HIV infections among gay men have increased dramatically over the past two years in King County, Wash., and health officials are renewing their pleas for caution and vigilance against the disease. A new analysis shows HIV infections diagnosed in public health clinics jumped 40 percent last year and are projected to increase by another 60 percent this year. "It's the most dramatic increase since the beginning of the epidemic" more than 20 years ago, said Dr. Bob Wood, director of AIDS control for Public Health -- Seattle and King County.

Decreased fears of the disease, based on the availability of new drugs, have combined with safe sex message burnout to cause riskier sexual behavior. Gay and bisexual men comprise about 85 percent of the cumulative AIDS cases in King County.

Health officials based their analysis on HIV test results from public clinics beginning in 2000. The clinics generally see patients who have high infection risks, so increases in private clinics likely are fewer, Wood said. Officials estimate 400 to 500 new HIV infections in King County each year.

The health department and community-based HIV organizations are urging gay men to be tested for the virus, disclose their status to sexual partners, and practice safe sex. The health department has begun a pilot project offering a new rapid HIV test that gives results in 20 minutes. "We need to take HIV out of the closet. It's the responsibility of all guys who are sexually active to be talking about it. And don't be afraid to talk about it if you have it," said Jack Johnston, program coordinator for Positive Power, a group that helps HIV-positive men.

Wood estimated about 8,400 King County residents are living with HIV, compared to 7,500 two years ago. About 3,000 have AIDS. "I think a lot of my friends who have died would be rolling over in their graves about now," said Wood, who has battled AIDS for years but is now relatively healthy. "I think they would say to the community, 'Don't you guys care? Did I have to die for nothing?'"

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