This report highlights the issues faced by children living with HIV, adolescents engaged in risky behaviors, pregnant women using drugs, and the more than one million children and young people who live or work on the streets of the Eastern Europe and Central Asia region. Marginalized young people are exposed on a daily basis to multiple risks, including drug use, commercial sex and other exploitation and abuse, putting them at higher risk of contracting HIV. The trends are especially troubling, as the region is home to 3.7 million injecting drug users - almost a quarter of the world's total. For many, initiation into drug use begins in adolescence. Existing health and social welfare services are not tailored to adolescents at greatest risk, who are often exposed to moral judgment, recrimination and even criminal prosecution when they seek treatment and information on HIV.