At a time in U.S. history when young women are presented with more choices and opportunities than ever before, women's health problems abound, and adolescent girls are placed at risk for sexually transmitted diseases (STDs), HIV infection, unwanted pregnancy, drug and alcohol abuse, eating disorders, depression, and other assorted perils that endanger their lives and well-being. This article describes the rationale for an alternative prevention strategy, a young women's support group, and the nature of the group and its participants.
ADOLESCENT HEALTH PROBLEMS
President Clinton recently requested that the Office of National AIDS Policy talk to young people about HIV infection. A newly released report found that one in four new infections in the United States occurs among people younger than age 20 ("White House Report," 1996). Genuis and Genuis (1995) pleaded for more primary prevention of adolescent sexual involvement, arguing that in the past decade, despite excellent methods of testing and effective treatment, there has been an unprecedented epidemic of STDs, especially among adolescent women. In a national school-based survey of adolescents, 53 percent of high school students had experienced sexual intercourse (only 52.3 percent of sexually active students had used a condom during their last sexual intercourse), 80.9 percent had consumed alcohol, 32.8 percent had used marijuana, 24.1 percent had seriously considered attempting suicide (girls significantly more than boys), 8.6 percent had attempted suicide, 34.3 percent thought that they were overweight, 40.3 percent were attempting weight loss (girls significantly more than boys), and 1.4 percent had injected an illegal drug (Kahn et al., 1995). Many young women engage in risky and unhealthy behaviors, and adolescent health care professionals agree that social and behavioral factors play a primary role in the epidemiology of morbidity and mortality in this age group (Athey, 1989; Blum, 1987; Hofmann, 1990; Irwin & Millstein, 1986; Jessor, 1984). Although teenagers may consult medical personnel about organic problems, they seldom seek help from a physician for the social and behavioral problems that can make them sick (Curtis, 1992). Therefore, the responsibility for prevention and treatment of these problems often falls to those in the schools and in the community, with the emphasis for primary prevention heavily placed on the school-based programs.
Although prevention programs are often designed to address one specific problem, adolescent health problems tend to cluster and form interrelationships around risky behavior (Friedman, 1989; Osgood, Johnston, O'Malley, & Bachman, 1988). Some researchers have linked alcohol/ drug abuse, sexual precocity, and cigarette smoking (Jessor & Jessor, 1977; Nathan, 1985). Mental health factors often provide key linkages. Depression has been related to the use of illicit drugs (Deykin, Levy, & Wells, 1982; Kandel & Davies, 1982), sexual behavior (Rotheram-Borus, Koopman, & Bradley, 1989), and developing AIDS (Diley, Ochitill, Perl, & Volberding, 1985; Perry & Jessor, 1985). Stiffman, Dore, Earls, and Cunningham (1992) in a study of 602 inner-city youths at risk for AIDS reported that depression, along with other mental health symptoms, was associated with higher numbers of risk behaviors. They also found that changes in mental health symptoms between adolescence and young adulthood were related to reduction of risky behaviors.
Issues of self-esteem and peer support have also been linked to risky behavior. Low self-esteem was related to low contraceptive use (Hayes, 1987) and smoking, especially among young adolescent females (Abernathy, Massad, & Romano-Dwyer, 1995). Some researchers have suggested that loneliness, isolation, and alienation provide the key linkages among vulnerability factors in emotionally disturbed youths at risk for AIDS (Giordano & Groat, 1989). …