Increasing numbers of homeless men and women are testing positive for the AIDS virus or turning up with related illnesses at District shelters, according to health workers. Among the patients they see, the fastest-growing group is women of childbearing age.

Since June 1, doctors at Health Care for the Homeless, a nonprofit medical group that runs regular clinics at 11 shelters in the District, have identified 277 people with the AIDS virus. They tested only those with symptoms or high-risk factors and those who agreed to be tested.

Kenneth Singleton, an internist with Health Care who has overseen the testing, found 20 percent of those tested were HIV positive. But Singleton said that number is inflated because the population tested is a high-risk one. He said the disease may touch up to 12 percent of the city's estimated 15,000 homeless people.

The D.C. Coalition for the Homeless said staff members asked the nearly 100 men at their transitional shelters if they were HIV infected, and 30 percent answered yes.

"Homeless people are very vulnerable," said Daria Virven, a nurse at a clinic in the downtown shelter of the Community for Creative Non-Violence. "This is really going to be the population hardest hit by the HIV infection."

In some cases, as long as 10 years elapse from the time of infection with the human immunodeficiency virus to the development of symptoms. The virus destroys the infection-fighting white blood cells in the immune system. Eventually, the body cannot fight off diseases. AIDS is the final stage of this infection.

Studies show that AIDS, once considered an affliction of gay men, is becoming a disease of those living in poverty, drug abusers who share needles, and the sexual partners of drug users. Among the homeless, many AIDS sufferers also are people with mental health problems, health experts say. They are often alone and afraid.

"Can you imagine what the impact is for a person who is homeless to be told they are HIV positive?" said Janae Fisher, project coordinator for the HIV Prevention Project for the Homeless.

"They don't have resources or a support system. This is a person who is already ostracized and who is risking being ostracized again within the shelter. So you have people who keep {the diagnosis} to themselves and may continue to have sex with people inside and outside the shelter," she said.

The first impact is already being felt in clinics set up to offer basic health services at city shelters. Too weak to work and too poor to buy medical care, HIV-infected men and women, including some pregnant women, are now turning to those facilities for long-term treatment.

"One day I had five people who are HIV positive walk in off the streets, so sick," said Janelle Goetcheus, medical director of the Christ House shelter in Northwest. "Today, I told two more people they are HIV positive, a woman and a man. I saw a young man with weight loss, diarrhea, fever, chills and difficulty swallowing. He goes to the Randall Shelter {in Southwest} during the night and is out on the street during the day, trying to get food, searching for a bathroom."

Physicians said efforts to test homeless people have begun only recently and it is too soon to tell if people who are homeless are getting the AIDS virus at a faster rate than others. But stresses of joblessness and homelessness compounded by inadequate nutrition, drug abuse and prostitution exacerbate the disease.

Early last year, CCNV added a weekly HIV clinic at its shelter at Second and D streets NW, the first shelter in the District to do so. This year, CCNV designated one room as a special infirmary for those who are sick but not so ill they must be hospitalized.

There they can get prescriptions for free doses of AZT, the only federally approved treatment for the AIDS virus, with the cost shared by the District and Medicaid.

"We follow a person until they are sick enough for hospitalization, then we refer them to a hospital," said Singleton. "We give them tokens for transportation. But occasionally, someone is too sick. I had to put one guy in my car and take him to the hospital."

Typical is a 24-year-old man known as T.J, who was among 10 men lined up for treatment one recent afternoon, shivering from chills and yawning from the constant sluggishness that plagues him. He said he got the disease two years ago from a girlfriend.

"When I went to work at night -- as a security guard -- she went to work at night, if you get my meaning," he said. "She was a prostitute. I didn't know it until her girlfriend told me. I haven't seen her since I was diagnosed."

He lived with his grandmother until she had to move into a senior citizens building, he said. Unemployed and sick, he started going to an emergency shelter at night and walking the streets during the day, until one day last June he "passed out in the street. Some guys brought me here. The people here gave me a bed in the infirmary."

CCNV's infirmary contains 32 beds away from the rest of the shelter. Now he can get medical attention daily and a checkup Wednesdays at the HIV clinic.

"I spend my days trying to take care of myself," the young man said. "I get up, have my temperature taken at the clinic, get breakfast, lay down. Go sit outside, lay down, eat lunch. Go outside. Lay down, eat dinner. Stay in and rest.

"I can't do like I used to. I lost my job because I had to keep going to the hospital."

Health care workers say more HIV clinics are needed to reach people who aren't trying to get help. They say infected homeless women, many of them mentally ill, too often are diagnosed and then, frightened and distrustful, never return for treatment.

"There's resistance and ignorance about the disease," said Adrienne Schultz, a family practitioner who works at several shelter clinics.

Health Care for the Homeless recently was awarded a $436,000 federal grant to extend AIDS services and intends to open three more HIV clinics as well as a day-care unit for people with the virus.

"We'll have outreach nurses go to places other people aren't willing to go -- under bridges, on the streets and to evening soup kitchens," Singleton said.

The people will be referred to the clinics, given counseling and interviewed so attempts can be made to find their sexual partners, Singleton said.

Advocates for the homeless say there is are few affordable alternatives for these people, particularly housing linked with a system of care.

In a few weeks, the District's Office of AIDS Activities will begin an experimental rent subsidy program that would allow people with AIDS to find a private apartment and pay only a portion of the rent. The initial program will serve 20 people.

Meanwhile, shelters are not ready or funded to get ready, Singleton said. "They were set up to handle overnight care, and they do that very well. But when you have sick people who can't go out during the day, that increases the cost, and the money is just not there."