ediatricians should speak out in support of needle exchange programs to reduce the spread of HIV among injection drug users, the American Academy of Pediatrics says in a toughened policy statement.

Doctors should also discuss HIV risk with their teenage patients "with a nonjudgmental approach" and offer confidential help if local laws allow, the group says in the statement that appears Monday in the journal Pediatrics.

Unprotected sex is the most common way young people become infected, but sharing dirty needles or having sex with an injection drug user accounts for about 13 percent of youth AIDS cases.

The new policy statement says of needle exchange programs, which let addicts trade dirty syringes for clean ones: "Pediatricians should advocate for unencumbered access to sterile syringes and improved knowledge about decontamination of injection equipment."

Congress has banned federal funding of needle exchange programs, but the Centers for Disease Control and Prevention says they can reduce the spread of disease without increasing drug use.

Thirty-six states and the District of Columbia have needle exchange programs, according to the nonprofit North American Syringe Exchange Network.