Confidential Sexual Healthcare for Teens

Feb. 4, 2003 -- Finding a doctor you know and trust may be even more difficult for teenagers who need medical care for sexual health needs such as contraception, pregnancy, and sexually transmitted diseases (STDs). A new study shows many doctors' offices inaccurately relay information about teen confidentiality policies.

Researchers also found that pediatricians are much less likely than family or internal medicine physicians to offer sexual health services to their adolescent patients. And even if they do, their office staff may not be communicating that message to their patients.

"When teens call about making an appointment, they're likely to get inaccurate information about whether they can get those services and whether or not it will be confidential," says researcher Lara Akinbami, MD, of the National Center for Health Statistics, a division of the CDC. In the study, more than half of all practices' office staff gave information about confidentiality that contradicted what the doctor had said.

For example, 91% of the pediatricians surveyed said they offer STD testing without parental notification to adolescents at their practice, but only 49% of their office staff offered the same response.

Researchers say that all 50 states entitle adolescents to receive care for so-called "medically emancipated conditions," such as contraception, pregnancy, STDs, substance abuse, and mental health issues, without a parent's consent. But many teens may be unaware that they have this legal right, and experts say the information adolescents get from their doctor's office about confidentiality is often the deciding factor in whether or not they seek care at all.

"If they can't get or believe they can't get confidential care then they won't seek those services," says Robert Blum, MD, professor of pediatrics and director of the Center for Adolescent Health and Development at the University of Minnesota. He says previous studies show that there is a very large number of young people who report that in past year they have forgone the medical care for confidentiality reasons.

"Many teens probably aren't aware that they have a legal right to it, but they have a great awareness that they have a need for it," Blum tells WebMD. "If we don't provide confidential care, they aren't going to get care they need, and parents understand that and are accepting of that."

In the study, published in the February issue of Pediatrics, Akinbami and colleagues surveyed 264 physicians in at 170 randomly selected practices in the Washington, D.C. area about the availability of confidential sexual health services.

Overall, researchers found that internal and family medicine physicians and office staff were much more likely than pediatrician offices to say they offered pelvic examinations, contraceptive services, and STD testing and treatment for teens.

For example, 97% of family practitioners and 79% of internal medicine doctors said they provide pelvic examinations to adolescents compared with only 50% of pediatricians.