But that may be part of the reason why South Dakota is seeing more cases of sexually transmitted diseases.
State health records show cases of Chlamydia have doubled over the past 12 years in South Dakota.
Gonorrhea is twice as common as it was in 2007.
And since 2009, new HIV infections have increased by two-thirds.
Health officials say the rising rates of STD's are troubling. Anita Pendo with Planned Parenthood tells KSFY News, "These are very concerning rates we never like to see a disease on the increase, so when any disease is on the increase, it's a matter of concern and a matter than needs to be addressed - 1:30 //NEWS4 01:24 - It's an issue anywhere, when it comes right down to it, perhaps in the rural areas it might be a bit more so, again, simply a lack of information, lack of access to healthcare."
Health leaders say it's important that people who are sexually active, get tested.
One in two sexually active young people contract at least one STD by the age of 25.