Following a national trend, cases of AIDS and HIV infection in Maine are on the rise, a dark reflection, perhaps, of the successes in preventing and treating the deadly condition.

The number of people living with HIV-AIDS in Maine has never been higher, according to state officials, but because they’re living longer and healthier lives, public interest and awareness seem at an all-time low.

According to state Bureau of Health statistics, there are upward of 500 people diagnosed with AIDS in Maine and another 700 diagnosed with the HIV virus. Bureau epidemiologist Mark Griswold, who compiles data for the state’s HIV program, said Tuesday that between Jan. 1 and July 24, 2003, 33 cases of HIV were reported.

For the same period in 2002, that figure was just 19, with 39 cases reported for the year.

AIDS cases reported so far in 2003 number 28, compared with 21 during the same period last year and 42 for all of 2002.

“The numbers are tiny,” Griswold said, “but it’s still very troubling.”

These increases mark the first time in several years that AIDS – acquired immunodeficiency syndrome – and HIV – human immunodeficiency virus, the microbe that causes AIDS – have shown an upward trend. After a flood of testing and diagnoses in the late 1980s and early 1990s, when testing became more reliable and public concern was high, the numbers have shown a general tapering off.

Griswold said the state has been watching the numbers closely in anticipation of the increase that has been noted in other regions, especially in major urban areas, for a year or so. “What really concerns us right now,” Griswold said, “is the big increase in our [sexually transmitted diseases].”

Before HIV and AIDS spike, he said, public health officials often note increases in other sexually transmitted diseases. In Maine, the incidence of gonorrhea increased from 66 in the first half of 2002 to 123 during the same period in 2003. Chlamydia, a common infection, rose from 829 cases to 1,121, and syphilis from one case to nine during the reporting periods. These increases indicate changes in sexual behaviors overall, Griswold said, and forecast similarly steep increases in HIV and AIDS.

Almost all of Maine’s HIV-AIDS cases are attributable to sexual activity between men, he said. A secondary source is through shared needle use when injecting drugs.

The HIV virus suppresses the body’s natural immune system. Though it may take years, it develops into AIDS, eventually rendering the body incapable of fighting off illnesses that are normally treatable.

While important progress has been made in the management of HIV infection and AIDS, there is still no cure. Infected people can live productively for many years with a positive HIV status, depending on overall health, lifestyle and good luck, said Drew Thomits, supervisor of educational programs for the Eastern Maine AIDS Network in Bangor.

“HIV infection is different for everybody,” he said, but eventually victims develop fatal co-infections such as pneumonia, hepatitis, tuberculosis or other diseases, or die of complications such as organ failure or aneurysms from the potent medications used to manage their HIV.

“People who do live long with HIV infection get tested early,” Thomits said. “The sooner you know, the more treatment options you have.”

But people are not getting tested early, as they did in the earlier, high-profile days of the disease. Griswold said almost half of the people who tested positive for HIV between 1998 and 2002 received a diagnosis of AIDS within six months.

“That means they had HIV for a long time before they got tested,” he said. “They’re not getting tested until they get sick.”

Both Griswold and Thomits attribute the general lack of public interest to a combination of “prevention fatigue” in older gay and bisexual men and a lack of awareness in younger men who haven’t seen firsthand the ravages of AIDS.

“People get tired of hearing ‘safe sex’ all the time and never ‘We’ve made great strides and now you don’t have to worry,'” Thomits said. “When we didn’t have effective testing and treatments, people saw wasting and death and all the horrible things that happen with this disease. Now if they know someone, they may see them healthy, out working – they don’t see how hard it is to live with AIDS.”

Thomits said EMAN provides education, testing and support for men, women and teens at all stages, including the HIV-negative population.

Presentations to high school students and other community groups, weekly support groups and anonymous HIV testing – at EMAN’s Harlow Street office, as well as in jails, substance abuse centers and other high-risk locations – help spread the word about prevention and treatment, he said.

New tests that detect HIV antibodies in saliva have replaced blood-based tests, he said, making the process quick, easy and discreet. “We’ll meet people for testing almost anywhere,” he said.

Charles Dwyer, manager of Maine’s HIV program, said it would be nice if, in response to worries about an increase in cases, the state could channel more money to community agencies such as EMAN and its counterparts in other areas.

“Unfortunately, due to flat-funding at the state and federal levels, there is actually less money available for community HIV programs,” he said. Over the past two years, he said, programs like EMAN have had funding cuts of about 4 percent.

Dwyer said the state would be launching a public awareness campaign in the coming weeks, with informational posters in 1,000 doctor’s offices, nightclubs and other high-visibility places.

For more information on HIV-AIDS, visit the Eastern Maine AIDS Network at www.maineaidsnetwork.com