Young people are often not aware of the resources available to them. Medical services focused on adolescent AIDS, while scarce, do exist. These efforts are wasted, though, if young people who need them are not aware of how to reach them. Too often, it is a failure to connect, rather than a failure to care, which leads to tragedy. Young people often refuse to admit that they could benefit from health services. Researchers have shown that at-risk youth tend to fall into two categories: Those who deny any vulnerability to HIV infection. This group believes that HIV/AIDS cannot happen to them. Despite information about HIV and how it is transmitted, many youth who are at immediate risk or HIV infected have not internalized the message -- they think that prevention does not apply to them (Stiffman et al 1995). This phenomenon has been linked by developmental psychologists to feelings of invincibility, which are common in young people. Those who are resigned to an early death. This group embraces a desire to live for the moment, and is correspondingly cavalier about prevention. Lack of a hopeful future generally makes young people willing to engage in risky behaviors despite their knowledge of the possible consequences (Friedman 1993). Young people who are at high risk for HIV infection often see no need for testing or health maintenance since, as one subject put it, "a death sentence is a death sentence." Traditional medical services are not ideally suited to the needs of adolescents. Youth culture and health care systems are distinct and often distant worlds. Each has its own language, rules, and carefully controlled access. Friedman's 1993 study showed that most health care and mental health support services are adult-oriented, and are unequiped to deal with young peoples' unique situations. Understanding young people is critical: an HRSA advocate-sponsored study led by Kunins (1993) found that reaching and retaining young people in heath services requires different methods and resources than are found in traditional care. These approaches include moving services out of institutional facilities into more youth-friendly places, providing support and advocacy for participants, and attending to psycho/social/emotional needs. In addition, adolesence is a period when independence is being established. Direction from authority figures is often rejected. For this reason, young people need neutral individuals to help them understand and evaluate treatment options. Youth also have a greater need for privacy, and this need often makes youth feel that medical visits are intrusive. Kunin and others (1993) remind researchers that their teenage patients "may be experiencing their first pelvic, male genital exams, and breast exams, therefore, the clinician must be sensitive to [the patient's] feelings of invasion and discomfort." Unfortunately, most health care and mental health clinicians and service providers have not developed the necessary knowledge, skills, and attitudes necessary to successfully work with adolescents (Hein, 1994).

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