lady favorably and 39 percent unfavorably.

Among potential GOP contenders, none generated a net positive reaction from the public, with 2012 vice presidential nominee Paul Ryan faring best – 27 percent viewed him favorably, 29 percent unfavorably.

Among Republicans, majorities have favorable impressions of Ryan and former Arkansas Gov. Mike Huckabee. But in a sign that the past isn’t always prologue, nearly half of Republicans say they don’t know enough to have an opinion about former Sen. Rick Santorum of Pennsylvania, a large factor in the 2012 nomination fight.

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The AP-GfK Poll was conducted March 20-24, 2014 using KnowledgePanel, GfK’s probability-based online panel designed to be representative of the U.S. population. It involved online interviews with 1,012 adults, and has a margin of sampling error of plus or minus 3.4 percentage points for all respondents.

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

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