HIV / STI
The effects of minor consent laws for STI/HIV prevention on STI/HIV testing among adolescents in the United States Alexandra Skinner* Kimberly M. Nelson Alexandra Skinner Shira I. Dunsiger Emily Unger Samantha Haiken Camille LaBranche Michele Ybarra S. Bryn Austin Kristen Underhill
Minor consent laws allow US minors to consent independently to medical care without guardian involvement. Although these state laws are intended to remove barriers to care, research assessing their impact on adolescent health care use is scarce. This study evaluates whether changes in minor consent laws for STI/HIV prevention services are associated with changes in STI/HIV testing among US adolescents.
We linked longitudinal state-level minor consent law data with individual-level National Survey of Family Growth data (2006-2019; 15–20-year-olds: N=13,169). Among 15–17-year-olds (n=6,759), effects of implementing a statewide minor consent law for STI/HIV prevention services on self-reported STI/HIV testing in the past year were modeled using a difference-in-differences approach with event study specification and survey weights to produce nationally representative estimates. Linear regression models included state and year fixed effects and controlled for age, sex, race/ethnicity, sexual minority status, urbanicity, and poverty status. STI testing questions differed depending on participant sex and thus were modeled separately. Conditional effects by age range (15–17-year-olds vs 18–20-year-olds) crossed with sex, sexual minority status, and race/ethnicity were examined.
We found no association between minor consent law implementation and changes in STI testing (females: -0.07, 95% CI: -0.18—0.03; males: 0.001, 95% CI: -0.05—0.05) or HIV testing (-0.02, 95% CI: -0.05—0.01). Effects did not vary by age range, sex, sexual minority status, or race/ethnicity.
Simply enacting minor consent laws for STI/HIV prevention services may be insufficient to increase STI and HIV testing among US adolescents. Research assessing barriers to the implementation of these laws (e.g., youth and provider knowledge of the laws, providers’ attitudes about relying on minor consent) is needed to optimize their utility and increase STI/HIV testing among minors.