7 Furthermore, only 1% of adolescent girls who indicated they would stop using family planning services reported that they would also stop having intercourse the vast majority reported that they would continue to have sex, but use less effective contraceptive methods or none at a11. For example, half of single, sexually active females younger than 18 years surveyed in family planning clinics in Wisconsin reported that they would stop using the clinics if parental notification for prescription contraceptives were mandatory another one in 10 reported that they would delay or discontinue use of specific services, such as services for STDs. 5 In one of these, a third of students who did not seek care reported that one of their reasons was "not wanting to tell their parents." 6 The impact of privacy concerns when adolescents require specific services to address sensitive health issues is likely much higher.
4 In two large nationally representative surveys, approximately a quarter of middle and high school students reported having forgone health care they needed. 3Ĭoncerns about privacy can prevent adolescents from seeking care. 2 From both a clinical and a public policy perspective, protection of confidentiality for adolescents has been based on recognition that some minors would not seek needed health care if they could not receive it confidentially, and that their forgoing care would have negative health implications for them as well as society. Over the past several decades, adolescents have gained many opportunities to receive confidential health care services, particularly for concerns related to sexual activity, pregnancy, HIV and other sexually transmitted diseases (STDs), substance abuse and mental health.
These provisions represent a compromise between competing viewpoints about the importance of parental access to minors' health information and the availability of confidential adolescent health care services.
1 The rule, which is based on requirements contained in the Health Insurance Portability and Accountability Act of 1996 (HIPAA), embodies important protections for minors, along with a significant degree of deference to other laws (both state and federal) and to the judgment of health care providers. In August 2002, a new federal rule took effect that protects the privacy of individuals' health information and medical records.
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