A large proportion of people infected with the human immunodeficiency virus (HIV) are adolescents. Unfortunately, there is no uniform policy on minors' rights to consent to HIV testing and treatment. The process of obtaining consent is complex and depends on several factors, including individual state HIV laws and laws relating to a minor's capacity to consent to general health care. These issues are particularly relevant given the growth of HIV in this population. In this review, the complex laws of informed consent and confidentiality surrounding HIV disease in adolescents are reviewed. Familiarity with these laws by the clinician is essential to halting the HIV epidemic in adolescents and will be underscored.