Updated October 16, 2014.

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Make no mistake about it, it is great to be young. It's a time in life to explore who you are and what you want to be. It's about taking risks, making mistakes and engaging in the rites of passage that are part of every generation's legacy. It's about grabbing life with both hands, fully and unafraid.

But in the shadow of HIV, have the rules suddenly changed?

The Impact of HIV/AIDS in Young People

On the face of things, the numbers seem to speak for themselves.

According to the Centers for Disease Control and Prevention (CDC), approximately 26% of the 50,000 Americans infected each year with HIV are under the age of 25. That's just over 12,000 new infections annually, or 1,000 new infections every month. Add to that the fact that 60% of infected youth are unaware of their status, and are unknowingly passing the virus on to others.

But the numbers alone barely reflect the true nature of the problem. Addressing the issue of HIV youth prevention is often akin to walking through a socioeconomic house of cards. It touches upon behavioral and sexual issues, biological factors, social influences and a multitude of other factors, each balanced precariously against the next. Tug one issue independently, and the entire structure suffers.

Breaking Down the Numbers

Building an informed strategy is key to overcoming this, and it starts by effectively breaking down the numbers to identify the areas of greatest risk. In an on-going surveillance by the U.S. Centers for Disease Control, researchers looked at youth infections in America and were able to determine that:

• approximately 85% of all youth infections are through sexual contact.
• infections from intravenous drug use run anywhere from 7-12%.
• young males represent around 60% of new infections.
• of male infections, 75% are among "men who have sex with men" (or MSM).
• of MSM infections, 14% are African American and 7% are Latino.
• African American youth account for more than 50% of new infections.
• Latinos and African Americans are twice as likely to be infected through IV drug use than whites.

Identifying External Vulnerabilities

But this is not where the issue stops. Underpinning these statistics are a number of other social and clinical factors that increase the likelihood of HIV infection—essentially the "external" forces over which we have little control as individuals. Chief among them:

• Poverty remains an integral factor in the high rate of infection among poorer communities, where there is inadequate access to public healthcare, services, support and outreach.
• Yet while the rate of poverty is eight times greater for African Americans than for whites, it's important to note that the rate of infections among impoverished groups—whether white, Latino or African American—is pretty much the same. Ethnicity plays no part.
• Mode of transmission plays a major role in the infection rate among young MSM, whether they identify as gay, bisexual or neither. This is due to a number of factors, including the fear of disclosure and the high-risk of exposure through unprotected anal sex.
• Similarly, young females have greater vulnerability to HIV than older females due to the single-layer columnar cells that line the cervix. (After puberty, these cells are gradually replaced by a thicker, multi-layered cell structure.)
• The social acceptability of sex with older men further compounds the issue in some cultures, since older men are more likely to be HIV-infected. Both this and biological susceptibility are two of the reasons that young women are often infected at an earlier age than young men.
• In the U.S., approximately 25% of the reported cases of sexually transmitted diseases (STDs) occur among youth. STDs are directly associated with a higher risk for HIV infection.
• Fear of stigma, abuse and homophobia send many youth underground, preventing them from seeking the care and treatment they need. This often leads to depression and substance abuse, which can in turn lead to incidences of high-risk sexual behavior.
• Alcohol and drug use remain a challenge across all groups, lowering inhibitions and blurring judgment. The prevalence of crystal methamphetamine in the gay community, in particular, has been linked to a 250% greater risk of infection.

Youth Attitudes About HIV/AIDS

Yet another challenge in the prevention of HIV is the very attitudes of our youth. In a far-reaching, national survey conducted by the Kaiser Family Foundation, researchers discovered that

• three out of five respondents stated that delaying sex was "a nice idea, nobody does it."
• one in six believe that having occasional unprotected sex is "not that big a deal."
• three in five reported that either they or a partner have had a pregnancy scare.
• 70% regard birth control methods other than condoms as "practicing safer sex."
• 50% regard condoms as a sign of mistrust, infidelity or promiscuity.
• 20% believe that you can tell someone has HIV by looking at them.

What was most telling, perhaps, was that few of the young people surveyed ever engaged in discussions about HIV/AIDS with their sexual partner, despite the fact that more than 75% said that they want more information.

NEXT PAGE:Strategies to Reduce HIV Risk in Youth