Minor Consent Laws and HIV Prevention Among Adolescents in the United States

美国青少年的未成年人同意法和艾滋病毒预防

• 批准号: 9924815
• 负责人: Kimberly M Nelson
• 金额: $ 39.36万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-12-25 至 2024-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9924815
• 关键词: 17 year old; AIDS prevention; Address; Adolescent; Affect; Age; Amendment; Awareness; Behavior; Behavioral; Centers for Disease Control and Prevention (U.S.); Comprehension; Consent; Data; Data Set; Decision Making; Disclosure; District of Columbia; Effectiveness; Ethnic Origin; Evaluation; Exposure to; Family; Fright; Gender; Goals; Growth; HIV; HIV risk; Health Personnel; Health Promotion; Health behavior; Healthcare; Human immunodeficiency virus test; Incidence; Intention; Knowledge; Laws; Legal; Link; Methodology; Minor; Perception; Play; Policies; Population; Prevention; Prevention strategy; Public Health; Race; Recommendation; Reporting; Research; Research Personnel; Rights; Risk; Role; Services; Sexual Health; Sexual and Gender Minorities; Sexually Transmitted Diseases; Specific qualifier value; Statutes and Laws; Strategic Planning; Surveys; Testing; Time; United States; United States National Institutes of Health; Youth; adolescent health; condoms; design; ethnic minority population; health organization; longitudinal dataset; overtreatment; pre-exposure prophylaxis; prevention service; racial and ethnic; screening; sex; sexual HIV transmission; sexual minority; sexually active adolescent; testing services; transmission process; treatment services; uptake

PROJECT SUMMAY / ABSTRACT Human immunodeficiency virus (HIV) significantly burdens youth 13–17 years of age in the United States (US). Adolescents also have high rates of other sexually transmitted infections (STIs), which increases risk of HIV acquisition and transmission. Sexual, gender, and racial/ethnic minority adolescents are disproportionately affected. Increasing HIV/STI testing and pre-exposure prophylaxis (PrEP) use are key components of the US national strategy to decrease HIV rates among adolescents. Despite this, few adolescents have received HIV/STI testing or PrEP. Confidentiality concerns are a significant barrier to HIV/STI testing and PrEP use among adolescents. To allay these concerns, many states have enacted statutes permitting minors to waive guardian consent for HIV/STI testing, treatment, and prevention services, including PrEP. Although these laws are meant to protect youth from unwanted disclosure to their guardians—and thereby increase uptake of HIV/STI testing and PrEP—there is a dearth of research assessing how these laws relate to behavior and whether youth are aware of these laws. Our proposed study addresses this gap through pursuing three aims. First, to assess longitudinal changes in minor consent laws for HIV/STI testing, treatment, and prevention from 1985–present, legal experts on our team will conduct the first-ever longitudinal content analysis of state minor consent laws. A longitudinal dataset specifying and quantifying changes in the laws over time and by state will be created and made publicly available. Second, we will longitudinally evaluate the effect of changes in minor consent laws on HIV/STI testing and treatment among adolescents. To do this we will link the longitudinal legal dataset created in the first aim to adolescent health behavior data in the National Survey of Family Growth. Using a difference-in-difference-in-differences approach, we will evaluate whether changes in minor consent laws were associated with changes in HIV/STI testing and treatment for youth overall and by sex, race/ethnicity and sexual minority status. Third, we will assess relations between current knowledge and perceptions of minor consent laws, HIV/STI testing, and PrEP uptake among adolescents via a cross-sectional online survey of adolescents (N = 6120, ages 13-17 years) from all 50 states and the District of Columbia. The survey will examine: (1) knowledge and perceptions of current minor consent laws; (2) HIV/STI testing and PrEP knowledge and uptake; and (3) best practices for disseminating this information to youth. Analyses will be conducted for youth overall and by sex, gender, race/ethnicity and sexual minority status. This study will (1) provide the most comprehensive, methodologically rigorous evaluation of minor consent legislation to date; (2) identify for the first time how these statutory protections affect testing and treatment over time; and (3) identify awareness and comprehension of these laws, as well as potential barriers that continue to impede HIV/STI testing and PrEP access among adolescents.

项目求和 /摘要 在美国，人类免疫缺陷病毒（HIV）显着烧伤了13-17岁的青年（美国）。 青少年还具有其他性传播感染（STI）的率很高，这增加了艾滋病毒的风险 获取和传输。性，性别和种族/族裔少数青少年不成比例 做作的。增加HIV/STI测试和暴露前预防（PREP）是美国的关键组成部分 降低青少年艾滋病毒率的国家战略。尽管如此，很少有青少年收到 HIV/STI测试或准备。机密性问题是HIV/STI测试和PREP使用的重大障碍 在青少年中。对于所有这些问题，许多州颁布了统计数据，允许未成年人放弃 监护人同意HIV/STI测试，治疗和预防服务，包括PREP。虽然这些法律 旨在保护青年免受监护人的不需要披露，从而增加了吸收 HIV/STI测试和准备 - 研究评估的死亡是这些法律与行为和 青年是否知道这些法律。我们提出的研究通过追求三个目标来解决这一差距。 首先，评估艾滋病毒/STI测试，治疗和预防的未成年人同意法的纵向变化 1985年 - 我们团队中的法律专家将对州未成年人进行首次纵向内容分析 同意法。一个指定和量化法律随着时间和状态的更改的纵向数据集将 被创建并公开可用。其次，我们将纵向评估未成年人变化的影响 关于青少年的艾滋病毒/性传播感染测试和治疗的同意法。为此，我们将链接纵向法律 在全国性家庭增长调查中，在第一个目标中创建了数据集。 使用差异差异差异方法，我们将评估是否较小同意中的变化 法律与艾滋病毒/性传播感染测试的变化和对年轻人的整体以及性别，种族/种族的治疗有关 和性少数群体地位。第三，我们将评估当前知识与对 通过横断面的在线调查 来自所有50个州和哥伦比亚特区的青少年（n = 6120，年龄13-17岁）。调查将 检查：（1）当前未成年人同意法的知识和看法； （2）HIV/STI测试和准备 知识和吸收； （3）将这些信息传播给青年的最佳实践。分析将是 由整体和性别，性别，种族/种族和性少数群体地位为青年进行。这项研究将（1） 迄今为止，对未成年人同意立法进行最全面，方法上的严格评估； （2） 首次确定这些法定保护如何影响测试和治疗。 （3）识别 对这些法律的认识和理解，以及继续阻碍艾滋病毒/STI的潜在障碍 青少年的测试和准备访问。