Even in Idaho, where morality is legislated as often as the nearly all-Republican state lawmakers can get away with it, HIV/AIDS just won't go away.
"At this point, we are still pretty lucky," says Danielle Mahoney, director of the North Idaho AIDS Coalition, which will conduct free HIV screening on Friday at its downtown Coeur d'Alene offices. "We have the second- or third-lowest incidence of HIV/AIDS in the nation.
"Our concern is: It's here and people don't know it," Mahoney says.
Since tracking began in 1986, 98 North Idaho residents have suffered full-blown AIDS, she says. Forty-seven of those are dead, including three in the last year.
Only 35 people in the five northern Idaho counties are seeking medical services for HIV or AIDS, but a couple of things worry Mahoney and staffers at the Panhandle Health District: unprotected sex among teenagers, and needle-swapping among methamphetamine users.
"In District 1 [northern Idaho], our chlamydia rates are skyrocketing - mostly among 15- to 24-year-olds," Mahoney says. "If you introduce HIV to that group...."
Officially, Idaho is an abstinence-based state, which makes it a little bit tricky for public health workers to speak frankly about condoms and birth control with "nice" kids.
Mahoney says she spends most of her outreach at places like juvenile detention, Anchor House and the alternative schools.
"We focus on more alternative areas, not because we assume the kids are more sexually active, but because the [administrative] policies may be more lenient and the kids may listen a little more."
In regular high schools, where Panhandle Health workers lecture on sexual health issues once a semester, abstinence is mentioned first and everything else comes later.
Abstinence, Mahoney and health workers agree, is the only sure-fire way to avoid sexually transmitted diseases and pregnancy.
Still, nobody's fooling anybody.
"There are kids who are pretty sexually active," says Donna Marshall-Holden, STD/AIDS coordinator for Panhandle Health.
Chlamydia rates for younger girls jumped from the low 200s to 348 cases in the last year, Marshall-Holden notes. Interpreting numbers can be tricky, she says, and the increase could merely mean more kids and more doctors are aware of - and reporting - the infection than previously.
But people with an STD are more vulnerable to a virus such as HIV/AIDS, and circles of kids having unprotected sex with multiple partners are far more at risk than they realize.
Marshall-Holden says she does pretty explicit sex math for students.
"So if you and your partner each had sex with two people, you are exposed to three. (But) if you had 12 partners and your partner had 12 partners you are exposed to the germs of 4,095 people," she says. "I try to get them to think of it as germs, because sexually transmitted diseases are germs, and that's how they are transmitted. The kids are like, `Ewwww, gross.'"
On the job since January, Marshall-Holden says the range of North Idahoans affected by HIV/AIDS has already surprised her.
It's not a gay disease, not an urban disease, not a black disease. "No one is immune," she says.
Health workers also fear that meth use - rampant in North Idaho - is a potential pathway for HIV.
"North Idaho sees a lot of Hepatitis C, which comes from sharing needles," NIAC's Mahoney says. "If you bring someone with HIV into that circle, that's another pathway."
Idaho has no needle-exchange program. Mahoney says she tries to demonstrate needle-cleaning techniques whenever she visits drug rehab centers.
Her grant-funded agency didn't get enough money to cover a staff for the last couple of years, but Mahoney says it's not all because of morality-minded state lawmakers: "Idaho a conservative state, but across the nation HIV money is being cut."
The North Idaho AIDS Coalition (NIAC) offers free HIV screening and testing on Friday, July 1, from 9 am to 4 pm at the NIAC office, Fourth St. and Sherman Ave. in downtown Coeur d'Alene. Call (208) 665-1448.