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Almost 10 years ago, Wayne Perkins got a phone call at work that forever divided his life into "before" and "after." The call informed him that he'd tested positive for HIV, and nothing's been the same since. But instead of giving up, the 28-year-old resident of Candor, west of Southern Pines, has been helping others who've faced the same soul-shaking news by volunteering with AIDS programs in his area.

Perkins' story is one of several front-line accounts featured in the newest North Carolina AIDS Index. Produced by the North Carolina AIDS Advisory Council--an appointed group of concerned citizens and professionals--the report graphically outlines the scope of HIV/AIDS infection in the state, as well as trends in medical care, research and support services.

Sadly, the index got scant attention when it was released last month--a response that's reflective of one of the key challenges facing the AIDS community. "The fight against HIV and AIDS is suffering from its own success," Advisory Council Chair Ed White, a pastor from Thomasville, says in the report. People are living longer with AIDS, which is "heartening," White says. "But we've noted that people are less likely to perceive the disease as the serious threat it continues to be."

The new index paints a clear picture of that threat and who is most at risk. While North Carolina is home to some of the leading AIDS treatment and research facilities (the report was partially funded by AIDS drug manufacturer, Glaxo Smith Kline), the people most likely to be suffering are those with the least access to new treatments and services.

Among the report's major findings:

More than 13,000 North Carolinians are living with HIV and AIDS.

African Americans account for nearly 75 percent of all new infections in the state.

The number of women diagnosed with AIDS has grown every year since 1990.

Nearly one-third of all reported HIV cases in North Carolina occur among people in their 20s.

While needle-exchange programs have proven successful in combating the spread of AIDS, they are illegal in North Carolina.

North Carolina is one of the few states that does not offer health insurance assistance to people living with HIV and AIDS.

The new index, the Advisory Council's third, does strike some hopeful notes. The number of deaths from AIDS is falling and major progress has been made in preventing the transmission of HIV to newborns. But serious obstacles remain, including widespread under-reporting of new infections, and the disproportionate burden the disease places on poor, non-white and rural North Carolinians.

As immediate steps, the council recommends that the state expand health insurance assistance, lower income-eligibility limits for AIDS drugs, authorize pilot needle-exchange programs, and bolster AIDS prevention and education in North Carolina schools.

For Jacqueline Clymore, Wake County program director for the Alliance of AIDS Services, the report is a touchstone for issues she confronts every day. One consequence of people thinking that the epidemic is over is a dearth of funding for AIDS services, Clymore says. "For example, we've been serving clients in Durham for five years now but we get no support from the city's political community and no money from the city or county."

The index takes some bold stands because it's written by people who are on the front lines of the epidemic. "The frustration, of course, is does anyone who can make changes in the situation pay attention?" Clymore says.

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