The two camps of American youth growing up with HIV today represent, alternately, a victory and an abject failure of public health.

Because of treatment advances, the lives of many perinatally infected children (those who contracted HIV in utero, during birth or via breast feeding) have been spared and now those children are navigating their way toward or through adulthood. They are the products of public health gone right. What's more, our ability to prevent mother-to-child transmission today, particularly in the United States, makes it far less likely that new children will join their ranks.

Other young people acquire HIV behaviorally, through having unprotected sex or sharing injection drug works. People ages 13 to 29 represent 34 percent of all new HIV infections in the United States. This staggering rate of infection despite HIV's preventable nature is the direct result of a lack of comprehensive sex and health education in America. What we are not telling our kids is killing them. To be fair, some schools and parents do educate their kids about safer sex. But the fact that young people comprise more than a third of all new infections stateside speaks largely to a failure of public health and our unwillingness to address the facts of life.

Regan HofmannThey're called the facts of life for a reason. Talking frankly to kids about sex keeps them safe. And if living with HIV for 15 years and disclosing and discussing sex openly with the general public and intimate partners has taught me anything, it's that we can get over our hysteria about talking about sex—even with kids—when   doing so maintains health and saves lives.

The stories of the young people featured in “All Grown Up With HIV” highlight how their challenges differ from, and align with, those of us who are older and have HIV. What inspires me most about these young people with HIV is their determination to use their stories to help others stay safe, and their energy to fight for the health care and rights of all people living with HIV/AIDS.

It's a good thing. We're gonna need them. With the combination of the economic crisis and proposed budget cuts, health care for people with HIV served by the AIDS Drug Assistance Program (ADAP) and Medicaid is not guaranteed. As you will read in “Facing the Future of HIV Care,” some organizations are positioning themselves to provide care in a new era.

We've been saying for months that the ADAP crisis is the tip of the iceberg. Medicaid is under serious fire, and unlike Medicare, which affects a huge swath of the voting populace, Medicaid addresses the needs of the underprivileged who fall last on the scale of political sway. We must fight for the preservation of Medicaid-—and the Affordable Care Act. One way we do that is to tell the people who will be running for reelection that we will vote against those who don't make the health care of all Americans a priority.

Advocacy is a tough job. Luckily, a whole new generation of young people living with HIV are ready to fight for their lives—and ours. And fortunately, many of them are also old enough to vote.