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More than 1 million Americans are infected with HIV. Yet even as the number continues to grow, public concern seems to be dropping.

That’s one of the tricky realities that public health officials are grappling with in fighting the disease.

Tuesday marked the 21st anniversary of World AIDS Day, and the landscape, in some ways, has changed markedly over the years.

Where once a diagnosis all but amounted to a death sentence, antiretroviral drugs have greatly lengthened the lives of people with HIV.

And attention to the staggering toll the disease is taking elsewhere in the world has, perhaps, distracted from what is happening here.

Although places such as sub-Saharan Africa have been devastated, that doesn’t mean there isn’t a problem here as well, said Addison Ore, executive director of the Triad Health Project, a nonprofit that assists people living with HIV and AIDS.

“It’s right here in our backyard here in Guilford County,” she said. “It’s obviously still a huge public health issue here.”

Some 1,700 people are living with HIV in Guilford County, according to the county’s public health department.

Worldwide, the total is now 33.4 million.

The problem is worse in the South than elsewhere, according to the health department, and recent statistics showed that HIV numbers across the United States were worse than had previously been thought.

But concern seems to be diminishing.

A recent poll found that the percentage of Americans who think HIV/AIDS is the country’s most urgent health problem dropped from 44 percent in 1995 to 6 percent in 2009.

But for Ore and others, the disease is still a serious problem.

Although medications have changed the outlook for those with HIV, they also can create serious health complications themselves, she said.

The disease continues to spread, in part because many — perhaps a fifth or more — of those who have it are unaware that they do, according to the Centers for Disease Control.

Testing is critical, Ore said, as is working to remove the stigma from those who have HIV. Funding for organizations fighting the disease and helping those with it is also essential, she said.

Contact Jason Hardin at 373-7021 or at jason.hardin@news-record.com