Adolescents represent a significant number of the persons infected with human immuno-deficiency virus (HIV) in the United States. However, many adolescents do not receive HIV testing because of the parental consent requirements in most states. Historically, minors have been deemed incompetent to consent to their own medical care. The state of Connecticut amended its confidentiality law in 1992 to include consent by minors for HIV testing. Meehan and associates analyzed the records from HIV counseling and testing sites funded by the Connecticut Department of Public Health to determine the change in the use of HIV testing by minors after removal of the parental consent requirement.
Over a two-year period (the 12 months before and the 12 months after the legislative change), 1,601 minors visited HIV testing and counseling sites. The patients ranged from 13 to 17 years of age. The girls who were tested for HIV outnumbered the boys three to one. During the first 12-month period, 656 minors were counseled, and 392 were tested. During the 12 months after the consent law was amended, 945 minors visited these same sites, and 801 were tested for HIV antibody. This represented a 44 percent increase in patient visits over the first 12-month period. Testing of males increased by 151 percent and of females by 90 percent. Of the total group of patients who visited testing sites, the number of minors at high risk for HIV infection (two or more risk factors) tripled, while the number at low risk remained the same.
The authors conclude that by allowing minors to be tested for HIV without parental consent, the number of persons receiving counseling and testing, when appropriate, would increase considerably. They recommend that states remove legislation currently prohibiting minors to be tested for HIV infection without parental consent. Existing laws impose barriers to the diagnosis of HIV infection and hinder efforts to control the epidemic. Making counseling and testing more available to minors would also provide an opportunity to promote healthy behavior in this at-risk population.