Minor Consent Laws for Sexually Transmitted Infection and Human Immunodeficiency Virus Services in the United States: A Comprehensive, Longitudinal Survey of US State Laws

Abstract

Objectives. To assess changes in minor consent laws for sexually transmitted infection (STI) and HIV testing, treatment, and prevention services in all 50 US states and the District of Columbia from 1900 to 2021. Methods. We coded laws into minor consent for (1) health care generally; (2) STI testing, treatment, and prevention; (3) HIV testing, treatment, and prevention; and (4) pre- or postexposure prophylaxis for HIV prevention. We also coded confidentiality protections and required conditions (e.g., threshold clinician judgments). Results. The largest increase in states allowing minors to consent to STI services occurred during the 1960s and 1970s. By 2021, minors could consent independently to STI and HIV testing and treatment in all 50 states plus DC, STI prevention services in 32 jurisdictions, and HIV prevention services in 33 jurisdictions. Confidentiality protections for minors are rare. Prerequisites are common. Conclusions. Although the number of states allowing minors to consent independently to STI and HIV services has increased considerably, these laws have substantial limitations, including high complexity, prerequisites requiring clinician judgments, and neglect of confidentiality concerns. (Am J Public Health. Published online ahead of print February 2, 2023:e1–e11. https://doi.org/10.2105/AJPH.2022.307199 )

Knowledge, sex, and region associated with primary care providers prescribing adolescents HIV pre-exposure prophylaxis

“…Moreover, Western and Northeastern states tend to allow minors to access HIV prevention services, including PrEP, without parental/guardian permission 51 , 52 . Thirty-four states and D.C. allow minors to consent to HIV prevention services; however, only 18 of these address confidentiality protections.…”

“…Similarly, participants provided their agreement and disagreement to questions about PrEP delivery to adolescents aged 13–18 years old rather than a specific age (e.g., 16 years old) or an age range (15–17). However, some states define minors as those who are 18–21 51 , 52 . Medical providers have noted in prior research that patient characteristics and providers’ perceptions of patients play a part in their intention to prescribe and in their actual prescribing of PrEP to adolescents 12 – 15 , 17 , 18 .…”