Twenty years into the fight against AIDS, Maine health officials warned that complacency in prevention efforts could be responsible for the gradual rise seen in recent years in the number of people who have tested positive for the virus that causes the condition.

Dora Anne Mills, director of Maine’s Bureau of Health, said health officials must increase their efforts to educate a new generation who because of recent breakthroughs in treatment have not seen the rash of deaths that startled the nation and put the highest priority on stopping the spread of the virus.

“Those prevention efforts are no longer high on the radar screen,” Mills said this week. “They are not seeing as many people die from AIDS, and we’re becoming complacent – and maybe too complacent – because of it.”

While the number of AIDS cases and deaths in Maine has declined since 1999, Mills pointed to a 13 percent increase since that year, to 51 cases, in the number of reported positive tests for HIV antibody – an indicator of the presence of the virus that causes AIDS. That’s the highest total since 1996, when more than 80 people tested positive for HIV, according to Bureau of Health statistics.

But much like the rest of the nation, Maine has seen dramatic declines in AIDS deaths since the discovery of effective inhibitor drugs in the mid-1990s. From a high of 71 deaths in 1993, last year only seven people died as a result of the disease.

Maine’s 960 AIDS cases since 1982 make up just 0.1 percent of the total AIDS cases nationwide through June 2000. Between 950 and 1,300 Mainers are living with HIV, the virus that causes AIDS, compared with the estimated 800,000 to 900,000 nationwide.

Of the 605 people who disclosed how they became infected, 53 percent are men who have had sex with men. Other major populations include injection drug users, at 20 percent, and women who have had sex with infected men, at 12 percent.

Just as there are significant differences between Maine and the nation in terms of the number of people with HIV diagnoses, there are significant differences within the state itself, statistics show.

Cumberland, Androscoggin and Waldo counties have shown the highest rates of HIV infections during the past five years, with Cumberland County showing the highest rate of 45.4 cases per 100,000 people.

Penobscot County, with a rate of 20.4 cases per 100,000 people, falls just below the statewide rate of 21.1 cases per 100,000 people, according to Bureau of Health statistics.

In eastern Maine, Denis Cranson, executive director of the Eastern Maine AIDS Network, has seen the disease change in his 11 years with the agency from a short-term, fatal illness to a chronic but debilitating affliction.

“We used to bury a person every two weeks here,” he said. “Our service delivery has switched from preparing people to die to teaching people how to live again.”

The agency, based in Bangor and serving Penobscot, Piscataquis and Aroostook counties, provides case-management services to those living with HIV and AIDS, assisting with housing, medical and dental services.

Living with the disease has become a costly proposition in many ways, Cranson said, adding that the expensive new drugs – costing about $12,000 a year – can put families in financial straits in addition to the physical and emotional toll the disease takes.

Mills, Maine’s highest-ranking health official, has followed the illness since its discovery and has seen the damage it can do. She was in medical school on June 5, 1981, when a bulletin reported an unexplained outbreak of an illness that affected five homosexual men in Los Angeles.

Today she marvels at the strides made in treating the condition that once confounded and frightened the nation’s best medical minds in the early 1980s.

“We’ve come a long way,” Mills said. “But we have a long way to go.”