In contrast to the success in reducing perinatal HIV infection in the United States and other developed countries, the HIV epidemic among adolescents has remained unchecked. Both national epidemiologic and clinical information indicate that HIV transmission and acquisition among adolescents and young adults continues to increase, as is also true globally. In the United States, surveillance data indicate that new infections among adolescent females equal or surpass new cases in adolescent males. Heterosexual transmission is the predominant mode of HIV acquisition in adolescent females, and homosexual transmission accounts for an increasing number of cases in adolescent males.

In developing countries, youth, particularly young women, are on the front lines of the HIV epidemic. The World Health Organization estimates that 10.3 million youth aged 15 to 24 years are living with HIV/AIDS (most without knowing they are infected) and half of all new infections are occurring among young people on a global basis. Additionally, increasing numbers of children infected perinatally are surviving into adolescence. Treatment of HIV-infected adolescents is further complicated by unique challenges and management demands.

The PAMA Branch has committed significant resources to understanding the transmission dynamics, course of HIV infection, and its management in youth. The PAMA Branch recognizes that support of research in this group is critical to intervening in the epidemic. Domestically, the Branch is supporting interventional research in youth from pre-adolescent age through 24 years that addresses the full scope of prevention activities, including primary prevention through both behavioral and preventive vaccine research, secondary prevention in clinical management of HIV infection to maintain health, and tertiary prevention in restoring HIV-infected youth to optimal functioning and well-being.