In the early years of the HIV-AIDS epidemic in the United States, the disease was primarily associated with homosexuals and people who injected illegal drugs.  But over the years, heterosexual transmission has accounted for a growing number of AIDS cases, including increasing numbers of young people who are becoming infected with the incurable illness.  In this segment of our Youth and Politics series, VOA's Jessica Berman reports on the attitudes of America's young people toward the disease and efforts designed to educate them.

According to the U.S. Centers for Disease Control and Prevention (CDC), there are approximately 40,000 new cases of HIV infection reported every year in the United States.  Half of them are in people under the age of 25. 

Teenage girls are at the greatest risk.  In 2002, more than half of new HIV cases were reported in girls between the ages of 13 and 19.  Young African Americans represented 65 percent of AIDS cases reported among 13 to 19-year-olds.

A group of teenagers at a high school in suburban Washington, D.C. offer recently offered their views on HIV-AIDS.

"I think that it's a very big problem, but I don't feel that it affects us directly," said one teenage girl.  "Like, I'm sure that it does, but because of the lack of information we're receiving and we're not educated enough about it, we don't see it as a problem that's going to affect us immediately."

The teenagers say the information they get in school about HIV-AIDS is outdated and incomplete, and focuses too much on deferring sex, much to the amusement of this senior named Ben, 18.

"Abstinence.  Come on.  It's human nature [to have sex].  I mean, you can't stop that from happening," he said.

Cynthia Gomez, co-director of the Center for AIDS Prevention Studies at the University of California at San Francisco, develops programs designed to keep people of all ages and ethnicities from acquiring and transmitting HIV.  

Professor Gomez say the problem with most AIDS education programs in the United States aimed at young people is they're not relevant.

"I think it's really important to remember that HIV showed up 20 years ago," she said.  "So, for most young people, they have never known a world without HIV.  They did not have the opportunity, if you will, to see, to witness, the devastation of this disease because there are medications that hide, in some ways, some of what were the more obvious symptoms in the earlier parts of this epidemic."

Ms. Gomez says many kids think they can take a "magic" pill and not worry about HIV-AIDS.  But the high school kids I spoke with called the disease a "death sentence," noting that anti-retroviral drugs are not a cure, and all of them agreed that it is important to get to know their partners well before engaging in sexual relations.

However, there were mixed feelings about HIV testing.  The students say some of their classmates do not get tested because they don't know anybody infected with HIV so they assume they're safe.  They also believe some of their classmates are scared to find out if they are HIV-positive.

This teenager, in her third year of high school, says she knows of classmates who have non-HIV, sexually-transmitted diseases but continue to have sexual relations anyway.

"They're sexually active, but they'll tell them after the fact, because they don't want to be denied like, 'I don't want to be with you, because you're a freak; you're a diseased animal, or something.'  But they're scared because of what people are socially going to think about them and they don't want that upon them," she said.

Professor Gomez says successful AIDS prevention programs must involve direct and frank discussions about the importance and long-term benefits of sexual health. 

Ms. Gomez says trying to scare young people into practicing safe sex or being abstinent doesn't work in the long run.

"Young people are very smart today, much more sophisticated than we were at their age," she noted.  "And I think that it's very hard sometimes for people to accept that; that our youth are making their own decisions and choices without very much information."

In the end, the students say they know they need to be more aware about the risks of HIV.  But as one girl suggests, the message may take awhile to sink in.

"It used to not be socially OK for gay people to come out of the closet, and now it kind of is," she explained.  "So, I mean like I think it's going to be a gradual thing for people to be more aware of it with more information.  And over time, we'll be more aware of it.  But until then, I don't think people are really going to change."

Even so, there is some evidence that the AIDS epidemic may already be having an effect on young people in the United States.  According to the latest government data, the percentage of students between the ages of 13 and 19 who used a condom during their last sexual encounter increased from 46 to 63 percent during 2003.