Must-Tell Rules Would Keep Sexually Active Teens
Away
Reddy DM, Fleming R, Swain C. Effect of mandatory
parental notification on adolescent girls' use of sexual
health care services. JAMA. 2002;288: 710-714.
Ford CA, English A. Limiting confidentiality of
adolescent health services: what are the risks?
[editorial] JAMA. 2002;288:752-753.
Almost half of the adolescent girls who seek
prescribed contraception and other sexual health
services would cease doing so if they knew that their
parents were going to be notified -- but most would
continue to have sexual intercourse, indicate survey
results published recently in JAMA. These circumstances,
warn Reddy et al, could increase unintended pregnancies,
abortions, and the spread of sexually transmitted
diseases (STDs).
In 1999, the investigators surveyed 950 sexually
active adolescent girls ages 12 to 17 (mean age, 16.8)
who presented to Wisconsin Planned Parenthood clinics.
The survey asked respondents whether they would use the
clinic's sexual health services if they knew their
parents would be informed of it in writing.
In an additional data sample collected in 2001 at
three Milwaukee Planned Parenthood clinics, 230 sexually
active girls ages 12 to 17 were asked if the possibility
of parental notification would induce them to stop using
the clinic's family planning services. A yes response
prompted additional questions regarding what form(s) of
birth control they would then use.
Of the respondents in the first sample, 47% reported
that they would stop the services if their parents had
to be notified. An additional 12% reported that they
would change the way they used the services, such as
delaying testing or treatment for HIV or other STDs, and
discontinuing pregnancy testing, HIV testing, health
examinations, and use of birth control services.
In the Milwaukee sample, 48% reported that they would
stop using the birth control services if their parents
had to be notified that they were seeking contraception.
Fifty-seven percent indicated that they would use
condoms instead, 29% would have unprotected intercourse,
29% would rely on withdrawal, and 1% would engage in
oral sex instead of genital intercourse. Fourteen
percent of those who said that they would use condoms
admitted that they would, at times, have unprotected
sex.
In an accompanying editorial, Carol A. Ford, MD, and
Abigail English, JD, both of the University of North
Carolina, Chapel Hill, call for a combination of
confidential health care and efforts to strengthen
communication between adolescents and their parents
about sexual decision making. They acknowledge, however,
that not all parents and teens will be able to
communicate effectively.
Mandatory parental notification
could cause half of the adolescent girls who obtain
sexual health services and contraceptives from clinics
to stop doing so.
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