Asperger's dropped from revised diagnosis manual

CHICAGO (AP) — The now familiar term "Asperger's disorder" is being dropped. And abnormally bad and frequent temper tantrums will be given a scientific-sounding diagnosis called DMDD. But "dyslexia" and other learning disorders remain.

The revisions come in the first major rewrite in nearly 20 years of the diagnostic guide used by the nation's psychiatrists. Changes were approved Saturday.

Full details of all the revisions will come next May when the American Psychiatric Association's new diagnostic manual is published, but the impact will be huge, affecting millions of children and adults worldwide. The manual also is important for the insurance industry in deciding what treatment to pay for, and it helps schools decide how to allot special education.

This diagnostic guide "defines what constellations of symptoms" doctors recognize as mental disorders, said Dr. Mark Olfson, a Columbia University psychiatry professor. More important, he said, it "shapes who will receive what treatment. Even seemingly subtle changes to the criteria can have substantial effects on patterns of care."

Olfson was not involved in the revision process. The changes were approved Saturday in suburban Washington, D.C., by the psychiatric association's board of trustees.

The aim is not to expand the number of people diagnosed with mental illness, but to ensure that affected children and adults are more accurately diagnosed so they can get the most appropriate treatment, said Dr. David Kupfer. He chaired the task force in charge of revising the manual and is a psychiatry professor at the University of Pittsburgh.

One of the most hotly argued changes was how to define the various ranges of autism. Some advocates opposed the idea of dropping the specific diagnosis for Asperger's disorder. People with that disorder often have high intelligence and vast knowledge on narrow subjects but lack social skills. Some who have the condition embrace their quirkiness and vow to continue to use the label.

And some Asperger's families opposed any change, fearing their kids would lose a diagnosis and no longer be eligible for special services.

But the revision will not affect their education services, experts say.

The new manual adds the term "autism spectrum disorder," which already is used by many experts in the field. Asperger's disorder will be dropped and incorporated under that umbrella diagnosis. The new category will include kids with severe autism, who often don't talk or interact, as well as those with milder forms.

Kelli Gibson of Battle Creek, Mich., who has four sons with various forms of autism, said Saturday she welcomes the change. Her boys all had different labels in the old diagnostic manual, including a 14-year-old with Asperger's.

"To give it separate names never made sense to me," Gibson said. "To me, my children all had autism."

Three of her boys receive special education services in public school; the fourth is enrolled in a school for disabled children. The new autism diagnosis won't affect those services, Gibson said. She also has a 3-year-old daughter without autism.

People with dyslexia also were closely watching for the new updated doctors' guide. Many with the reading disorder did not want their diagnosis to be dropped. And it won't be. Instead, the new manual will have a broader learning disorder category to cover several conditions including dyslexia, which causes difficulty understanding letters and recognizing written words.

The trustees on Saturday made the final decision on what proposals made the cut; recommendations came from experts in several work groups assigned to evaluate different mental illnesses.

The revised guidebook "represents a significant step forward for the field. It will improve our ability to accurately diagnose psychiatric disorders," Dr. David Fassler, the group's treasurer and a University of Vermont psychiatry professor, said after the vote.

The shorthand name for the new edition, the organization's fifth revision of the Diagnostic and Statistical Manual, is DSM-5. Group leaders said specifics won't be disclosed until the manual is published but they confirmed some changes. A 2000 edition of the manual made minor changes but the last major edition was published in 1994.

Olfson said the manual "seeks to capture the current state of knowledge of psychiatric disorders. Since 2000 ... there have been important advances in our understanding of the nature of psychiatric disorders."

Catherine Lord, an autism expert at Weill Cornell Medical College in New York who was on the psychiatric group's autism task force, said anyone who met criteria for Asperger's in the old manual would be included in the new diagnosis.

One reason for the change is that some states and school systems don't provide services for children and adults with Asperger's, or provide fewer services than those given an autism diagnosis, she said.

Autism researcher Geraldine Dawson, chief science officer for the advocacy group Autism Speaks, said small studies have suggested the new criteria will be effective. But she said it will be crucial to monitor so that children don't lose services.

