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.

___

Online:

International AIDS conference: http://www.aids2012.org

Poll results: http://www.ap-gfkpoll.com

AP-Times Square Poll: Shootings Weighed on Americans in 2015
By Verena Dobnik, Associated Press
Mass shootings and attacks weighed heavily on the minds of Americans in 2015, according to a new poll that found most believe this year was worse for the world than last year.A look at the key findings of The Associated Press-Times Square Alliance poll:

———

PREOCCUPIED BY MASS SHOOTINGS

Americans say the most important events of 2015 were a string of mass shootings, including the attacks in San Bernardino, California, and Paris, plus Islamic State group atrocities.

Fifty-seven percent of those polled say this year was worse than the last year for the world as a whole, up from the 38 percent asked that question a year ago. Only 10 percent believe 2015 was a better year than 2014, while 32 percent think there wasn’t much difference.

Americans also are much less likely than they were a year ago to believe that the current year was better for the United States — only 17 percent compared with 30 percent a year ago. Thirty-seven percent think this year was worse for the country than last year, while 44 percent don’t think there was much difference.

On a personal level, fewer than a third (29 percent) believe 2015 was better for them than 2014, while 21 percent feel it was worse, compared with 15 percent in 2014.

Interviewed separately from the poll, Jason Pruitt, a 43-year-old corporate pilot from the Detroit area, said security concerns were a factor in deciding whether to take his wife and daughter along on a Christmas trip to New York.

“We were thinking about not coming this year, because of everything that’s going on,” Pruitt said. But they went ahead “because when you change your life, the terrorists win.”

———

THREE EVENTS SHARE THE TOP SPOT

Of those polled, 68 percent listed mass shootings in the U.S. as very or extremely important news events this year, including the one in San Bernardino that heightened fears of domestic terrorism, plus shootings in Charleston, South Carolina; Roseburg, Oregon; and Chattanooga, Tennessee.

Close behind, at 64 percent, were the Paris attacks that ushered in 2015, targeting Charlie Hebdo and the Jewish market, then the Bataclan concert hall and other city sites in November.

And third, at 63 percent, came the Islamic State group’s various far-flung atrocities.

Commenting on the completed poll was 32-year-old J.P. Fury, working in a food truck in Times Square.

“At this point, I’m numb to all of it,” he said. “This is nothing new. Every week there’s a new shooting somewhere in America, and there’s a new terrorist attack somewhere around the world.”

———

OTHER ISSUES

Domestically, 44 percent of those polled rate as extremely or very important the deaths of blacks in encounters with police that sparked “Black Lives Matter” protests in Baltimore and Chicago.

Another 44 percent rate the deal reached to curtail Iran’s nuclear program as important, and nearly as many (42 percent) Europe’s migrant crisis.

Only 40 percent said the presidential race was important to them, with the Paris climate change conference right behind (at 38 percent), followed by the Supreme Court’s legalization of gay marriage (36 percent) and the Cuban-U.S. thaw (30 percent).

———

RINGING IN THE NEW YEAR

Most Americans plan to celebrate New Year’s Eve either at home (48 percent) or at the home of a friend or family member (20 percent). Nine percent plan to be at a bar, restaurant or organized event, while just under a quarter (22 percent) don’t plan to celebrate at all.

A majority of Americans (56 percent) will watch the New Year’s Eve events in Times Square, and 95 percent of those will see it on TV.

Those findings were similar to those of the past two years.

———

THE YEAR IN POP CULTURE

No single pop culture event of 2015 stands out, with fewer than four in 10 Americans rating any as memorable.

The eagerly awaited “Star Wars: The Force Awakens” was memorable only to 37 percent of those polled, and forgettable to 34 percent.

Bill Cosby’s legal woes were memorable to 36 percent; forgettable to 33 percent.

Bruce Jenner becoming Caitlyn Jenner, with a highly orchestrated publicity campaign, was forgettable to 52 percent, and Taylor Swift’s world tour to 55 percent.

———

METHODOLOGY

The AP-Times Square Alliance Poll of 1,020 adults was conducted online Dec. 11-13, 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 percentage points.

