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 believe allegations about Trump and women
WASHINGTON (AP) — Donald Trump’s behavior has long grated on Carolyn Miller, but the allegations he sexually assaulted women was one factor that helped her decide in the last week to cast her ballot for Hillary Clinton.
“I don’t think she’s a bad person. Trump, I think, is a bad person,” the 70-year-old Fort Myers, Florida, resident said. As for Trump’s accusers, Miller added, “I believe them.” And she said her vote for Clinton is “a default.”

Miller is among the more than 7 in 10 Americans who say in a new Associated Press-GfK poll that they believe the women who say the Republican presidential candidate kissed or groped them without their consent, a verdict that may have turned off enough voters, including some Republicans, to add to his challenges in the presidential race.

 Forty-two percent of Republican voters and 35 percent of Trump’s own supporters think the accusations are probably true. Men and women are about equally likely to think so.

While the poll suggests the wave of allegations about Trump’s treatment of women may blunt the impact of voters’ concerns about Clinton, it was taken before Friday’s news that the FBI will investigate whether there is classified information in newly uncovered emails related to its probe of her private server. Those emails were not from her server, according to a U.S. official who was not authorized to discuss details publicly and spoke on condition of anonymity.

Before the development, the poll found that about half of voters say her use of the private server while she was secretary of state makes them less likely to vote for her. But they were more likely to say that Trump’s comments about women bother them a lot than to say the same about Clinton’s email server, 51 percent to 43 percent.

Since September, Clinton seems to have consolidated her support within her own party and drawn undecided voters such as Miller to her campaign, or at least pushed them away from Trump. The billionaire’s recent trouble with women seems to be one factor preventing him from doing the same.

He feuded with former Miss Universe Alicia Machado after Clinton noted he’d called her “Miss Piggy” for gaining weight while she wore the crown. Days later, a 2005 recording surfaced in which Trump can be heard describing himself sexually assaulting women in a conversation with Billy Bush, then the host of “Access Hollywood.”

Several women have since publicly accused Trump of groping and kissing them without permission, including a People magazine reporter who said Trump attacked her when his wife, Melania, was out of the room.

Trump called his remarks on the video “locker room talk,” dismissed the accusations as “fiction” and said of several accusers that they aren’t attractive enough to merit his attention.

Asked Thursday on Fox News Channel’s “The O’Reilly Factor” whether he thinks he would be ahead were it not for the “Access Hollywood” video, Trump replied, “I just don’t know. I think it was very negative.”

A majority of voters, 52 percent, say allegations about the way Trump treats women make them less likely to vote for him, including a fifth of Republican likely voters. And within that group, only about a third say they will vote for him, with about a third supporting Clinton and the remainder supporting third party candidates.

That may help explain why just 79 percent of Republican in the poll said they’re supporting Trump compared with 90 percent of Democrats supporting Clinton. Trump needs to close that gap to have any shot at victory.

Trump has tried to equate the accusations against him with charges of infidelity and sexual assault leveled for years against his rival’s husband, former President Bill Clinton. Trump has paraded the former president’s accusers before the cameras and accused Hillary Clinton of undermining her husband’s accusers.

The poll shows a majority of voters don’t buy Trump’s attempt at equivalence. Six in 10 say the allegations against the Clintons have no impact on their vote. That’s despite the fact that 63 percent think Hillary Clinton has probably threatened or undermined women who have accused her husband of sexual misconduct.

“The vote will be about Hillary Clinton, not her husband,” said Ryan Otteson, 33, of Salt Lake City, who’s voting for a third-party candidate, conservative independent Evan McMullin.

Valori Waggoner, a 26-year-old from Belton, Texas, said she believes Hillary Clinton probably did intimidate her husband’s accusers, but she said it makes no difference to how Waggoner is voting.

Waggoner was not going to vote for Clinton anyway, because as a doctor, Waggoner said she sees firsthand the inefficiency of the national health care plan that Clinton supports. But the alleged wrongdoing by Trump made her less likely to vote for the Republican. Instead, she’s backing Libertarian Gary Johnson.

The degree of alleged wrongdoing by the Republican and Democratic presidential candidates, Waggoner said, “are not equal.”

Most likely voters in the poll say they think Trump has little to no respect for women, with female voters especially likely to say he has none at all.

Clinton leads female likely voters by a 22 point margin in the poll, and even has a slight 5 point lead among men. In September’s AP-GfK poll, Clinton led women by a 17 point margin and trailed slightly by 6 points among men.

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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.

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Online:

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


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.”

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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.

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Online:

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

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Swanson reported from Washington.

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Follow Jonathan Lemire and AP Polling Editor Emily Swanson on Twitter at: http://twitter.com/JonLemire and http://twitter.com/El_Swan