President George W. Bush introduced the President’s Emergency Plan for AIDS Relief (PEPFAR) in January 2003.[1] Responding, Congress passed the U.S. Leadership against HIV/AIDS, Tuberculosis, and Malaria Act and authorized $15 billion for PEPFAR over five years.[2] PEPFAR has made gains against HIV/AIDS, mostly by providing life-extending anti-retroviral therapy (ART) in the 15 focus countries and 100 plus other bilateral countries receiving its funds. Including young people—both infected and uninfected—as critical target groups is essential. However, according to available data, PEPFAR inadequately addresses the pandemic among youth.