Young people account for the largest portion of new HIV infections, but only 22% of sexually active high schools students have ever been tested for HIV, the Centers for Disease Control and Prevention reports.

Those between 13 and 24 accounted for about 26% of all new HIV infections in 2010, and almost 60% of youths with HIV in the U.S. don’t know they are infected. The new analysis, in the biennial National Youth Risk Behavior Survey, looks at high school students from 1991 to 2013, but found that the number of students getting tested has remained stagnant since 2005. In this age group, female and black students were more likely to be tested for HIV.

“We do believe that some amount of complacency is having some impact,” said Laura Kann, the lead researcher of the report and a scientist at CDC’s Division of Adolescent and School Health. “As the (AIDS) epidemic becomes less of a crisis, young people become less aware of (the dangers of) HIV.”

The analysis looks at trends of sexual risk behaviors-which include the proportion of high school students who have had sex, been tested for HIV, have had four or more sexual partners in their lifetime and had used a condom the last time they had sex. More than 13,000 students were surveyed.

The majority of teens between 12 and 17 don’t think they’re at risk for HIV, according to a study by the MAC AIDS Fund, a charity organization operated by cosmetics company MAC Cosmetics. and awareness of HIV and how to prevent it is low, with only two-thirds of American teens knowing that HIV is a sexually transmitted disease.

“I think kids live on a very short time horizon,” said Nancy Mahon, Global Executive Director of the MAC AIDS Fund and chairman of the Presidential Advisory Council on HIV/AIDS. “Pregnancy seems like a much more urgent issue than HIV. We need to do better job of educating kids about HIV, we have tools to end the epidemic, and it’s a 100% preventable disease.”

Only 22 states and Washington, D.C. require sex education in schools, according to the Guttmacher Institute; and of these, only 20 and D.C. mandate HIV education.

“The amount of time given to these subjects is very limited,” said Heather Boonstra, a public policy associate with Guttmacher.

According to the CDC’s analysis, substantial progress has been made in reducing sexual risk behaviors among black students, but they remain at higher risk for HIV than white and Hispanic students.

“While the gap is narrowed significantly, African Americans are still the highest risk,” Kann said.

It’s critical that young people are provided with the essential skills they need to stay safe and healthy, Kann said.

“It’s a wake-up call and call to action,” Mahon said.

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