While a significant and increasing number of adolescents are infected with the human immununodeficiency virus (HIV), few youth are identified as seropositive and even fewer are linked to medical care and social services. If more youth were identified, transmission to sexual partners and offspring would be reduced and individuals could benefit from treatment. Prior to initiating wide-scale early detection for HIV, we must (1) examine alternative strategies of conducting pretest and posttest counseling; (2) address barriers to prevention and testing within the HIV system of care; and (3) mount community-level intervention campaigns that address youth at high risk of infection.