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美国性传播感染和人类免疫缺陷病毒服务未成年人同意法:对美国州法律的全面、纵向调查。

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

机构信息

Kimberly M. Nelson and Claire D. Stout are with the Department of Community Health Sciences, Boston University School of Public Health, Boston, MA. Alexandra Skinner, Will Raderman, and Julia Raifman are with the Department of Health Law, Policy, and Management, Boston University School of Public Health. Emily Unger and S. Bryn Austin are with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston. Madina Agénor and Shira I. Dunsiger are with the Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI. Michele L. Ybarra is with the Center for Innovative Public Health Research, San Clemente, CA. Kristen Underhill is with Cornell Law School, Ithaca, NY.

出版信息

Am J Public Health. 2023 Apr;113(4):397-407. doi: 10.2105/AJPH.2022.307199. Epub 2023 Feb 2.

Abstract

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. 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). 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. 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. (. 2023;113(4):397-407. https://doi.org/10.2105/AJPH.2022.307199).

摘要

评估从 1900 年到 2021 年美国所有 50 个州和哥伦比亚特区的未成年人同意进行性传播感染(STI)和 HIV 检测、治疗和预防服务的相关法律的变化。我们将法律编码为未成年人同意以下内容:(1)一般医疗保健;(2)STI 检测、治疗和预防;(3)HIV 检测、治疗和预防;(4)HIV 预防的暴露前或暴露后预防。我们还对保密性保护和所需条件(例如,临床医生判断的阈值)进行了编码。允许未成年人同意进行 STI 服务的州的最大增幅发生在 20 世纪 60 年代和 70 年代。到 2021 年,50 个州加上哥伦比亚特区的未成年人都可以独立同意进行 STI 和 HIV 检测和治疗,32 个司法管辖区的未成年人可以独立同意进行 STI 预防服务,33 个司法管辖区的未成年人可以独立同意进行 HIV 预防服务。未成年人的保密性保护措施很少。前提条件很常见。尽管允许未成年人独立同意进行 STI 和 HIV 服务的州的数量已经大大增加,但这些法律存在很大的限制,包括高度复杂性、需要临床医生判断的前提条件,以及忽视保密性问题。(2023 年;113(4):397-407. https://doi.org/10.2105/AJPH.2022.307199)。

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