This book began with the hypothesis that a definable segment of America’s youth is so disadvantaged that this group will not be able to grow up into productive adults unless they receive immediate attention. An analysis of successful prevention programs has documented that enough information is now available to launch the necessary interventions to change the prospects for many of these young people. In Chapters 3 to 7, the prevalence and overlap in high-risk behavior were described and quantified; Chapter 8 reviewed the organizational structure that defines categorical programs; and Chapters 9 to 13 compiled extensive information on successful prevention programs. In this final chapter, we build on those findings to outline specific procedures that may lead to the development of more rational and effective strategies for changing the life trajectories for millions of children. These strategies rely heavily on the concept of centralized Youth Development Agencies, at the local, state, and federal levels. Such structures would be empowered to package the various program components so that they would have greater impact and efficiency. . . . Who Is At Risk? . . . It should be well understood by now that approximately one in four children of the 28 million aged 10 to 17 are in dire need of assistance because they are at high risk of engaging in multiple problem behaviors—in other words, of being substance abusers, having early unprotected intercourse, being delinquents, and failing in school. Based on current population estimates, this means that 7 million young people living primarily in disadvantaged neighborhoods are in the target population for intensive care. Minority youth have higher prevalence rates and are more visible in densely populated urban areas; nevertheless, the majority of these multiproblem youth are white (and male). Another 7 million young people—25 percent—practice risky behavior, but to a lesser degree, and are therefore less subject to negative consequences. And, it is estimated that about half of the youth population, 14 million, are not currently involved in high-risk behaviors and appear to be moving through the educational system at expected levels. However, their problem-solving skills need sharpening and they need access to a higher quality of education, as do all children.
Men at Risk; a Qualitative Study on HIV Risk, Gender Identity and Violence among Men Who Have Sex with Men Who Report High Risk Behavior in Kampala, Uganda