Other changes include:

—A new diagnosis for severe recurrent temper tantrums — disruptive mood dysregulation disorder. Critics say it will medicalize kids' who have normal tantrums. Supporters say it will address concerns about too many kids being misdiagnosed with bipolar disorder and treated with powerful psychiatric drugs. Bipolar disorder involves sharp mood swings and affected children are sometimes very irritable or have explosive tantrums.

—Eliminating the term "gender identity disorder." It has been used for children or adults who strongly believe that they were born the wrong gender. But many activists believe the condition isn't a disorder and say calling it one is stigmatizing. The term would be replaced with "gender dysphoria," which means emotional distress over one's gender. Supporters equated the change with removing homosexuality as a mental illness in the diagnostic manual, which happened decades ago.

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner .

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Police: Kansas City Chiefs player kills girlfriend, takes own life

Chiefs and Panthers will play at regularly scheduled time on Sunday:
The Kansas City Chiefs announced that Sund... http://t.co/Ah1nFJf4

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Suu Kyi wants gov't apology for violent crackdown

MONYWA, Myanmar (AP) — Opposition leader Aung San Suu Kyi on Friday said authorities must apologize for a violent crackdown on monks and other foes of a mine in northwest Myanmar, but she also stuck to the government's view that the country must follow through on its commitment to build the project.

Speaking Friday morning to a crowd of more than 10,000 in the northwestern town of Monywa, the Nobel Peace laureate said people had the right to ask why authorities cracked down so harshly on the nonviolent protesters who had occupied the nearby Letpadaung copper mine for 11 days. It was the government's biggest crackdown on demonstrations since reformist President Thein Sein took office last year.

The United States also voiced concern Friday over the "forcible eviction" of peaceful protesters. State Department spokeswoman Victoria Nuland said the U.S. has been urging the government to ensure security forces exercise maximum restraint and protect the right of free assembly.

Police used water cannons, tear gas and smoke bombs to break up the protest early Thursday. Weapons that protesters described as flare guns caused severe burns to protesters and set shelters ablaze. A nurse at a Monywa hospital said 27 monks and one other person were admitted there to be treated for burns.

"I want to ask, 'What was their purpose of doing this?' Frankly, there's no need to act like this," Suu Kyi said. People in the crowd shouted back: "Right!"

"I'm not saying this to agitate people," she continued. "I never persuade people by agitating. I explain to people so that they can decide by thinking."

In remarks to reporters Friday, Suu Kyi said the authorities "need to apologize to the monks."

Yet she has taken a soft line on the broader conflict over the expanding mine, which protesters say is damaging the environment and forcing villagers to move without adequate compensation.

She noted that many people asked her to help stop the project at once, but said she did not know details of the original contract and a parliamentary investigating committee had yet to do its work.

She went on to suggest that Myanmar should honor the contracts establishing the project, especially since they involved a neighboring country. The mine is a joint venture between a military-controlled holding company and a Chinese mining company.

She said that even in some cases where the people's interest was not taken into account, the agreement should be followed "so that the country's image will not be hurt."

Senior government officials have said the protesters' demands to stop operating the mine risk scaring off foreign investment in Myanmar's long-neglected economy.

Now serving in parliament after years as a political prisoner of the long-ruling junta, Suu Kyi received a hero's welcome in Monywa. Her visit had been scheduled before the crackdown, and she has said she will try to negotiate a solution to the conflict over the mine.

On Thursday she met mining company officials, activists and injured protesters, and she met security officials Friday.

The crackdown is a big blot on the government's efforts to woo popular support, especially because many of the targets were monks, who are admired for their social activism as much as they are revered for their spiritual beliefs in deeply religious Myanmar.

The previous military government infamously cracked down violently on monks who were leading the 2007 pro-democracy protests that came to be known as the "Saffron Revolution," from the color of their robes.

Monks in Myanmar's two biggest cities, Yangon and Mandalay, staged small nonviolent protests Friday.

The Upper Myanmar Monks organization in Mandalay issued a statement calling on the government to formally apologize for the action within five days, to provide sufficient health care for those who were injured and to release seven monks they say were detained.

U Withuta, a prominent activist monk who is a member of the group, said more than 40 monks were hurt, some seriously and at risk of losing their eyesight. He said he was lightly burned on the thigh.

