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The evidence since then has been mixed on many counts, with a number of small studies, typically relatively short in duration, continuing to suggest potential benefits from hormone therapy. Depending on the hoped-for clinical outcome, some evidence, mostly from animal studies, suggests that for a woman to benefit from hormone replacement, it may be essential to start soon after menopause, before the rapid postmenopausal decline in estrogen and progesterone availability irreversibly damages hormone-starved cells and tissues. For example, adolescent brain and behavior research suggests that despite rational assessment of risk in the 'cold hard light of day', adolescents are more prone to 'hot cognitions', meaning they are more affected than adults by exciting or stressful situations when making decisions. Despite its widespread legal significance, the age of 18 years clearly no longer signifies adulthood in many parts of the world. However, given that there are more than 1 million new HIV infections in the 15-24 yr old age group each year, which account for 41% of all new infections in those aged 15 years or over, the authors suggest that even in this traditional area of adolescent health, there has been insufficient policy and programming attention.