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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”



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.