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.



International AIDS conference:

Poll results:

AP-GfK poll: Most Trump supporters doubt election legitimacy

By Jonathan Lemire and Emily Swanson

CHARLOTTE, N.C. (AP) — Donald Trump’s dubious claims the presidential election is “rigged” have taken root among most of his supporters, who say they will have serious doubts about the legitimacy of the election’s outcome if Hillary Clinton wins, according to a new Associated Press-GfK poll.

Just 35 percent of Trump’s supporters say they will most likely accept the results of the election as legitimate if Clinton wins, while 64 percent say they’re more likely to have serious doubts about the accuracy of the vote count if the Republican nominee is not the victor.

“Of course I believe it’s rigged, and of course I won’t accept the results,” said Mike Cannilla, 53, a Trump supporter from the New York borough of Staten Island. “It’s from the top: Obama is trying to take over the country, he’s covering up all of Hillary’s crimes and he’s controlling the media trying to make Trump lose.”

“Our only chance on Nov. 9 is if the military develops a conscience and takes matters into its own hands,” Cannilla said.

By contrast, 69 percent of Clinton’s supporters say they’ll accept the outcome if Trump wins. Only 30 percent of the Democratic nominee’s backers express a reluctance to accept the results if the former secretary of state loses on Election Day.

Overall, 77 percent of likely voters say they’ll accept the legitimacy of the results if Trump wins, while 70 percent say the same of a Clinton win.

In the final weeks of the campaign, Trump has made doubts about the integrity of the U.S. election system a cornerstone of his closing argument. Asked directly at the final presidential debate if he would accept the election results, Trump refused, saying: “I will keep you in suspense.”

That extraordinary statement, with its potential to challenge the peaceful transition of power that is a hallmark of the American democracy, did little to harm him with his base of supporters. The poll found that 44 percent of all likely voters say Trump’s stance makes them less likely to support him, but the vast majority of his supporters say it doesn’t make a difference.

“He should fight it all the way,” said George Smith, 51, a Trump supporter from Roswell, Georgia. “Spend weeks in court if he has to. He can’t let it be taken from him. That’s his right.”

Trump has also repeated inaccurate claims that vote fraud is a widespread problem, and the poll finds that most of Trump’s supporters share that concern. Fifty-six percent think there’s a great deal of voter fraud, 36 percent believe there is some, and 6 percent say there’s hardly any.

Most Clinton supporters, 64 percent, think there’s hardly any voter fraud. Overall, just 27 percent of likely voters think there’s a great deal of fraud. A third of voters overall believe there is at least some, while 38 percent say there is hardly any.

While there have been isolated cases of voter fraud in the U.S., there is no evidence of it being a widespread problem. In one study, a Loyola Law School professor found 31 instances involving allegations of voter impersonation out of 1 billion votes cast in U.S. elections between 2000 and 2014.

Beyond allegations of fraud, 40 percent of Trump supporters say they have little to no confidence that votes in the election will be counted accurately. Another 34 percent say they have only a moderate amount of confidence, and just 24 percent say they have a great deal or quite a bit of confidence in the vote count.

Among Clinton supporters, 79 percent say they have a great deal or quite a bit of confidence in the vote count’s accuracy. Many believe Trump should voice support for the electoral system even in defeat.

“Be an adult. Accept the results,” said Shavone Danzy-Kinloch, 37, a Clinton supporter from Farmingville, New York. “If the shoe was on the other foot, he’d expect Hillary to do the same.”

Trump’s supporters are also more likely than others to say they are concerned about hackers interfering with the election. Forty-six percent of them are extremely or very concerned and 37 percent somewhat concerned. Overall, 32 percent of voters say they’re extremely to very concerned and 39 percent somewhat concerned. Among Clinton supporters, 60 percent are at least somewhat concerned.

Although the poll shows many Trump supporters would have doubts about a Clinton win, the poll shows relatively little acute concern that claims of inaccuracy and voter fraud could prevent Americans overall from accepting the results. Just 30 percent of likely voters are extremely or very concerned about that, while another 40 percent are somewhat concerned.

Twenty-nine percent say they’re not very or not at all concerned.

“If she wins, we’re all going to have live with it,” said Daniel Ricco, 76, a Trump supporter from Milford, Connecticut. “It won’t be good for the country, but there’s nothing we can do.”


The AP-GfK Poll of 1,546 adults, including 1,212 likely voters, was conducted online Oct. 20-24, 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 2.75 percentage points, and for likely voters is plus or minus 3.1 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.



Poll results:


Swanson reported from Washington.


Follow Jonathan Lemire and AP Polling Editor Emily Swanson on Twitter at: and

AP-GfK Poll: Clinton appears on cusp of commanding victory


NEW YORK (AP) — Hillary Clinton appears on the cusp of a potentially commanding victory over Donald Trump, fueled by solid Democratic turnout in early voting, massive operational advantages and increasing enthusiasm among her supporters.

A new Associated Press-GfK poll released Wednesday finds the Democratic nominee has grabbed significant advantages over her Republican rival with just 12 days left before Election Day. Among them: consolidating the support of her party and even winning some Republicans.

“I’m going to pick Hillary at the top and pick Republican straight down the line,” said poll respondent William Goldstein, a 71-year-old from Long Island, New York, who voted for Mitt Romney in 2012. “I can’t vote for Trump.”

Overall, the poll shows Clinton leading Trump nationally by a staggering 14 percentage points among likely voters, 51-37. While that is one of her largest margins among recent national surveys, most show the former secretary of state with a substantial national lead over the billionaire businessman.

