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Meanwhile, Virginia has not tried some of the AIDS prevention strategies that research suggests are relatively effective. Unlike in the District and in Baltimore, no jurisdiction in Virginia has begun a needle-exchange program to try to prevent the spread of HIV among drug addicts who share tainted syringes.

Such reluctance, AIDS activists and researchers say, is the result of conservative social values in some Virginia communities, combined with the views of Gov. George Allen (R), who has been working to remove "family life" classes from public schools' required curriculum.

"I've had principals tell me 'I would get fired if I tried to bring in an AIDS speaker,'‚" said Brian Wispelwey, director of the University of Virginia Medical Center's HIV Clinic and the head of one of the state's four regional AIDS resource centers. "We have our heads in the sand."

Such attitudes have produced significant differences in what teenagers are told at school about sex and AIDS in different parts of the Washington area. In Montgomery County, Tina Clark, who until recently was in charge of the county's AIDS prevention programs, routinely entered schools to meet with hundreds of students at a time for frank discussions of love, sex and disease. "There are some kids who are not going to abstain from sex, so you have to find ways to keep them alive," Clark said.

The Northern Virginia AIDS Ministries receives AIDS prevention money, too, and brings HIV-infected speakers to meet students in 30 high schools in Alexandria and in Arlington, Fairfax and Prince William counties. But Rebecca Cowdrey, the ministries' education director, said speakers have not been able to go into junior highs, as she would like, and they must be careful to emphasize abstinence.

Bob Warfel, deputy director of Whitman-Walker's Northern Virginia branch, said that the clinic's workers talk with students at health fairs and shopping malls, but not in schools. "That is directly related to political considerations," Warfel said.

Following rules set by the CDC in 1994, Maryland, Virginia and the District each has formed a committee that drafts an AIDS prevention plan every year. Because AIDS activism in the area was relatively sophisticated even before the community prevention-planning began, the committees are highly representative, including advocates for women, prisoners, drug addicts, gay teenagers and members of racial and ethnic minority groups.

The committees work systematically, studying epidemiological data and sponsoring public opinion surveys to help guide their decisions about where the money — more than $16 million this year for the three states combined — should go. According to local health officials and AIDS activists, their deliberative process has channeled more help to the geographic areas and the groups in the population where new infections are most likely.

For example, Maryland spent $30,000 four years ago on three projects aimed at gay and bisexual male teenagers, a group believed to be at high risk. Now, the state devotes $90,000 to eight such projects. Maryland also has more than doubled expenditures on black women, starting projects in suburban Washington in Montgomery, Anne Arundel and Frederick counties, in addition to the one that has been underway for several years in Prince George's.

Similarly, Virginia used to have three projects that tried to prevent new infections among minorities. Now it has six. As a result, the Fairfax County Health Department has started to give federal money to Hopkins House, a nonprofit group that has begun to work with black residents who live in the southern part of the county near Route 1, providing them with counseling, encouragement to get tested, and lessons on how to avoid getting AIDS.

Although money is being spent with more precision, it remains unclear whether it actually is preventing the spread of HIV. "We know infections are slowing, but can we say it is because of our program? We don't know," said Elaine Martin, who coordinates HIV education for the Virginia Health Department and is co-chairman of the state's prevention planning committee.

All three states have begun to devote more attention to evaluating the projects they are subsidizing, but some AIDS experts believe they nevertheless are failing to find out whether their prevention efforts truly are doing any good.

"We can count the number of people who've been tested. We can count the number of condoms that have been given out," Levi said. "But we don't know much about whether people are really changing their behavior."