"We wanted to forget what happened in 2007 and proceed forward, but what happened yesterday was like opening an old wound," Withuta said. He said it was premature to say what the monks would do if their demands were not met.

Citizen activism has increased since the elected government took over last year. Street demonstrations have been legalized, and are generally tolerated, though detentions have occurred in sensitive cases.

Political and economic liberalization under Thein Sein has won praise from Western governments, which have eased sanctions imposed on the previous military government because of its poor record on human and civil rights.

The Letpadaung mine is a joint venture between China's Wanbao Mining Copper Ltd. and the military-owned Union of Myanmar Economic Holdings Ltd. Many in Myanmar remain suspicious of the military and see China as an aggressive and exploitive investor that helped support its rule.

In Yangon, more than 30 monks who staged a peaceful protest at downtown Sule pagoda, were joined by nearly 100 people who chanted prayers in front of the office of the army's holding company.

"May all be free from harm, may all be peaceful and may the Letpadaung mountains be green," they chanted in the Friday dusk.

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Associated Press writer Matthew Pennington in Washington contributed to this report.

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Katy Perry, Carly Rae Jepsen get Billboard honors

NEW YORK (AP) — Billboard named Katy Perry its woman of the year, but the pop star thought her year was 2011.

"I felt like my year was last year ... I thought my moment had passed," Perry said in an interview with Jon Stewart at Billboard's Women in Music event Friday in New York City.

Perry released "Teenage Dream" in 2010, and the double platinum album sparked five No. 1 hits on the Billboard Hot 100 chart that spilled over to 2011. She tied the record Michael Jackson set with "Thriller" for most hits from a single album.

She re-released the album this year, which launched two more hits and a top-grossing 3-D film.

Perry thanked her fans, who stood outside of Capitale hoping to catch a glimpse of her.

"I don't really like to call myself a role model for my fans, but I hope I'm an inspiration, especially for young women," she said when she accepted the honor.

Perry also thanked her mom at the event, which honored women who work in the music industry.

In like fashion, newcomer Carly Rae Jepsen also thanked her mom — and stepmom — when accepting the rising star honor. The "Call Me Maybe" singer said she's happy and surprised by her success.

"It was sort of the key to unlocking the rest of the world for me and was something that none of us were expecting," she said, in an interview, of her viral hit.

British singer Cher Lloyd performed Perry's "E.T." at the luncheon, which also featured a performance from rising country singer Hunter Hayes.

Perry, who wore a fitted pink dress, joked about recording a follow-up to "Teenage Dream."

"Have you heard it? I haven't," the smiling singer said on the red carpet.

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Follow Mesfin Fekadu on Twitter at http://twitter.com/MusicMesfin

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Kenya village pairs AIDS orphans with grandparents

NYUMBANI, Kenya (AP) — There are no middle-aged people in Nyumbani. They all died years ago, before this village of hope in Kenya began. Only the young and old live here.

Nyumbani was born of the AIDS crisis. The 938 children here all saw their parents die. The 97 grandparents — eight grandfathers among them — saw their middle-aged children die. But put together, the bookend generations take care of one another.

Saturday is World AIDS Day, but the executive director of the aid group Nyumbani, which oversees the village of the same name, hates the name which is given to the day because for her the word AIDS is so freighted with doom and death. These days, it doesn't necessarily mean a death sentence. Millions live with the virus with the help of anti-retroviral drugs, or ARVs. And the village she runs is an example of that.

"AIDS is not a word that we should be using. At the beginning when we came up against HIV, it was a terminal disease and people were presenting at the last phase, which we call AIDS," said Sister Mary Owens. "There is no known limit to the lifespan now so that word AIDS should not be used. So I hate World AIDS Day, follow? Because we have moved beyond talking about AIDS, the terminal stage. None of our children are in the terminal stage."

In the village, each grandparent is charged with caring for about a dozen "grandchildren," one or two of whom will be biological family. That responsibility has been a life-changer for Janet Kitheka, who lost one daughter to AIDS in 2003. Another daughter died from cancer in 2004. A son died in a tree-cutting accident in 2006 and the 63-year-old lost two grandchildren in 2007, including one from AIDS.

