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Educational programs for school-aged males should adequately address the risks of unprotected intercourse among males who may have sex with males, while programs for young women and female adolescents in the United States should address the special threat of unprotected heterosexual intercourse with injection drug users and the exchange of sex for drugs.Finally, programs should address drug use and needle sharing.

About 3 million teenagers acquire an STD every year in the United States.(8) This represents roughly one in eight young people between the ages of 13 and 19, and about one in four of those who have ever had sexual intercourse.Sometimes these networks do not connect with each other.(4) Consequently, some STDs are limited to particular social networks, and HIV, for example, is not rapidly spreading from one network to another in the adolescent population.Condoms are recognized as an especially important form of contraception, because they are currently the only form of contraception that prevents the transmission of most STDs.In addition, there are some adolescents who engage in very frequent unprotected sex for drugs, and thereby greatly increase their risk, both by having frequent unprotected sex and by having sex with partners in high-risk groups.These high-risk groups are somewhat bounded by social networks, but this may change.First, they suggest that there should be effective HIV education programs for all young people.

Furthermore, they suggest that there should be additional, more focused programs targeting those groups of adolescents who are at higher risk of HIV infection.

This chapter presents data on adolescent sexual risk-taking behavior, reviews the studies measuring the impact of adolescent prevention programs, and identifies common characteristics of programs that have been effective in reducing sexual risk-taking behavior.

It recommends a) that these effective school and community programs be implemented more broadly, b) that promising clinic programs and comprehensive community-wide campaigns be replicated and evaluated, and c) that additional programs focusing on high-risk youth be implemented and evaluated.

Among adolescents aged 13-21, older adolescents, males, and members of racial minorities have the highest infection rates.(1) Among new cases of HIV infection reported among 13- to 24-year-old men in the United States in 2001, 48% were among men who have sex with men, 3% were among men who injected drugs, another 3% were among men who both had sex with men and injected drugs, and only 6% were among men who were exposed through heterosexual contact.(2) Among new cases of HIV reported among young women aged 13-24 years, the exposure category with the largest number of cases was heterosexual contact (33%).

Among both males and females, the risk category was often unidentified.

Consequently, an estimated 25% of all people with HIV in the United States contracted HIV when they were teenagers.(1,2) Accordingly, professionals concerned with adolescents have developed school and community programs to reduce adolescent sexual risk-taking behavior.