ABSTRACT. Objective. To examine the association between gang involvement and female adolescents' health.Methods. African American adolescent females (N ؍ 522) completed a survey that assessed their history of gang involvement and health behaviors and provided specimens that were analyzed for marijuana use and sexually transmitted diseases.Results. In logistic regression analyses, adolescents with a history of gang involvement were more likely to have been expelled from school (odds ratio [OR]: 3.6), be a binge drinker (OR: 3.3), have a positive toxicologic test for marijuana (OR: 2.6), have been in 3 or more fights in the past 6 months (OR: 3.8), have a nonmonogamous partner (OR: 2.4), and test positive for Trichomonas vaginalis (OR: 2.2) and Neisseria gonorrhoeae (OR: 3.6).Conclusion. This study extends the current research on risk behaviors associated with gang involvement to include biological markers for substance use and sexual health outcomes, namely, marijuana use and sexually transmitted diseases. Pediatrics 2002;110(5). URL: http:// www.pediatrics.org/cgi/content/full/110/5/e57; female gang involvement, sexually transmitted diseases, marijuana.ABBREVIATIONS. STD, sexually transmitted disease; HIV, human immunodeficiency virus.T he proliferation of youth gangs in the 1980s and 1990s has made gang involvement a growing social and public health concern for adolescents and society in general. Initially, research on gangs concentrated almost exclusively on males, 1 tacitly assuming that females did not typically participate in "masculine" acts of vandalism, violence, and other serious threats. Recent studies, however, consistently indicate that although female gang members, relative to male gang members, have lower delinquency rates, they are higher than those of nongang-involved males and females. [2][3][4] The prevalence of female gang involvement is substantial. Several recent nationwide surveys conducted by law enforcement agencies have estimated that between 8% and 11% of all gang members are female. 5,6 This may be an underestimate, however, as surveys of at-risk youth in a wide range of cities have identified between 9% and 22% of females as claiming gang membership. 7,8 Although statistics have not been recorded by gender, the National Youth Gang Center reported that in 1999, among gang members, 47% were Hispanic, 31% were African American, and 13% reported being white. 5 Female adolescents' gang involvement has been associated with their participation in a diverse array of health-compromising behaviors such as violence, 8 -10 risky sexual behaviors, 3,11,12 antisocial behaviors, 8,9 drug abuse, 3,13-15 and alcohol abuse. 14 Although these studies have been valuable in describing the prevalence and some of the adverse health consequences associated with female gang involvement, their validity and generalizability may be limited. Generally, these findings are derived from studies of incarcerated youth, 10,16 school-based populations, 7,8 or youth in large urban areas in the West 18,14 and Midwest. 2...