Centers for Disease Control and Prevention, Division of Adolescent and School Health, Atlanta, Georgia.
Oak Ridge Institute for Science and Education (ORISE), Atlanta, Georgia.
J Adolesc Health. 2019 Jun;64(6):725-731. doi: 10.1016/j.jadohealth.2018.11.022. Epub 2019 Mar 6.
Many young people are not aware of their rights to confidential sexual and reproductive health (SRH) care. Given that online health information seeking is common among adolescents, we examined how health education Web content about SRH for young people addresses confidentiality.
In Spring 2017, we conducted Google keyword searches (e.g., "teens" and "sex education") to identify health promotion Web sites operated by public health/medical organizations in the United States and providing original content about SRH for adolescents/young adults. Thirty-two Web sites met inclusion criteria. We uploaded Web site PDFs to qualitative analysis software to identify confidentiality-related content and conduct thematic analysis of the 29 Web sites with confidentiality content.
Sexually transmitted infection testing and contraception were the SRH services most commonly described as confidential. Clear and comprehensive definitions of confidentiality were lacking; Web sites typically described confidentiality in relation to legal rights to receive care without parental consent or notification. Few mentioned the importance of time alone with a medical provider. Only half of the Web sites described potential inadvertent breaches of confidentiality associated with billing and even fewer described other restrictions to confidentiality practices (e.g., mandatory reporting laws). Although many Web sites recommended that adolescents verify confidentiality, guidance for doing so was not routinely provided. Information about confidentiality often encouraged adolescents to communicate with parents.
There is a need to provide comprehensive information, assurances, and resources about confidentiality practices while also addressing limitations to confidentiality in a way that does not create an undue burden on adolescents or reinforce and exacerbate confidentiality concerns.
许多年轻人不知道他们享有保密性的性健康和生殖健康（SRH）护理的权利。鉴于青少年普遍在线寻求健康信息，我们研究了针对年轻人的 SRH 健康教育网络内容如何解决保密性问题。
2017 年春季，我们进行了谷歌关键字搜索（例如“青少年”和“性教育”），以确定美国公共卫生/医疗机构运营的、提供有关青少年/年轻成年人 SRH 的原创内容的健康促进网站。有 32 个网站符合纳入标准。我们将网站 PDF 上传到定性分析软件中，以识别与保密性相关的内容，并对 29 个具有保密性内容的网站进行主题分析。
性传播感染检测和避孕是最常被描述为保密的 SRH 服务。缺乏明确和全面的保密性定义；网站通常将保密性描述为在没有父母同意或通知的情况下获得护理的合法权利。很少提到与医疗服务提供者单独相处的重要性。只有一半的网站描述了与计费相关的潜在无意违反保密性的情况，甚至更少的网站描述了对保密性实践的其他限制（例如，强制性报告法）。尽管许多网站建议青少年核实保密性，但通常没有提供这样做的指导。关于保密性的信息通常鼓励青少年与父母沟通。
需要提供有关保密性实践的全面信息、保证和资源，同时以不会给青少年带来不必要负担的方式解决保密性的限制，并解决不会加剧保密性问题的限制。
