ANNAPOLIS -- Americans, said Dr. Gillian Ann van Blerk in her clipped South African accent, "want instant cures." Fair enough, she said, but when it comes to AIDS, don't expect anything instant.

As incoming director of the newly created Office on AIDS in the Maryland Department of Health and Mental Hygiene, van Blerk has taken on the Herculean task of containing AIDS in Maryland -- coordinating treatment of its victims, educating people about it and showing them how to avoid it -- until the cure arrives.

Currently head of the AIDS program in Anne Arundel County, she plans to pull together several elements of the sprawling state health bureaucracy in a concerted effort to stem the growing incidence of acquired immune deficiency syndrome in Maryland. She starts her job Aug. 26.

State health officials report 649 cases of AIDS in Maryland, including 399 deaths, and 1,260 cases in the Washington area, including Northern Virginia, with 725 deaths.

An energetic and at times combative physician who left South Africa more than a decade ago disillusioned with its system of apartheid, van Blerk, 47, is no stranger to controversy and is prepared for it here over AIDS policy.

She will advocate what she said may seem like radical steps: the continued free distribution of condoms, instructions for drug users on how to sterilize needles and avoid sharing them with other addicts, education in public schools as early as third grade on the facts of AIDS and its prevention.

"I could get shot down by the prison authorities because of my views on allowing inmates to have condoms," she said in an interview. "I could get shot down by the public health people because of my views on encouraging {intravenous} drug users to sterilize their needles."

But those are risks van Blerk said she is willing to take in the effort to curb the spread of AIDS -- a modern plague she said is "going to get worse before it gets better."

She notes that condoms already are available in state and local health clinics in so-called "three-for-free" packets, and that U.S. Surgeon General C. Everett Koop has urged AIDS education beginning in third grade in public schools.

As for encouraging drug addicts to sterilize needles, van Blerk acknowledges that such a policy by itself has the effect of perpetuating illegal acts. Instead, she said, such encouragement should be given, but in the larger context of counseling and treatment to overcome drug addiction.

Van Blerk said she draws the line at distributing sterilized needles to addicts, as is done at "needle exchanges" in the Netherlands. "I'm not comfortable with that," she said. She said Maryland also has no plans for providing bleach or other sterilizing agents to addicts.

Like the beefed-up efforts to combat AIDS in the District, Virginia and other states, Maryland's program costs money -- about $2.8 million this year and perhaps more in 1988, if van Blerk can persuade state lawmakers of the urgency of the cause.

Van Blerk, who will receive more than $65,000 a year, will have about 30 workers under her, ranging from epidemiologists analyzing medical data to counselors urging drug addicts and other people in high-risk groups to take preventive measures.

With no cure or preventive vaccine available, AIDS is considered fatal in virtually all cases. The federal Centers for Disease Control reported 8,000 AIDS deaths nationwide last year and expects 54,000 by 1991.

Even with the increased public awareness and preventive steps taken in the past two years, van Blerk said, the situation is going to worsen before it improves. The incubation period of the AIDS virus can last as many as seven years, she said, meaning there is a large, unknown population of Americans who were infected by the virus in the early 1980s but who still have not come down with the disease.

Van Blerk, who along with her husband, physician Roy Myers, and their two daughters has become an American citizen, specialized in preventive medicine in South Africa in the 1960s, working as a medical officer in black and racially mixed ghettos in Johannesburg. She also worked for a period in leprosy outpatient clinics in Thailand.

Van Blerk said development of a vaccine for AIDS is likely in the future, "but I don't know what the time frame is . . . . It's very important to keep hoping."