RELATED ITEMS On the Web The Center for Disease Control and Prevention allows people to search the databases of the National AIDS Clearinghouse or order publications online. The South Carolina Department of Health and Environmental Control provides race, gender and age breakdowns of 1996 AIDS cases. The phone number of the National AIDS hotline is 1-800-342-AIDS. Students at Eastchester Middle School in Eastchester, N.Y., have made their own AIDS education handbook. Maryland's AIDS effort is documented in the quarterly state publication, HIV Times. From the AP Related articles from the Associated Press are available online. Editor's Note: Some of the above links will take you out of The Post's Web site. To return, use the Backbutton on your browser. Go to National Section Go to Home Page

Now that better treatments for AIDS are available, officials at the Centers for Disease Control and Prevention (CDC) in Atlanta are considering a new public service announcement campaign to encourage more people to be tested for HIV, but that project is still in the planning stages.

Instead, America's war against AIDS has fractured into thousands of local skirmishes, which are being fought in high schools and housing projects, bars and barber shops. These small grass-roots programs are designed to target groups considered at higher risk of infection, such as drug or alcohol users, young male homosexuals, minority women living in housing projects and sexually active teenagers.

Priorities for fighting the epidemic are set by community planning groups — committees of public health experts, behavioral scientists, activists and ordinary citizens who try to figure out what will work best in their state or city. The result is a patchwork of locally designed and run prevention efforts as varied as the vast AIDS Quilt.

Supporters of the change say it was painful but salutary. Critics, however, contend that the quality, content and intensity of the efforts vary widely, and no one really knows if they are effective.

And the virus continues to spread. Despite recent improvements in AIDS therapies, and a slowing of the pace of the epidemic in the United States, an estimated 40,000 Americans continue to become infected with HIV each year. Public health officials are particularly concerned that the virus is spreading fastest among African Americans, Hispanics, young people, women and, in general, people who acquire the infection through heterosexual sex.

"The news is good news, but it's not as good for everybody," said Helene Gayle, director of the National Center for HIV, STD and TB Prevention at the CDC. "Our challenge is to make sure we can have the same benefits for all parts of our population and where there are inequities, address those inequities."

Officials such as Gayle acknowledge today's prevention efforts favor groups that are politically organized and experienced in health advocacy, such as gay white men, and tend to leave out others, including some of those at the highest risk. How to reach these groups, and how to ensure that more than $400 million a year in federal funds for preventing HIV infection is being spent effectively, are the subjects of fierce debate within the CDC.

Some critics charge that the new approach has allowed the pendulum to swing too far toward local control. In many parts of the country, conservative political groups have successfully opposed the use of prevention strategies such as needle-exchange programs or sex education for teenagers.

Sauls's home state of South Carolina — a state that is predominantly rural and politically conservative — is, in many ways, a good place to examine how the nation's new approach to stopping the spread of HIV is working — and how it isn't.

Throughout the 1990s, the epidemic has been growing faster in southern states such as South Carolina than in any other region of the country. In 1994 (the last year for which complete data are available), South Carolina ranked ninth among the 46 states that measured infection rates in pregnant women, with a positivity rate of 2.2 per 1,000 women tested. AIDS has become the second leading cause of death among people age 25 to 44 in the state.

The patterns of disease transmission generally mirror national trends. As in the nation as a whole, South Carolina blacks are disproportionately affected: seven times more likely than whites to be infected with HIV, five times more likely to have a diagnosis of AIDS. As in the nation as a whole, men who have sex with men continue to make up the majority of South Carolina AIDS cases, although the rates among both male homosexuals and injecting drug users are stabilizing or falling. And as in the nation as a whole, HIV and AIDS rates among women in South Carolina are climbing, a reflection of the growing importance of heterosexual transmission as a driving force in the epidemic.