A study suggests that adolescent sexual minority males do not actively test for HIV, despite having the legal capacity to consent to testing without parental/guardian permission; confidentiality concerns are a potential barrier to testing. Findings from this study were published in AIDS and Behavior.
A total of 127 individuals between the age of 14 and 17 were surveyed on the nature of their sexual activity history, whether or not they have disclosed their activity and/or sexuality to their parents/guardians, and the sex of their sexual partners. Also, researchers asked participants whether they had ever been tested for HIV and, if so, whether this testing required parent/guardian permission.
Approximately 51% of the study participants identified as racial/ethnic minorities and 61% identified as gay. Of participants who identified as gay, approximately 85% had not disclosed their sexual activity to their parents/guardians. Only 15% of participants reported lifetime HIV testing, and participants who reported testing were more likely to be older and report anal sex, oral, or vaginal sex. No association was found between having the legal capacity to consent to HIV testing vs ever testing for HIV (adjusted odds ratio 0.3; 95% CI, 0.1-1.1). Individuals who had not disclosed their sexuality to their parents/guardians were 70% less likely to report testing for HIV vs individuals who had disclosed sexual activity to their parents/guardians (adjusted odds ratio 0.3; 95% CI, 0.1-0.9).
Limitations of the analysis include the small sample, the inclusion of mostly gay individuals from only 32 states, the questionnaire nature of the data collection, and the lack of data on paying or beliefs regarding the ability to maintain confidentiality while using parent’s insurance.
“As confidentiality concerns likely contribute to low testing rates among [adolescent sexual minority males], additional research with larger, more geographically and demographically diverse samples is needed to more thoroughly assess the impact of these laws on testing behaviors, methods to leverage legal protections to allay confidentiality concerns, and ways to inform youths about their legal rights,” the researchers concluded.
Nelson KM, Underhill K, Carey MP. Consent for HIV testing among adolescent sexual minority males: legal status, youth perceptions, and associations with actual testing and sexual risk behavior [published online February 12, 2019]. AIDS Behav. doi:10.1007/s10461-019-02424-9