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

Kayla Mueller’s brother: Swap with Taliban raised IS demands

PRESCOTT, Ariz. (AP) — The brother of an American woman who was killed after spending months as a hostage of Islamic State militants says Kayla Mueller’s situation worsened after the government traded five Taliban commanders for a captive U.S. soldier.

The militants increased their demands after the May swap for Army Sgt. Bowe Bergdahl, Eric Mueller told NBC’s “Today” in an interview that aired Monday.

“That made the whole situation worse because that’s when the demands got greater,” he said. “They got larger. They realized that they had something.”

Mueller’s death was confirmed Feb. 10 by her family and U.S. officials. The Islamic State group claimed she died in a Jordanian airstrike, but U.S. officials have not confirmed that. The Pentagon said it didn’t know how she was killed.

The 26-year-old international aid worker, who grew up in Prescott, Arizona, was captured in August 2013 after leaving a Doctors Without Borders hospital in Aleppo, Syria.

Mueller’s brother and parents spoke to “Today” host Savannah Guthrie. The family has declined repeated requests for an interview with The Associated Press.

Mueller’s father, Carl Mueller, said that the United States’ willingness to swap for Bergdahl but not pay ransom or allow ransom to be paid for his daughter “was pretty hard to take.”

“I actually asked the president that question when we were in the White House,” he said without elaborating.

Mueller’s parents said in the interview that the U.S. government put policy ahead of American lives.

White House spokesman Josh Earnest said Monday that the Mueller family had been put in a difficult position by the U.S. policy against making concessions to terrorists, but he defended it as being in the best interests of the nation.

“The president is confident that his administration did do everything that was possible within the confines of that policy — using our military might, using our intelligence capability, using our diplomatic influence — to try to secure the safe release and return of Kayla Mueller,” Earnest said.

A recent Associated Press-GfK poll found that only 3 in 10 Americans think the United States should pay a ransom to save an American hostage overseas, even if it’s the only way to rescue the hostage. A quarter of Americans say there are circumstances when the United States should directly negotiate with a terrorist group.

The poll of 1,045 adults was conducted online Jan. 29-Feb. 2. The margin of sampling error for all respondents is plus or minus 3.5 percentage points.

The Obama administration has defended the Bergdahl swap. Some U.S. lawmakers were outraged by the exchange of five Taliban commanders held at the Guantanamo Bay prison for the Idaho native who left his post in Afghanistan and was captured and held by the Taliban for five years.

The Joint Chiefs of Staff unanimously supported the exchange, insisting that the United States has a sacred commitment to men and women who serve that it never will leave anyone behind on the battlefield.


AP-GfK Poll: Most back Obama plan to raise investment taxes

WASHINGTON (AP) — The rich aren’t taxed enough and the middle class is taxed too much. As for your taxes, you probably think they’re too high as well.

Those are the results of an Associated Press-GfK poll that found that most people in the United States support President Barack Obama’s proposal to raise investment taxes on high-income families.

The findings echo the populist messages of two liberal senators — Elizabeth Warren of Massachusetts and Bernie Sanders of Vermont — being courted by the progressive wing of the Democratic Party to run for president in 2016. The results also add weight to Obama’s new push to raise taxes on the rich and use some of the revenue to lower taxes on the middle class.

Obama calls his approach “middle-class economics.”

It’s not flying with Republicans in Congress, who oppose higher taxes.

But Bob Montgomery of Martinsville, Virginia, said people with higher incomes should pay more.

“I think the more you make the more taxes you should pay,” said Montgomery, who is retired after working 40 years at an auto dealership. “I can’t see where a man makes $50,000 a year pays as much taxes as somebody that makes $300,000 a year.”

According to the poll, 68 percent of those questioned said wealthy households pay too little in federal taxes; only 11 percent said the wealthy pay too much.

Also, 60 percent said middle-class households pay too much in federal taxes, while 7 percent said they paid too little.

Obama laid out a series of tax proposals as part of his 2016 budget released this month. Few are likely to win approval in the Republican-controlled Congress. But if fellow Democrats were to embrace his ideas, they could play a role in the 2016 race.

One proposal would increase capital gains taxes on households making more than $500,000. In the survey, 56 percent favored the proposal, while only 16 percent opposed it.

Democrats, at 71 percent, were the most likely to support raising taxes on capital gains. Among Republicans and independents, 46 percent supported it.

Obama’s other tax plans didn’t fare as well.

About 27 percent said they favored making estates pay capital gains taxes on assets when they are inherited, and 36 percent opposed it.

Just 19 percent said they supported the president’s aborted plan to scale back the tax benefits of popular college savings plans, 529 accounts, named after a section in federal tax law. Obama withdrew the proposal after Republicans and some Democrats in Congress opposed it.

“I think that’s a poor idea,” said Jamie Starr of suburban Atlanta. “Being that I’m a mother of five children, that is a wonderful program.”

“That’s kids trying to make their own away in this world without having student loans,” she said.

Obama’s proposal to levy a new tax on banks was supported by 47 percent of those surveyed. Only 13 percent opposed it, while 36 percent were undecided.

It’s tax season, that time of the year when people are confronted by their obligations to the government. The poll found that 56 percent of us think our own federal taxes are too high, and 4 percent said they pay too little.

If taxes are increased, a slight majority said the additional money should help pay down the national debt. Using the money to cut other taxes or fund government programs were less popular options.

Republicans, in general, are more likely than Democrats to oppose higher taxes, except when it comes to low-income families.

Only 19 percent of respondents said low-income families pay too little in federal taxes, but there was a significant split between the political parties. Just 10 percent of Democrats said low-income families pay too little, while 33 percent of Republicans said they don’t pay enough.

According to the nonpartisan Congressional Budget Office, the poorest 20 percent of households paid less than 1 percent of all federal taxes in 2011, the latest year for data. The top 10 percent paid more than half of all federal taxes.

That’s OK, said Sen. Sanders, an independent from Vermont, because wealthy people have seen their incomes soar while the rest of the country’s wages have been much more flat.

“Most people understand that at a time when the rich are becoming much richer, the middle class is continuing to disappear,” Sanders said. “And people also understand that the very wealthy and large corporations are able to take advantage of huge loopholes, which enable them not to pay their fair share of taxes.”

Obama has been pushing to raise taxes on the rich since his first campaign for president in 2008. He has had some success. In January 2013, Obama persuaded Republicans in Congress to let income tax rates go up for families making more than $450,000 a year. It was part of a deal that made permanent a large package of tax cuts first enacted under Republican President George W. Bush.

Some liberals are looking for a candidate to push for higher taxes on the rich in the 2016 race. Sanders and Democrat Warren would fit the profile, though Warren says she is not running for president and Sanders says he has not made up his mind.

Among Democrats, Hillary Rodham Clinton is seen as the front-runner for the nomination; she has yet to make her candidacy official.

Clinton hasn’t offered specifics on how she would approach taxes as a candidate. But she offered a glimpse of her views following Obama’s State of the Union Address in January, when she tweeted that Obama “pointed way to an economy that works for all. Now we need to step up & deliver for the middle class. #FairShot #FairShare.”

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The AP-GfK Poll of 1,045 adults was conducted online Jan. 29-Feb. 2, 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 3.5 percentage points.

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.

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Online:

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

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