"When I came here I was released from the grief because I am always busy instead of thinking about the dead," said Kitheka. "Now I am thinking about building a new house with 12 children. They are orphans. I said to myself, 'Think about the living ones now.' I'm very happy because of the children."

As she walks around Nyumbani, which is three hours' drive east of Nairobi, 73-year-old Sister Mary is greeted like a rock star by little girls in matching colorful school uniforms. Children run and play, and sleep in bunk beds inside mud-brick homes. High schoolers study carpentry or tailoring. But before 2006, this village did not exist, not until a Catholic charity petitioned the Kenyan government for land on which to house orphans.

Everyone here has been touched by HIV or AIDS. But only 80 children have HIV and thanks to anti-retroviral drugs, none of them has AIDS.

"They can dream their dreams and live a long life," Owens said.

Nyumbani relies heavily on U.S. funds but it is aiming to be self-sustaining.

The kids' bunk beds are made in the technical school's shop. A small aquaponics project is trying to grow edible fish. The mud bricks are made on site. Each grandparent has a plot of land for farming.

The biggest chunk of aid comes from the United States President's Emergency Plan for AIDS Relief (PEPFAR), which has given the village $2.5 million since 2006. A British couple gives $50,000 a year. A tree-growing project in the village begun by an American, John Noel, now stands six years from its first harvest. Some 120,000 trees have already been planted and thousands more were being planted last week.

"My wife and I got married as teenagers and started out being very poor. Lived in a trailer. And we found out what it was like to be in a situation where you can't support yourself," he said. "As an entrepreneur I looked to my enterprise skills to see what we could do to sustain the village forever, because we are in our 60s and we wanted to make sure that the thousand babies and children, all the little ones, were taken care of."

He hopes that after a decade the timber profits from the trees will make the village totally self-sustaining.

But while the future is looking brighter, the losses the orphans' suffered can resurface, particularly when class lessons are about family or medicine, said Winnie Joseph, the deputy headmaster at the village's elementary school. Kitheka says she tries to teach the kids how to love one another and how to cook and clean. But older kids sometimes will threaten to hit her after accusing her of favoring her biological grandchildren, she said.

For the most part, though, the children in Nyumbani appear to know how lucky they are, having landed in a village where they are cared for. An estimated 23.5 million people in sub-Saharan Africa have HIV as of 2011, representing 69 percent of the global HIV population, according to UNAIDS. Eastern and southern Africa are the hardest-hit regions. Millions of people — many of them parents — have died.

Kitheka noted that children just outside the village frequently go to bed hungry. And ARVs are harder to come by outside the village. The World Health Organization says about 61 percent of Kenyans with HIV are covered by ARVs across the country.

Paul Lgina, 14, contrasted the difference between life in Nyumbani, which in Swahili means simply "home," and his earlier life.

"In the village I get support. At my mother's home I did not have enough food, and I had to go to the river to fetch water," said Lina, who, like all the children in the village, has neither a mother or a father.

When Sister Mary first began caring for AIDS orphans in the early 1990s, she said her group was often told not to bother.

"At the beginning nobody knew what to do with them. In 1992 we were told these children are going to die anyway," she said. "But that wasn't our spirit. Today, kids we were told would die have graduated from high school."

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On the Internet:

http://www.trees4children.org/

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Pelosi vows to force tax rate vote

House Minority Leader Nancy Pelosi (Mark Wilson/Getty Images)

WASHINGTON—House Minority Leader Nancy Pelosi will try to force a vote on the House floor to extend current tax rates for the middle class next week if Republicans do not act, the California Democrat announced on Friday.

During a press conference on Capitol Hill, Pelosi called on House Republicans, who control the chamber, to hold another floor vote on whether to extend current tax rates for individuals who earn $200,000 or less and families making $250,000 or less. If they don't, Pelosi vowed to file a "discharge petition" that would force a vote if 218 House members sign it, which is unlikely.

The bill Pelosi wants to see put to a vote is identical to a measure passed in the Democrat-controlled Senate in July that extends the rates for middle-income earners for one year. House Republicans responded by rejecting the bill and passing their own measure that extends current tax rates for all income brackets.

