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SAN DIEGO — A growing number of people diagnosed with AIDS in San Diego have used intravenous drugs or had sex with people who injected drugs, according to the county’s health department. 

The report was released Tuesday, a week after the City Council moved a step closer toward authorizing a clean needle exchange program. 

“Cases attributable to directly injecting drugs and secondary spread to sexual partners and offspring account for a larger proportion of AIDS cases each year,” the report said. 

Since the first case of AIDS was reported in San Diego County in 1981, 10,244 people have been diagnosed with the disease, the third highest number of AIDS cases among California counties.  

An additional 4,700 to 9,000 are estimated to be HIV positive. 

In 1984, 2 percent of people with AIDS reported using intravenous drugs. By 1999, it was 13 percent. 

As of Sept. 30, nearly 7 percent of the 10,553 people with AIDS in the county were women, but among drug users with AIDS, females comprised nearly 33 percent.  

Additionally, a third of all people with AIDS were ethnic minorities but more than half of the people with AIDS who were also intravenous drug users were ethnic minorities. 

Sixty percent of women and 20 percent of men attributed their HIV infection directly to injection drug use or being a sexual partner of an injection drug user, the report said. 

While the county Board of Supervisors has refused to approve a clean needle exchange program, the City Council last week declared a health state of emergency, one of the first steps needed to implement a needle exchange. 

At least four California cities – Berkeley, Los Angeles, San Francisco and Santa Cruz – and Marin County have adopted emergency ordinances allowing such needle exchanges. 

The number of new HIV and AIDS cases in the county is similar to trends nationwide showing that the disease is spreading fastest among women and ethnic minorities. 

The number of AIDS cases among young men is also on the rise. Of the men testing positive for HIV and AIDS at the county’s clinics, more than a third are between the ages of 19 and 30, said Terry Cunningham, director of the county Office of AIDS Coordination, which compiled the report. 

New drug therapies have helped people with AIDS live longer, the report said. In 1996, 400 county residents died of AIDS compared with 151 deaths in 1998.