The World Health Organization (WHO) estimates that two-thirds of all STIs worldwide occur in young people--teenagers and those in their early twenties (WHO 1993, WHO 1995). The provision of STI services to these age groups should therefore be high on the agenda of STI programme planners and adolescent/young people's health programmers alike. However, attempts to promote the sexual health of young people have so far tended to focus on prevention, education and counselling, while the provision of services to those who have already faced the consequences of unprotected sexual activity, including pregnancy and STI, or sexual violence, has lagged behind. In 1999-2000 a review was commissioned by GTZ of the characteristics of adolescent sexuality, evidence of STI risk in adolescents, the profile of adolescents in need of STI care, types and evidence of success of different STI service delivery models for adolescents and the advantages and disadvantages of each of these, and to what extent a youth-specific approach to STI services or an STI-specific approach to adolescent health service delivery, is warranted. This review will be published jointly by GTZ and WHO with the title Sexually Transmitted Infections among Adolescents: The Need for Adequate Health Services. This is a shortened form of the Summary and Conclusions of this book.

Laith Abu-Raddad and colleagues assess the current state of knowledge of the HIV epidemic among people who inject drugs in the Middle East and North Africa. Please see later in the article for the Editors' Summary

Although they do not provide complete protection against HIV spread, near universal male circumcision and possibly the prevailing sexually conservative cultural norms seemed to have played so far a protective role in slowing and limiting HIV transmission in MENA relative to other regions. If the existing social and epidemiological context remains largely the same, HIV epidemic transmission is likely to remain confined to high-risk populations and their sexual partners, in addition to exogenous exposures. HIV prevention efforts in this region, which continue to be stymied by stigma associated with HIV/AIDS and related risk behaviors, need to be aggressively expanded with a focus on controlling HIV spread along the contours of risk and vulnerability. There is still a window of opportunity to control further HIV transmission among high-risk groups in MENA that, if missed, may entail a health and socioeconomic burden that the region, in large part, is unprepared for.

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