Confidentiality's role in supporting adolescent health

The Minnesota legislature is pushing a bill, SF 1017, to remove a minors right to obtain medical care. There is an exception for incest, rape and abuse but only when the abuse comes at the hand of a parent or a legal guardian - the victim would be forced to go in front of a judge to prove that abuse occurred. This bill would not only force rape and many incest victims to confront their assailants to obtain permission for an abortion, they would have to obtain their permission for STI testing, pregnancy testing, alcohol/drug counseling, mental health counseling and all other medical care.

In Minnesota, STI's disproportionally affect teens. According to the American Medical Association, parental consent and notification laws prevent teens from seeking health care. Removing the right to privacy will not only prevent teens from accessing health care but will prevent teens from obtaining the counseling medical professionals provide. Counseling that includes teaching teens about safe sex practices and guidance for talking to parents about sex. Confidential access to medical care has been a cornerstone to improving the health of American teens.

Guttmacher

Research from as far back as the late 1970s has highlighted the importance of confidentiality to teens' willingness to seek care. Recent research confirms these original findings. For example, a study appearing in 1999 in the Journal of the American Medical Association (JAMA) found that a significant percentage of teenagers had decided not to seek health care that they thought they needed due to confidentiality concerns. With respect to reproductive health care, specifically, a 2002 JAMA study found that almost half of sexually active teens (47%) visiting a family planning clinic would stop using clinic services if their parents were notified that they were seeking birth control, and another 11% reported that they would delay testing or treatment for sexually transmitted diseases (STDs) or HIV; virtually all (99%), however, reported that they would continue having sex.

The American Academy of Pediatrics states that parental consent legislation does not increase family communication, but does increase the risk of harm to the adolescent by delaying access to medical care. Physicians agree that minors should be encouraged to discuss their health with their parents/guardians, but should not be forced in order to obtain care. Parental notification/consent laws have been shown to decrease adolescents’ likelihood of seeking health care and use of contraceptives by almost 50% - thus completing the circle - and increasing the rates of teen pregnancy.

MNCASA provides some linkes to take action.

Education and access to family planning can reduce STI cases in MN

April is sexually transmitted infections (STI) awareness month. During April, programs work to raise awareness about the impact of STIs and the importance of discussing sexual health. In Minnesota, The Department of Health currently funds 31 community programs that provide STI/HIV testing, medically accurate sex education, contraception and support groups. While these programs help prevent the spread of STIs and unplanned pregnancy in Minnesota, the state legislature is aiming to eliminate funding (and block federal funding) for projects that deliver these services - even in the face of increases rates of STIs in Minnesota. The family planning special projets (FPSP) grants were implemented in 1978 under Governor Carlson and Governor Pawlenty increased the funding for this program. This bipartisan program provides grants to mostly rural communities helping them provide family planning and education. These clinics serve patients that are more likely to live below the poverty line and have an even greater need for state and federal aid. Last year alone, these dollars provided family planning methods for 25,109 people, 15,101 of which live below the poverty line.

>How great is the need for family planning services? With the prevalence of abstinence-only education, many sexually active teens and young adults never receive medically accurate sex education. Not knowing how to protect themselves, they are much more likely to have unprotected sex. This has lead to an increase in STIs in Minnesota and the United States. Approximately 1 in 2 Americans will contract an STI at some point in their lifetime with 1 in 4 teens contracting an STI each year. Considering that less than half of adults 18-44 have EVER been tested for an STI (other than HIV), these numbers are staggering. In Minnesota, STI rates increased by 5% in 2010 - chlamydia 6%, syphilis 110% and gonorrhea decreased by 9%. The incidence rate of chlamydia has more than doubled since 1996 and tripled for those 25-39. The incidence of chlamydia infection among minority groups ranges from 2.5 to 15 times the incidence of white Minnesotans. In 2009 alone, there were 370 new HIV cases reported in Minnesota - every day last year, someone found out they were HIV positive. Teen pregnancies already account for a large percentage of births, especially in rural areas and over half of all MFIP (MN welfare program) dollars go to families that begin with a teen parent.

Failing to educate our youth feeds back into these patterns of increased incidence of STIs and more unplanned pregnancies. Undiagnosed and untreated STIs can even lead to lifelong health problems or death. STIs can damage organs (reproductive, heart, joints and brain), increase the risk of infertility and tubal pregnancy, increase the risk of birth defects or stillborns, and increase the risk of transmitting or getting HIV.

STIs are preventable and many are easily treated. While the best prevention method is abstinence, consistant and correct usage of latex condoms is a highly effective method to prevent HIV and STI transmission. Vaccines are also available to prevent hepatitis A, hepatitis B and HPV (the viruses that cause genital warts and cervical cancer). Removing funding for highly efficient public health programs - every dollar spent on family planning services saves taxpayers four dollars in other state medical spending - is short-sighted and ignores 32 years of effective bipartisan public policy. All Minnesotans should have the knowledge and resources to prevent unintended pregnancies. Eliminating state funding and blocking federal funding for family planning in Minnesota will result in more unintended pregnancies, increases in incidence and complications from STIs, and will disproportionately hurt the poor and the youth of Minnesota.

Regular STI testing helps catch infections at early stages. href=" http://sexualhealthmn.org.">Get tested!

Statistics for this post were found at the CDC and MDH
Image from MDH

Cross-posted from Planned Parenthood Advocate: http://www.plannedparenthoodadvocate.org/content/education_and_access_to_family_planning_can_reduce_sti_cases_in_mn