MACON, GA. -- Between the red clay bluffs of the Piedmont and the coastal beach towns lies I-75, the six-lane superhighway some health officials are coming to call the AIDS Line. It is a favorite route for drug couriers speeding north out of Florida who increasingly make this small city a pit stop, finding its housing projects, roller rinks, parks and schools convenient places to trade some of their cocaine for cash or sex.

Here in this gracious, antebellum city -- the proud hometown of music greats Otis Redding, Little Richard and the Allman Brothers, is emerging what the National AIDS Commission terms "an unholy triangle" of drugs, sex and AIDS.

Over the past year, the rate of syphilis infections in the Macon area has soared 300 percent. Surveys show that 43 percent of middle schoolers and 60 percent of high school students in this area say they are sexually active. Middle Georgia, as this area is known, has the nation's third highest rate of teenage pregnancy.

"The 14-year-old pregnant girl with syphilis, on crack and in trouble with the law, is all too common," said Ted Holloway, a district health official in nearby Waycross.

Aside from a couple of doctors, including Holloway, and the strained staff of the Bibb County Health Department, few people here have acknowledged that their city of 118,000, a little more than an hour's fast drive southeast of Atlanta through low hills covered by loblolly pine, is smack in the center of the second wave of the AIDS epidemic, which is spreading to the heartland.

"We seem to be witnessing the ruralization of AIDS," said June E. Osborn, chairwoman of the National AIDS Commission, which spent two days touring the area in April. What is happening here, she said, is being repeated elsewhere as AIDS spreads from the East and West coast cities to small-town America, to places that are unprepared to cope with the epidemic that has altered the fabric of life in big cities like New York and San Francisco. "What we're doing in Macon and places like it," Osborn said, "is reinventing the wheel all over again."

Since October, the number of AIDS cases in Macon and the surrounding area has more than tripled to nearly 150, according to Bibb County health officials. The number infected with HIV is believed to be 100 times that. With 3,649 reported cases of AIDS, Georgia ranks eighth among states, according to the Centers for Disease Control. By the end of 1991, state health officials expect more than 7,000 cases of AIDS will have been reported in the state.

The explosion of cases is tied to alarming increases in the rates of sexually transmitted diseases, especially syphilis, which makes sufferers more susceptible to AIDS. The cause is simple: crack.

"Crack cocaine," Holloway said, "has invaded the rural area of southeast Georgia with a vengeance." Between 1984 and 1989, the rate of syphilis increased 1,000 percent, he said, from 48 new cases to 500.

Crack dealers, according to Holloway and law enforcement officials, target young women in particular; many become prostitutes or small-time dealers to support their habits. Police say that some of these women, who are giving birth to AIDS-infected babies, have so many sexual contacts and are so mindless in their need that they are known by the local dealers as "chicken heads."

As a result, there are more new cases of AIDS among heterosexual intravenous drug users and their female sexual partners.

Other AIDS patients include an ordained minister's wife who was infected by her husband, who says he contracted AIDS in Africa, where he received an inoculation. Dozens of other sufferers, doctors here say, apparently contracted AIDS as teenagers.

The county's public hospital in Macon has a clinic for all types of infectious diseases. In the beginning of the epidemic, the clinic treated AIDS patients -- though somewhat secretively. The clinic, which provides outpatient care, is also limited to people from Bibb County. Public health officials felt they needed to open it to people from neighboring counties, which have no such facilities, and to publicize their services. The hospital declined, fearing the clinic would become a magnet for patients from around the region as well as those testing positive for the virus.

In 1989, the Health Department's administrator for public and mental health, Cecil Baldwin, climbed out on a political limb and opened an ambulatory infectious disease clinic in the health department's building across the street from the hospital. Baldwin has done it by shifting and straining his already thin resources, without an extra dime of state or federal money.

"I hope at the end of a year to prove it's actually cheaper to provide the treatment," he said.

Baldwin said he believes the expense of caring for AIDS patients can be reduced by offering outpatient care that provides the medicines and psychological support to keep an AIDS sufferer stronger and out of a hospital during most of the illness.

In addition, one of the volunteer doctors at the clinic has launched a prevention and education campaign in schools and churches in this bastion of Christian fundamentalism.

"Who can say how many cases we've been able to prevent by educating our patients about the dangers of continuing to have {unprotected} sex," Baldwin said.

With no additional public funds available, two volunteer doctors who work at the clinic must bootleg medicine. One is Harold Katner, who says he has more than 100 patients infected with HIV. Katner said he begs them to leave him their AZT when they become too sick to take it or after they die. That way he can give AZT, which costs between $3,000 and $9,000 per year, to other patients too poor to afford the drug.

A nurse at the clinic laments that, while treatment and counseling are free at the clinic, the lab work and the medicines are not. Yet patients with monthly incomes in excess of $400 are ineligible for Medicaid in Georgia.

"So," said the nurse, "these people don't get the medicine, so of course they get sicker and then they end up in the hospital and it costs the taxpayers a lot more. Now does that make sense?"