The AP-GfK poll finds that Clinton has secured the support of 90 percent of likely Democratic voters, and also has the backing of 15 percent of more moderate Republicans. Just 79 percent of all Republicans surveyed say they are voting for their party’s nominee.

With voting already underway in 37 states, Trump’s opportunities to overtake Clinton are quickly evaporating — and voters appear to know it. The AP-GfK poll found that 74 percent of likely voters believe Clinton will win, up from 63 percent in September.

Troubles with President Barack Obama’s signature health care law have given Trump a late opening to warn voters against putting another Democrat in the White House. But even Republicans question whether the rising cost of insurance premiums is enough to overcome the damage the businessman has done to his standing with women and minorities.

“Donald Trump has spent his entire campaign running against the groups he needs to expand his coalition,” said Whit Ayres, a Republican pollster who advised Florida Sen. Marco Rubio’s failed presidential campaign. Ayres called Trump’s campaign “strategically mindless.”

Even if Clinton’s support plummets in the contest’s closing days, or she’s unable to motivate strong turnout in her favor, it’s not clear that Trump could marshal the resources to take advantage and collect enough states to win the 270 electoral votes needed to claim the White House.

Clinton’s team has overwhelmed Trump’s campaign in its effort to turn out voters.

An Associated Press review of campaign finance filings finds that her campaign, the Democratic National Committee and Democratic parties in 12 states have more than three times as many paid employees as Trump’s campaign and the main Republican organizations supporting him. Clinton and Democrats had about 4,900 people on payroll in September, while Trump and Republicans had about 1,500.

Both sides benefit from legions of volunteers knocking on doors and making phone calls to voters, as well as outside forces such as unions and super PACs pitching in on voter turnout operations. But key Republican groups such as the ones funded by the conservative billionaire Koch brothers are sitting out the presidential race because of their distaste for Trump, further extending Clinton’s likely advantage at getting out the vote.

The strength of the Democratic turnout effort appears to be paying dividends in states where voting is underway. Nationwide, more than 12 million voters have already cast ballots, according to data compiled by the AP, a pace far quicker than 2012.

In North Carolina, a must-win state for Trump, Democrats lead Republicans in early ballots, 47 percent to 29 percent. The Democrats hold an advantage even though turnout among blacks, a crucial voting bloc for Clinton in the state, is down compared to this point in 2012. Strategists in both parties attribute the lower black turnout in part to an early reduction in polling stations, though more sites are to open in the days leading up to Nov. 8.

In Florida, a perennial battleground, Democrats have drawn even to Republicans in votes cast, reaching that milestone faster than in 2012. Traditionally, Republicans do well initially with mail-in ballots. But Democrats were able to keep it close, putting Clinton in position to run up the score during in-person voting.

Clinton also appears to hold an edge in Nevada and Colorado based on early returns. David Flaherty, a Republican pollster based in Colorado, said the data signal “a Democrat wave in the making.”

Buoyed by support from white voters, Trump looks strong in Ohio, Iowa and Georgia, a Republican state where Clinton is trying to make inroads. But wins in those states would still leave him well short of the required 270 Electoral College votes.

Trump’s top advisers have conceded in recent days the businessman is trailing Clinton. But they point to his large rallies and enthusiastic supporters as an indication he could be poised for an upset. Clinton draws smaller crowds to her events and has been perceived by some voters a lesser of two evils.

“We have a couple of different paths to get to 270 and we’re actively pursuing them,” Kellyanne Conway, Trump’s campaign manager, told MSNBC on Monday.

The AP-GfK poll suggests Clinton’s advantage is about more than just voter dislike for Trump. Clinton supporters are more likely than his backers to list their candidate’s leadership, qualifications for the presidency and positions on issues as major factors in their support.

Although voters are still more likely to have an unfavorable than a favorable view of Clinton, her ratings have improved slightly in the past month. Forty-six percent of likely voters now say they have a favorable view of the former secretary of state, up from 42 percent in September. Just 34 percent of all likely voters have a favorable view of Trump.

Trump’s unpopularity has opened surprising opportunities for Clinton as the White House race barrels toward its finish. Her campaign is actively competing for Arizona, a state that has voted for the Democrat in only one presidential race since 1952, and she is also spending money in Georgia, a reliably Republican state over the past two decades.

Both states have been on Democrats’ wish lists in recent years given their increasingly favorable demographics, though the party had little expectation they might flip this year. Hispanics are a growing share of the Arizona electorate, while Georgia is on its way to becoming a majority-minority state.

The real electoral map surprise this year is Utah, one of the most conservative states in the country. Utah’s heavily Mormon population has turned its back on Trump, providing an opening for third-party candidate and Utah native Evan McMullin to carry the state. Stripping Trump of six Electoral College votes Republicans have never had to worry about would further narrow his already slim path to victory.

With so much appearing to lean in their favor heading into Election Day, the Clinton campaign’s biggest concern is that some supporters take victory for granted and don’t show up to vote.

“Donald Trump said he could still win, and he could if our people get complacent,” Clinton communications director Jennifer Palmieri said.


The AP-GfK Poll of 1,546 adults, including 1,212 likely voters, was conducted online Oct. 20-24, 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 2.75 percentage points, and for likely voters is plus or minus 3.1 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.



Poll results:


Associated Press writers Hope Yen, Nicholas Riccardi, Thomas Beaumont and Chad Day contributed to this report.


Follow Julie Pace and Emily Swanson on Twitter at: and