"We're calling upon the Republican leadership in the House to bring this legislation to the floor next week. We believe that not doing that would be holding middle-income tax cuts hostage to tax cuts for the rich. Tax cuts for the rich, which do not create jobs, just increase the deficit, keeping mountains of debt for generations," Pelosi said. "To that end ... if it is not scheduled, then on Tuesday we will introduce a discharge petition."

Discharge petitions, which allow individual members of Congress to put a bill to a vote without committee or leadership approval, are rarely successful. In this case, Pelosi would need Republican support. But when asked if any Republicans had signaled that they would sign a discharge petition to force a vote, Pelosi responded, "No."

Pelosi said she wanted the bill passed so Congress will have more time to negotiate broader tax reform in 2013.

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Myanmar cracks down on mine protest; dozens hurt

MONYWA, Myanmar (AP) — Security forces used water cannons, tear gas and smoke bombs to clear protesters from a copper mine in northwestern Myanmar, wounding villagers and Buddhist monks in the biggest use of force against demonstrators since the reformist government of President Thein Sein took office last year.

Opposition leader Aung San Suu Kyi, who arrived in the area hours later on a previously scheduled visit, said she would try to negotiate a solution.

In a statement broadcast on state television, the government initially acknowledged using the riot-control measures but denied using excessive force. In an unusual move, it later retracted the statement without explanation.

Monks and other protesters had serious burns after the crackdown at the Letpadaung mine near the town of Monywa. Protesters who oppose the mine's impact on villagers and the environment had occupied the area for 11 days.

"I didn't expect to be treated like this, as we were peacefully protesting," said Aung Myint Htway, a peanut farmer whose face and body were covered with black patches of burned skin.

The police action risks becoming a public relations and political fiasco for Thein Sein's government, which has been touting its transition to democracy after almost five decades of repressive military rule.

"This is unacceptable," said Ottama Thara, a 25-year-old monk who was at the protest. "This kind of violence should not happen under a government that says it is committed to democratic reforms."

Police moved early Thursday to disperse protesters after some heeded earlier warnings to leave.

"Around 2:30 a.m. police announced they would give us five minutes to leave," Aung Myint Htway said. He said police fired water cannons first and then shot what he and others called flare guns.

"They fired black balls that exploded into fire sparks. They shot about six times. People ran away and they followed us," he said, still writhing hours later from pain. "It's very hot."

Photos of the wounded monks showed they had sustained serious burns on parts of their bodies. It was unclear what sort of weapon caused them, or whether the burns were caused by their shelters catching fire from whatever devices police used.

The government had defended its actions in a statement issued by the government's official information office Thursday afternoon. It denied using excessive force and said it used fire hoses, tear gas and smoke bombs according to international standards for riot control. The statement declared that the authorities took action for the sake of rule of law and in the interests of the country and its people, and said the project operated in accordance with international environmental standards.

Later, however, the president's office issued a one-sentence statement recalling the information office's statement without explanation. The move may reflect sensitivities over the injuries monks suffered, or second thoughts over admitting that authorities used force.

Suu Kyi's visit to nearby Kan-Kone village had been scheduled before the crackdown. The Nobel Peace laureate, elected to parliament after spending most of the last two decades under house arrest, unexpectedly went to the mine to meet with its operators before making her speech.

"I already met one side. I met with mine operators. I want to meet with villagers and protesters," she said. "I want to negotiate hearing from both sides."

She asked the crowd to be patient. "I haven't made any decision yet. I want to meet with both sides and negotiate," she said in a speech that lasted less than 15 minutes. "Will you agree with my negotiating?" The crowd shouted its assent.

Some of Suu Kyi's comments suggested that she may not fully embrace the tactics of the protesters. "When dealing with people, I don't always follow what people like. I only tell the truth," she said. "I will work for the long-term benefit of the country."

After her speech she went to the hospital where many of the injured were being treated, and met with protest leaders at the hotel in Monywa where she is staying. Thwe Thwe Win, a female protest leader, said afterward: "We will wait for Aung San Suu Kyi to negotiate with the companies. But we will not stop the protest until we achieve our demands, though I cannot tell you how we will proceed at this point."

