Advocacy groups in Central Missouri said the 18 percent increase in people seeking treatment for HIV is due in part to a casual attitude among young people about sex and HIV transmission, the Columbia Daily Tribune reports.

According to Cale Mitchell, executive director of RAIN, which offers case management to people living with HIV in Central Missouri, the group has added 58 clients in the 12-month period that ended in May and recently enrolled a 16-year-old girl, who is the youngest client the agency has ever had.

Marlin Martin of the AIDS Project of the Ozarks in Springfield, Missouri, said that young people are unaware of how HIV is transmitted and that they engage in high-risk behaviors such as oral and anal sex because they want to be sexually active while still “saving themselves” for marriage. In addition, he said, youth are mostly unafraid of the HIV because of its perceived manageability and the increased average life expectancy of a person living with the virus.

“We don’t see the same imagery that we did in the ’80s,” Mitchell said. “You have a whole generation that missed out on seeing those images of people wasting away and dying.… All they see is that there are ads in national magazines for HIV medication that show somebody climbing the side of a mountain or whitewater rafting and living a normal, healthy life because they take one pill a day.”