Federal policy and adolescent AIDS

Adolescent AIDS policy in the United States is piecemeal at best. While funding for preventive education programs is extensive and growing, the effort remains largely uncoordinated and chaotic despite the best efforts of CDC. The public health system, like the educational system, is highly decentralized; state and county health officials have considerable authority over state and local public health programs. Adolescent AIDS health policy is essentially nonexistent. Aside from the usual sources of funding and services, such as Medicaid and the Maternal and Child Health block grant, there has been little recognition of the special problems confronting this population. Nor has the nation's AIDS research portfolio adequately reflected the threat of adolescent AIDS or the unique research questions needing investigation. As is so often the case, it seems particularly difficult to mobilize resources on behalf of adolescents, particularly those who are gay, live on the streets, or are intravenous drug users. Sadly, the nation seems incapable of recognizing the gravity of the threat posed by adolescent AIDS and HIV infection until the number of victims becomes overwhelming, as is the case now with adult AIDS.