Ohn Kyaing, a spokesman for Suu Kyi's National League for Democracy party, said she told the mine's executives that force should not have been used. He said the executives said they did not direct the action, and that it had been the work of the state security forces. Ohn Kyaing said Suu Kyi on Friday would meet with officials in charge of the crackdown, as well as local villagers and their representatives.

Villagers affected by the mine claim they did not receive satisfactory compensation and demand a more comprehensive environmental impact assessment.

The mine, which is being expanded, is a joint venture between a Chinese company and a holding company controlled by Myanmar's military.

Most people remain suspicious of the military, while China is widely seen as having propped up army rule for years, in addition to being an aggressive investor exploiting the country's many natural resources.

Government officials had publicly stated that the protest risked scaring off foreign investment that is key to rebuilding the economy after decades of neglect.

State television had broadcast an announcement Tuesday night that ordered protesters to cease their occupation of the mine by midnight or face legal action. It said the protesters began occupying the mine area Nov. 18, and operations had been halted since then.

Some villagers among a claimed 1,000 protesters left the mine after the order was issued. But others stayed through Wednesday, including about 100 monks.

The protesters' concerns about the mine do not yet appear to be widely shared by the broader public. But hurting monks — as admired for their social activism as they are revered for their spiritual beliefs — is sure to antagonize many.

Aung Myint Htway said he didn't care that police treated him badly but added, "I won't forgive them for what they did to our monks."

According to a nurse at a Monywa hospital, 27 monks and one other person were admitted with burns caused by some sort of projectile that released sparks or embers. Two monks with serious injuries were sent for treatment in Mandalay, Myanmar's second-biggest city, a 2½ hour drive away.

Other evicted protesters gathered at a Buddhist temple about 5 kilometers (3 miles) from the mine's gates.

The protest is the latest major example of increased activism by citizens since the elected government took over last year. Street demonstrations have been legalized, and are generally tolerated, though detentions have occurred in some cases involving sensitive issues.

Political and economic liberalization under Thein Sein has won praise from Western governments, which have eased sanctions imposed on the previous military government because of its poor record on human and civil rights.

However, the military still retains major influence over the government, and some critics fear that democratic gains could be rolled back.

The government's surprise suspension last year of a Chinese-backed hydroelectric project, in response to similar concerns about social and economic consequences, was seen as a significant indicator of its commitment to democratic reform. But China was unhappy about the decision, and Thein Sein's ministers have warned about offending Myanmar's big neighbor to the north and scaring off other foreign investors.

China's foreign ministry defended the mining venture as mutually beneficial and said that environmental remediation and compensation to relocate affected residents all conformed to Myanmar law.

Like many throughout the country, villagers near the project are keen to have Suu Kyi involved.

"We feel really encouraged when we heard Mother Suu is coming," said Sartone village resident Thein Thein, using a popular familiar term for Suu Kyi. "She's our only hope."

Suu Kyi, however, recently told Myanmar reporters that not everything should be resolved through demonstrations, and sometimes it is better to use negotiations.

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Zynga slides after updated agreement with Facebook

NEW YORK (AP) — Zynga shares tumbled nearly 12 percent in after-hours trading Thursday after the online game company and Facebook disclosed that they changed their relationship status to become less attached to each other.

Zynga Inc. said in a regulatory filing Thursday that it will no longer have to display Facebook ads or use Facebook payments on its own properties — such as Zynga.com. In addition Zynga will no longer be required to use Facebook as the exclusive social site for its games, or to grant Facebook exclusive games.

Facebook Inc., which filed a similar disclosure, will also be able to develop its own games after the end of March. Its deal with Zynga previously prohibited that.

The amendments change the companies’ 2010 contract that gave Zynga special status among Facebook game developers. San Francisco-based Zynga relies on Facebook for most of the revenue it generates, but the company has been working to establish its independence — while also maintaining ties with Facebook.

Zynga’s titles range from “FarmVille” to “CityVille” to “Words With Friends,” the Scrabble-like game made popular on mobile devices.

Zynga shares fell 31 cents, or 11.8 percent, to $ 2.31 in after-hours trading. The stock closed up 11 cents, or 4.4 percent, at $ 2.62 in the regular session.

