Half of new HIV infections in the United States are in individuals aged 13 to 24 years, accounting for 20,000 new infections annually, or 1 every hour. Two thirds of infected youth contract HIV sexually, and more than 60% of new infections are in young women. Approximately 75% of infected youth are in racial or ethnic minority groups. More than one third of HIV-infected young people have not been tested for HIV infection, and the majority of homosexual HIV-infected youth are unaware of their infection status. Increased efforts are needed in comprehensive sex education, including safer sex practices, bringing young people into health care networks, increasing health care provider awareness of risk, and extending counseling and testing to young people. This article summarizes a presentation by Donna Futterman, MD, at the 7th Annual Clinical Conference for Ryan White CARE Act Title I, II, III, and IV Grantees, held in August 2004 in Washington, DC.