Must-Tell Rules Would Keep Sexually Active Teens Away
from
Clinician Reviews ®
Posted 01/07/2003
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. |