Social Media News Headlines – Yahoo! News

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Mayim Bialik files to end 9-year marriage in LA

LOS ANGELES (AP) — Court records show Mayim Bialik filed for divorce from her husband of nine years on the same day she announced the couple's split in a blog post.

She cited irreconcilable differences with husband Michael Stone in the documents filed Nov. 21 in Los Angeles.

Bialik currently stars on the CBS comedy "The Big Bang Theory" and rose to fame as the star of the TV show "Blossom."

She has been a proponent of "attachment parenting" and the former couple have two sons together, ages 7 and 4. Bialik has said their parenting style was not a factor in the divorce and she is seeking joint custody of the children.

The 36-year-old wrote in her post last week that the divorce is "terribly sad, painful and incomprehensible" for children.

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Clinton releases road map for AIDS-free generation

WASHINGTON (AP) — In an ambitious road map for slashing the global spread of AIDS, the Obama administration says treating people sooner and more rapid expansion of other proven tools could help even the hardest-hit countries begin turning the tide of the epidemic over the next three to five years.

"An AIDS-free generation is not just a rallying cry — it is a goal that is within our reach," Secretary of State Hillary Rodham Clinton, who ordered the blueprint, said in the report.

"Make no mistake about it, HIV may well be with us into the future but the disease that it causes need not be," she said at the State Department Thursday.

President Barack Obama echoed that promise.

"We stand at a tipping point in the fight against HIV/AIDS, and working together, we can realize our historic opportunity to bring that fight to an end," Obama said in a proclamation to mark World AIDS Day on Saturday.

Some 34 million people worldwide are living with HIV, and despite a decline in new infections over the last decade, 2.5 million people were infected last year.

Given those staggering figures, what does an AIDS-free generation mean? That virtually no babies are born infected, young people have a much lower risk than today of becoming infected, and that people who already have HIV would receive life-saving treatment.

That last step is key: Treating people early in their infection, before they get sick, not only helps them survive but also dramatically cuts the chances that they'll infect others. Yet only about 8 million HIV patients in developing countries are getting treatment. The United Nations aims to have 15 million treated by 2015.

Other important steps include: Treating more pregnant women, and keeping them on treatment after their babies are born; increasing male circumcision to lower men's risk of heterosexual infection; increasing access to both male and female condoms; and more HIV testing.

The world spent $16.8 billion fighting AIDS in poor countries last year. The U.S. government is the leading donor, spending about $5.6 billion.

Thursday's report from PEPFAR, the President's Emergency Plan for AIDS Relief, outlines how progress could continue at current spending levels — something far from certain as Congress and Obama struggle to avert looming budget cuts at year's end — or how faster progress is possible with stepped-up commitments from hard-hit countries themselves.

Clinton warned Thursday that the U.S. must continue doing its share: "In the fight against HIV/AIDS, failure to live up to our commitments isn't just disappointing, it's deadly."

The report highlighted Zambia, which already is seeing some declines in new cases of HIV. It will have to treat only about 145,000 more patients over the next four years to meet its share of the U.N. goal, a move that could prevent more than 126,000 new infections in that same time period. But if Zambia could go further and treat nearly 198,000 more people, the benefit would be even greater — 179,000 new infections prevented, the report estimates.

In contrast, if Zambia had to stick with 2011 levels of HIV prevention, new infections could level off or even rise again over the next four years, the report found.

Advocacy groups said the blueprint offers a much-needed set of practical steps to achieve an AIDS-free generation — and makes clear that maintaining momentum is crucial despite economic difficulties here and abroad.

"The blueprint lays out the stark choices we have: To stick with the baseline and see an epidemic flatline or grow, or ramp up" to continue progress, said Chris Collins of amFAR, the Foundation for AIDS Research.

His group has estimated that more than 276,000 people would miss out on HIV treatment if U.S. dollars for the global AIDS fight are part of across-the-board spending cuts set to begin in January.

Thursday's report also urges targeting the populations at highest risk, including gay men, injecting drug users and sex workers, especially in countries where stigma and discrimination has denied them access to HIV prevention services.

"We have to go where the virus is," Clinton said.

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