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BACKGROUND: Youth violence is one of the leading causes of morbidity and mortality among adolescents, yet rarely discussed during preventative care visits. The aim of this study was to understand the perspectives of adolescents on youth violence and health, and to determine facilitators and barriers to discussion in the primary care setting. METHODS: We conducted 5 structured focus groups with adolescents from a local community organization. Each focus group was made up of 3-10 male and female participants ranging from ages 12-24. Transcripts were analyzed for recurrent themes. RESULTS: All participants had personal experience with violence or close contacts affected by violence, though few had discussed violence with their primary care physician. Themes included (1) violence plays a large role in youth's health, well-being, and behavior choices; (2) youth do not inherently trust physicians; (3) physicians do not ask about violence; and (4) youth have mixed feelings on how physicians could help them with the violence in their lives. CONCLUSIONS: Barriers to youth violence discussions include youths' discomfort, mistrust, and discordant expectations of their providers, and lack of physician inquiry about violence in the primary care setting. [ABSTRACT FROM AUTHOR]