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Journal Issue: Critical Health Issues for Children and Youth Volume 4 Number 3 Winter 1994

Public Policy Implications of HIV/AIDS in Adolescents
Jill F. Blair Karen K. Hein


The relationship between the HIV/AIDS epidemic and the adolescent population in the United States has not received sufficient attention. Not only are an increasing number of adolescents of both sexes becoming infected, but a great many adults acquire the infection, often remaining asymptomatic, during their youth. Thus, the interface of the education and health systems is of central importance in preventing HIV/AIDS infection and subsequent death. This problem adds an urgency to making changes in school-linked health services previously addressed in the Spring 1992 issue of The Future of Children.

For those youth who are in school continuously and for those who are there intermittently (most school dropouts), the schools represent the most practical and best locus to deal with what, unfortunately, remains basically a matter of life (prevention) or death (infection). In this context the community need is to protect children and others from the epidemic by educating adolescents about high-risk sexual behaviors and their consequences and about measures to reduce the risk of infection and death (including programs that involve education about and distribution of condoms). This is in direct conflict with those who do not want matters of sexuality and reproduction addressed outside family and religious venues because of concerns about promoting promiscuity, denigrating religious beliefs, or displacing family responsibilities. The authors of this article attempt to reduce or resolve aspects of this conflict by analyzing available evidence on some of the important concerns that are inhibiting the initiation and implementation of life-saving, effective prevention programs. They also suggest changes in existing policies and programs at local, state, and national levels which might further reduce the risks of infection and death among this population of children and improve their health care generally.