Confidentiality concerns may deter teens from sexual, reproductive health care services

Confidentiality concerns may deter teens from sexual, reproductive health care services


According to a national survey, 12.7% of sexually-active teenagers and young adults who were on their parent’s insurance plan would not use sexual and reproductive health services due to concerns that their parents would learn about it.

“Changes in the U.S. health care system have permitted dependent children to remain on a parent’s health insurance plan until the child’s 26th birthday and required coverage of certain preventive services,” Jami S. Leichliter, PhD, from the Division of Sexually Transmitted Disease Prevention, the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the CDC, and colleagues wrote. “Although these provisions likely facilitate access to the health care system, adolescents and young adults might not seek care or might delay seeking care for certain services because of concerns about confidentiality, including fears that their parents might find out.”

To ascertain the prevalence of confidentiality concerns among teenagers and young adults, the researchers examined data from sexually-experienced individuals aged between 15 and 25 years (n = 10,205) included in the 2013-2015 National Survey of Family Growth. In addition to information on marriage, divorce, family life, having and raising children and medical care, the National Survey of Family Growth also measures reproductive health status and examines the efficacy or need of health education programs.

The survey included questions concerning confidentiality that addressed whether those aged 15 to 17 would “ever not go for sexual or reproductive health care because their parents might find out,” whether they had “time alone with a provider in the past 12 months without a parent, relative or guardian in the room” and the status of their current health insurance.

Respondents who received STD services were defined as those who had a sexual risk assessment or other clinical services in the past year. A risk assessment included a doctor or health care provider questioning about sexual orientation or the sex of their partners, number of partners, condom use and type of sex (vaginal, oral or anal). Other services include chlamydia testing for girls in the last 12 months or receiving treatment for an STD in the past year for both boys and girls.

Among sexually-experienced youth aged 15 to 17 years, 22.6% responded that they would not seek services with concerns that their parents would know. Girls who were concerned about confidentiality were less likely to report receipt of chlamydia testing (17.1%) compared with girls who did not have concerns about confidentiality (38.7%).

When both male and female youth received more time alone with their health care providers, researchers noted that

they were more likely to report receipt of risk assessment (71.1%); however, when parents were present, reporting dropped to 36.6%. Girls who spent more time alone with their health care provider reported a  higher rate of chlamydia testing (34.0%) than those who had a parent present (14.9%).

“Several medical organizations have emphasized the need for confidentiality for youths seeking care such as STD services,” Leichliter and colleagues wrote. “Previous research has found that females might have more general and sexual and reproductive health-specific confidentiality concerns than do males.” – by Katherine Bortz

Disclosure: The researchers report no relevant financial disclosures.

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