Evette Cordoba1, Carmelle M Kuizon2, Robert Garofalo3, Lisa M Kuhns3, Cynthia Pearson4, D Scott Batey5, Josh Bruce6, Asa Radix7, Uri Belkind8, Marco A Hidalgo9, Sabina Hirshfield10, Haomiao Jia11, Rebecca Schnall11. 1. School of Nursing, Columbia University, New York, New York. Electronic address: ec2678@cumc.columbia.edu. 2. Mailman School of Public Health, Columbia University, New York, New York. 3. Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. 4. Indigenous Wellness Research Institute, School of Social Work, University of Washington, Seattle, Washington. 5. Department of Social Work, University of Alabama at Birmingham, Birmingham, Alabama. 6. Birmingham AIDS Outreach, Birmingham, Alabama. 7. Mailman School of Public Health, Columbia University, New York, New York; Callen-Lorde Community Health Center, New York, New York. 8. Callen-Lorde Community Health Center, New York, New York. 9. Children's Hospital Los Angeles, The Saban Research Institute, Los Angeles, California; Keck School of Medicine, University of Southern California, Los Angeles, California. 10. STAR Program, SUNY Downstate Health Sciences University, Brooklyn, New York. 11. School of Nursing, Columbia University, New York, New York; Mailman School of Public Health, Columbia University, New York, New York.
Abstract
PURPOSE: The objective of this study was to determine whether state-level policies that restrict minors' access to confidential HIV testing without parental consent may suppress HIV testing in young men who have sex with men (YMSM) in the United States. METHODS: Secondary data from a national HIV prevention trial among YMSM aged 13-17 years (N= 612) were analyzed to evaluate the association between living in a state with restrictive HIV testing policies for minors and HIV testing behavior, awareness of home-based HIV testing, and confidential interactions with a physician. Multilevel logistic regression models were adjusted for age, parents' education level, race, ethnicity, sexual orientation, being sexually experienced, and health literacy of medical forms and controlled for clustering by state. Age-stratified models by state-level age of consent for HIV testing and a subanalysis (including only sexually experienced participants) were also conducted. RESULTS: Residing in a state with restrictive HIV testing policies was associated with the lack of awareness of home-based HIV testing (adjusted odds ratio [aOR]: 3.06; 95% confidence intervals [CI]: 1.49, 6.28). No significant associations were found for HIV testing behavior (aOR: 1.81; 95% CI: 0.85, 3.84), speaking privately with a physician (aOR: 1.00; 95% CI: 0.56, 1.79), or discussing confidentiality with a physician (aOR: 0.95; 95% CI: 0.52, 1.71) and HIV testing policies for minors. These results were consistent in both the age-stratified models and subanalysis. DISCUSSION: HIV testing proportions among YMSM did not differ by state-level minor consent laws. However, YMSM living in states with restrictive policies on HIV testing for minors were less likely to be aware of home-based HIV testing.
PURPOSE: The objective of this study was to determine whether state-level policies that restrict minors' access to confidential HIV testing without parental consent may suppress HIV testing in young men who have sex with men (YMSM) in the United States. METHODS: Secondary data from a national HIV prevention trial among YMSM aged 13-17 years (N= 612) were analyzed to evaluate the association between living in a state with restrictive HIV testing policies for minors and HIV testing behavior, awareness of home-based HIV testing, and confidential interactions with a physician. Multilevel logistic regression models were adjusted for age, parents' education level, race, ethnicity, sexual orientation, being sexually experienced, and health literacy of medical forms and controlled for clustering by state. Age-stratified models by state-level age of consent for HIV testing and a subanalysis (including only sexually experienced participants) were also conducted. RESULTS: Residing in a state with restrictive HIV testing policies was associated with the lack of awareness of home-based HIV testing (adjusted odds ratio [aOR]: 3.06; 95% confidence intervals [CI]: 1.49, 6.28). No significant associations were found for HIV testing behavior (aOR: 1.81; 95% CI: 0.85, 3.84), speaking privately with a physician (aOR: 1.00; 95% CI: 0.56, 1.79), or discussing confidentiality with a physician (aOR: 0.95; 95% CI: 0.52, 1.71) and HIV testing policies for minors. These results were consistent in both the age-stratified models and subanalysis. DISCUSSION: HIV testing proportions among YMSM did not differ by state-level minor consent laws. However, YMSM living in states with restrictive policies on HIV testing for minors were less likely to be aware of home-based HIV testing.
Authors: Ann E Kurth; Michelle A Lally; Augustine T Choko; Irene W Inwani; J Dennis Fortenberry Journal: J Int AIDS Soc Date: 2015-02-26 Impact factor: 5.396