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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%).

In contrast, adolescents in countries where HIV infection is widespread are at much higher risk of contracting HIV through sexual intercourse, as are adolescents in low-prevalence countries who have unprotected intercourse with members of very high-risk groups (eg, males who have sex with other males or injection drug users).Among sexually experienced people, adolescents aged 15 to 19 years have some of the highest reported rates of STDs.In addition, particular groups of adolescents (eg, males who have sex with males, injection drug users, and teens who have sex for drugs) engage in even greater risk-taking behavior.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.

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