Some patients are admitted to the county hospital when they become too sick to come into the health department clinic. Many, however, choose to die at home with their families. Katner encourages this and makes frequent house calls as death nears.

Although Katner and some others are supportive of AIDS patients, the general atmosphere in this area is not, witnesses told the AIDS commission.

Nursing homes here won't accept AIDS patients, the commission was told. Holloway said that a nurse in Waycross violated confidentiality while standing in a supermarket line, disclosing the name of an AIDS patient. The man standing behind her was the patient's employer; within hours, the AIDS sufferer had been fired.

Belinda Mason, a member of the AIDS commission who is from rural Kentucky, said the visit here had shown rural America at its "warm, supportive best" and at its "closed-minded, bigoted worst." Said Mason, "You're in small-town America, where people just are not good about people who are different."

Whether or not they like it, observed Katner, AIDS has arrived in Macon and he is braced for the worst. "The cost of the disease is going to overwhelm us," he said.

Harold Katner is a nice man who wants to scare children. He shows them disgusting pictures and tells them they're in danger of a horrible death if they're not careful.

Katner, a doctor with more than 100 HIV-infected patients, knows that teenagers are particularly vulnerable because they are experimenting with sex and drugs and the risk of AIDS seems remote.

It's not that some don't try to be careful. A number of girls have told Katner that they practice safe sex. "What's that?" he asks. "Anal sex," they say. "How is that safe?" he marvels. "Because," they tell him, "you can't get pregnant that way."

This is why, on a sunny morning in late May, Katner walks into Miller Middle School to show an auditorium filled with eighth graders a slide show with images no Hollywood horror film has matched. This short, plumpish doctor with a gentle voice is trying to gross out these kids more than Freddie of "The Chainsaw Massacres" ever did. Here, in color, are the ravages of AIDS few adults have seen -- the raw sores, bloated organs, shriveled limbs and glassy stares of the walking dead.

"I want to discuss types of sexual contact," Katner says. "Anal intercourse. It causes bleeding in the rectum" and is one of the most efficient ways of transmitting AIDS.

Slide: Tight focus on a tongue, covered with a yellow fungus as thick as custard.

"This man had sex with 40 married men in this area. He infected his wife."

Slide: Arms covered with sores, infected needle marks.

"This guy is now dying. What he looks like today I can't show you. He was good-looking, had a fancy car, fancy house. Because he was dealing drugs. he had 24 sexual contacts with Macon high school girls."

Slide: An open mouth, filled with blood.

"This guy is coughing up blood. This guy is a minister. This guy is married with five kids."

Some kids are squirming. There are rustlings, low titters and groans.

"I'm going to treat you like adults today," Katner admonishes. "So try not to laugh. Girls in middle schools are selling themselves for crack. I saw 21 new people in the last two weeks, and seven of them are women. These slides are ugly, but I want you to see."

Slide: Emaciated torso and face.

"This man, while in high school here in Macon, had sex a couple of times with another man. When you get this sick, I've got to shove tubes up your nose and into your stomach to feed you. I've got to shove other tubes up your nose so you can breath. You don't want to die like that."

"This man had been in the Army going all over the world. He spent his pay on prostitutes. I saw his Army records, and they show he contracted herpes, syphilis. But he stopped all that. He got married. They had two babies. Then he came down with AIDS, and his wife got it, too. One baby died of it. Nobody would play with his other little girl because her parents had AIDS. A week after he went home for the last time, this little 8-year-old girl called me at home. 'Please come wake my daddy up,' she cried. He was dead. And she's got to watch her mother die. And I've got five other families out there in which both parents died."

Slide: Something long, thin, red and raw that looks like a skinned squirrel.

"This is a newborn baby. It doesn't even look human. Thank God that baby died. Some don't."

Time and again during his presentation, Katner's voice quavers and cracks with sorrow and horror.

"I don't want you catching AIDS. I can't cure AIDS. There may never be a cure. People your ages are catching AIDS. Only you by your behavior can keep from catching AIDS.

"I need your help, to teach your friends, to teach your parents. Because I can't be everywhere."

Katner has many versions of his show, one for middle schools, one for high schools, one for physicians, one for "liberal" counties, one for "conservative" counties. In what he considers conservative counties, he doesn't mention anal sex. In Catholic schools, he tries to finesse his pitch about the necessity of using condoms, although once a boy pointed out the omission and the nuns bowed their heads and Katner, a Catholic himself, talked about condoms.

The show, approved by the Georgia Board of Education for use in schools throughout the state, is as shocking as the old World War II venereal disease films that revolted millions of soldiers. Katner concedes the aptness of the comparison and notes approvingly, "Those films cut VD rates 50 percent before the advent of penicillin."

That old strategy may work. Surveys conducted six weeks after each of Katner's presentations show that 50 percent of teenagers who admit to being sexually active say they reduced the number of sexual partners; 72 percent say they plan to use condoms.

As one student wrote after the program: "Your program on AIDS taught me some lessons and stoppped me from dealing with so many girls." Said another: "I DON'T use drugs, but I am becoming sexually active. Now I know most of the precautions I need to use before having sex."