Nurses at the Royal College of Nursing conference in the UK, say that school nurses are having to deal with children as young as 14 who are HIV positive, involved in prostitution and addicted to drugs.
Nurses are now being faced with a rising tide of self-harm, sexual exploitation and the effects of teenage gang culture and warn that chronic shortages of skilled staff in the field mean that vulnerable children are failing to be identified.
The nurses gave some graphic examples to illustrate their point including one of a 14-year-old boy who had tested positive for HIV contracted through sexual activity, who said when told, "I can't be HIV positive - only old people get it."
For reasons of client confidentiality, the nurses did not identify the areas but were from towns and cites across the country.
School nurse Babara Richardson-Todd said she has cases of young girls and young boys who are prostituting themselves through force of circumstances and has many children and young people on the child-protection register whose mothers have been forced to turn to prostitution to pay for their drug habit.
Liz Allan chair of the School Nurse Forum, who works in Kent, said that most school nurses at some time come across children who are subjected to sexual exploitation. She said young teenage girls were also forced to perform "sexual favours" on boys as part of the gang culture.
Judy McRae, a school nurse from London, spoke of a new trend of "daisychaining", where groups of teenagers go to one house and all have sex with each other.
Sexual health adviser to the RCN, Kathy French, said boys as young as 13 and 14 were feeling peer pressure from girls the same age to have sex, as well as the other way round. Her research has shown that poverty, combined with images of sex in films and on television, were driving many of the pressures on boys, in the past these boys may have had apprenticeships to go into that would have made them feel like men, now they are unemployed and the only thing that makes them feel like men is having sex.