The poll is a cooperative effort between AP and the organizers of the Times Square New Year’s Eve Celebration, the Times Square Alliance and Countdown Entertainment. The Alliance is a nonprofit group that seeks to promote Times Square, and Countdown Entertainment represents the owners of One Times Square and the New Year’s Eve Ball Drop.

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.

———

Online:

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


AP-GfK Poll: Support for legal abortion at highest level in 2 years

WASHINGTON (AP) — Support for legal abortion in the U.S. has edged up to its highest level in the past two years, with an Associated Press-GfK poll showing an apparent increase in support among Democrats and Republicans alike over the last year.

Nearly six in 10 Americans — 58 percent — now think abortion should be legal in most or all cases, up from 51 percent who said so at the beginning of the year, according to the AP-GfK survey. It was conducted after three people were killed last month in a shooting at a Planned Parenthood clinic in Colorado.

While support for legal abortion edged up to 40 percent among Republicans in this month’s poll, from 35 percent in January, the survey found that the GOP remains deeply divided on the issue: Seven in 10 conservative Republicans said they want abortion to be illegal in most or all cases; six in 10 moderate and liberal Republicans said the opposite.

 Count 55-year-old Victor Remdt, of Gurnee, Illinois, among the conservatives who think abortion should be illegal in most cases. He’s adopted, and says he “wouldn’t be here talking” if his birth mother had opted for abortion rather than adoption. Remdt, who’s looking for work as a commercial driver, said he’d like to see abortion laws become more restrictive but adds that he’s not a one-issue voter on the matter.
 John Burk, a conservative Republican from Houston, Texas, is among those whose position on abortion is somewhere in the middle. He reasons that banning the procedure would only lead to “back-alley abortions.” But he’s open to restrictions such as parental notification requirements and a ban on late-term abortions.

Burk, a 59-year-old computer programmer, said he tracks his beliefs on the issue to his libertarian leanings and the fact that he’s not religious. He doesn’t see the nation coming to a resolution on the divisive issue any time soon, saying hard-liners on both sides of the question are entrenched and “they’re never going to change.”

Among Democrats, 76 percent of poll respondents now think abortion should be legal all or most of the time, up slightly from 69 percent in January.

Independents are more evenly split, with 54 percent saying abortion should be legal all or most of the time, edging up from 43 percent in January.

For Larry Wiggins, who describes himself as a liberal Democrat from Henderson, North Carolina, legal access to abortion should be — but isn’t — a settled matter.

“A woman has the right to decide what she wants to do with her body,” he said flatly. “I don’t think the government has the right to interfere.”

Nefertiti Durant, a 45-year-old independent voter from Columbia, Maryland, sees abortion as more complex matter, calling it “kind of a Catch-22.” She thinks a woman should have the right to choose abortion but she’s “not so keen on the fact that just anybody can go and have an abortion.” She worries that young people may not understand the effects of the procedure, and the “deep issues” that go along with it.

Still, she said, abortion is legal and “let’s just leave it at that. … I don’t think it’s a matter of discussion.”

It undoubtedly will be up for discussion, though, in a presidential election year. All of the Republican presidential candidates say they favor restricting abortion rights. The Democratic candidates support broad abortion rights.

Interest in the issue picked up this year after anti-abortion activists began releasing undercover videos they said showed Planned Parenthood personnel negotiating the sale of fetal organs. Planned Parenthood said any payments were legally permitted reimbursements for the costs of donating organs to researchers, and it has since stopped accepting even that money. Republicans have sought to cut off federal funding for Planned Parenthood, and several GOP-governed states have tried to block Medicaid funding to the organization.

Overall, the poll found, 45 percent of Americans have a favorable opinion of Planned Parenthood, and 30 percent have an unfavorable opinion. A quarter said they don’t know enough about the organization to say.

The AP-GfK Poll of 1,007 adults was conducted online Dec. 3-7, 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 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.

___

Online:

http://ap-gfkpoll.com

___

Follow Nancy Benac and Emily Swanson on Twitter at http://twitter.com/nbenac and http://www.twitter.com/EL_Swan