Dianne Morrison-Beedy, PhD, RN, FNAP, FAANP, FAAN and Bernadette Melnyk, PhD, APRN-CNP, FNAP, FAANP, FAAN, issue an urgent call to action when it comes to tackling drug-taking. sexual risks and mental health problems in adolescent girls
Sexual risk-taking morbidities and mental health disorders are major public health epidemics negatively affecting the overall health and well-being of adolescent girls. The adolescence and emerging adulthood are a period of development characterized by increased experimentation, risk-taking, and evolving sexuality. This is also the time when mental health disorders often appear, especially anxiety and depression.
Sexual risk taking
The harmful consequences of risky sexual behavior, which often have a disproportionate impact on women in this age group, include unplanned pregnancy, sexually transmitted infections (STIs) and HIV. Alarmingly, although adolescents make up only a quarter of sexually active people, they account for half of all STI diagnoses each year (Centers for Disease Control and Prevention, 2019). Teenage pregnancies are still a major health problem costing billions of dollars each year. They are also one of the main reasons why girls drop out of school, which often leads to unemployment or underemployment. Although great strides have been made with treatments that help turn AIDS into a more chronic rather than acute disease entity, young women around the world still predominate in heterosexually acquired HIV cases, with women of color affected. disproportionately (Seth et al., 2011).
Mental health problems
To make this problem worse, mental health disorders (e.g. depression and anxiety) are alarmingly increasing in this age group and are predictive of unhealthy behaviors, including sexual risk-taking (World Organization for health, 2020). Mental health issues dominate this age group, and by mid-adolescence, girls are twice as likely to be diagnosed with a mood disorder as boys of the same age (Huang, Nigatu, Smail-Crevier , Zhang and Wang, 2018).
Depression affects 20% of adolescent girls, double the male prevalence, and is the main risk factor for suicide – the second leading cause of death among 10-34 year olds (Centers for Disease Control and Prevention, 2021). Despite the high prevalence of mental health disorders among adolescents, less than one in four receives treatment due to a lack of mental health care providers, inadequate screening practices, and the stigma associated with these disorders (Fitzpatrick, Darcy and Vierhile, 2017). The disparities are overwhelming, with the burden of untreated mental health disorders greatest among minority populations (Bailey, Mokonogho & Kumar, 2019).
Research has shown that certain conditions, such as depression, anxiety, and stress, are predictors of risky sexual behavior, including unprotected sex, multiple partners, and irregular use of protection (Hagedorn and Olfert, 2018; Norris et al. 2019). In adolescents with significant emotional distress at baseline, the frequency of participating in risky sexual behaviors, including unprotected and non-monogamous sex, was very high compared to those without such distress (Hops et al., 2011). Following their longitudinal study identifying correlations between mental health and unsafe sex among black adolescents, Foley et al. (2019) Recommended interventions should focus on mood and self-efficacy in order to improve safer sex practices.
Health promotion and prevention
Unfortunately, health systems around the world still focus on health and crisis care rather than health promotion and prevention. Sexual risk-taking and mental health issues are two major public health epidemics that lack evidence-based prevention and intervention approaches that treat these issues as related, not separate and unrelated issues. Despite studies that have examined interventions that address multiple risk behaviors, most multi-component interventions target substance use; none have been identified that target both mental health and sexual risk outcomes in adolescents.
Given the high prevalence of mental health disorders in this age group, it seems plausible that treating depressive and anxiety symptoms is essential to ensure maximum effectiveness of evidence-based sexual risk reduction interventions for adolescent girls. . Much work is needed to combine current evidence-based interventions targeting single-risk behaviors into more integrated programs that can address interrelated health challenges in adolescents. Only then will we improve population health outcomes for this vulnerable group of emerging adolescents and adults.
- Bailey, RK, Mokonogho, J., & Kumar, A. (2019). Racial and Ethnic Differences in Depression: Current Perspectives. Neuropsychiatric Disease and Treatment, 15, 603-609. doi: 10.2147 / NDT.S128584.
- Centers for Disaster Control and Prevention. (2017). HIV Surveillance Report 2016. Excerpt from https://www.cdc.gov/hiv/library/reports/hiv-surveillance.html
- Centers for Disaster Control and Prevention. (2019). Sexually Transmitted Disease Surveillance 2018. Atlanta: US Department of Health and Human Services. Recovered from https://www.cdc.gov/std/stats18/STDSurveillance2018-full-report.pdf
- Fitzpatrick, KK, Darcy, A., & Vierhile, M. (2017). Providing cognitive behavioral therapy to young adults with symptoms of depression and anxiety using a fully automated conversational agent (woebot): a randomized controlled trial. JMIR Mental Health, 4 (2), e19.
- Foley, JD, Vanable, PA, Brown, LK, Carey, MP, DiClemente, RJ, Romer, D., & Valois, RF (2019). Depressive symptoms as a longitudinal predictor of risky sexual behavior in African American adolescents. Health psychology: Official Journal of the Division of Health Psychology, American Psychological Association, 38 (11), 1001-1009. doi: 10.1037 / hea0000780 [doi].
- Hagedorn, RL, & Olfert, MD (2018). Food insecurity and behavioral characteristics for academic success in young adults attending a university in the Appalachians. Nutrients, 10 (3), 361. doi: 10.3390 / nu10030361. doi: 10.3390 / nu10030361 [doi].
- Houblon, H., Ozechowski, TJ, Waldron, HB, Davis, B., Turner, CW, Brody, JL & Barrera, M. (2011). Risky Sexual Behaviors for the Health of Adolescents: Effects of Drug Addiction Intervention. AIDS and Behavior, 15 (8), 1664-1676. doi: 10.1007 / s10461-011-0019-7 [doi].
- Huang, J., Nigatu, YT, Smail-Crevier, R., Zhang, X., & Wang, J. (2018). Interventions for common mental health problems in university and college students: a systematic review and meta-analysis of randomized controlled trials. Journal of Psychiatric Research, 107, 1-10.
- Norris, AL, Rich, C., Krieger, N., Guthrie, KM, Kaplan, C., Carey, KB, & Carey, MP (2019). Risky sexual behavior and substance use among diverse young women seeking treatment in a reproductive health clinic. BMC Women’s Health, 19 (1), 15. doi: 10.1186 / s12905-019-0709-2.
- Seth, P., Patel, SN, Sales, JM, DiClemente, RJ, Wingood, GM & Rose, ES (2011). The impact of depressive symptomatology on risky sexual behavior and sexual communication in African American adolescent girls. Psychology, Health and Medicine, 16 (3), 346-356.
- World Health Organization. (2020). Adolescent Mental Health Fact Sheet. Recovered from https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health