Native Americans throughout North America suffer from a greater prevalence of health problems than the population as a whole. One might believe that the problem of AIDS is insignificant for Native youth, but such a belief is inaccurate and shortsighted. As of March 1989, the Centers for Disease Control reported 1,792 cases of childhood and adolescent AIDS in the United States. There are clear indications that Native children and adolescents are at risk as a population, and that certain subgroups of Native youth are at particularly high risk. Native youth who are sexually active, substance abusing, homeless, transient, or in correctional institutions are at especially high risk for HIV infection. Transient youth drifting between reservation and city form a particularly high risk bridge. Unprotected sexual activity among Native Americans places them at risk for HIV infection. Native Americans have the highest rates of sexually transmitted diseases of any U.S. population. The major fear, especially within reservation confines, is that HIV would spread rapidly once introduced, and sexually active youth would be a major target. Culturally appropriate and coordinated AIDS educational efforts should be undertaken immediately to prevent the spread of HIV among Native youth. AIDS information must be designed to meet the needs of individual youth in appropriate cultural and community context. Creative approaches using the oral tradition and youth involvement in the creation and dissemination of information may be effective. (SV)