Confidentiality and adolescents' willingness to consent to sexually transmitted disease testing

Since asymptomatic Chlamydia trachomatis infections are common among sexually active adolescents routine universal screening is recommended to reduce infection rates associated morbidity and health care costs. This paper examines adolescent willingness to be tested for sexually transmitted diseases (STDs) under varying confidentiality conditions. Written survey was given to patients aged 15-24 years in two general pediatric practices in North Carolina. Multivariate logistic regression analyses were used for data analysis. Out of 803 who had completed the questionnaire 342 were sexually active. 92% of the participants reported that they would agree to STD testing without parental notification while 38% or 35% would agree to testing linked to potential or definite parental notification respectively. In terms of gender there were more males than females who were willing for STD testing with parental notification. Moreover age and socioeconomic status were not associated with willingness to consent to STD testing linked to parental notification. Due to the threats to privacy associated with billing and reimbursement issues this study indicates the need of changing the way the systems of providing confidential testing are organized.