Presence and Knowledge of Minor Consent Laws and STI Testing in US Adolescents

OBJECTIVE: To evaluate whether adolescents' legal capacity to consent independently to sexually transmitted infection (STI) and/or HIV services, and accurate knowledge of their ability, are positively associated with past-year STI/HIV testing. METHODS: Adolescents (N = 5888; aged 13-17 years) from all 50 US states and DC completed an online survey about minor consent laws and STI/HIV services. Legal capacity to consent independently to STI/HIV services was established using existing policy data. Youth were asked which STI/HIV services they could receive without guardian permission in their state, and whether they had been tested for HIV and STI in the past year. We used generalized linear models to calculate odds ratios and 95% CIs to estimate associations between legal capacity to consent, accurate knowledge of legal capacity, and STI/HIV testing behavior. RESULTS: Ability to consent independently to STI services was positively associated with past-year STI testing (adjusted odds ratio [aOR] = 1.19, 95% CI: 1.10-1.72). Similarly, ability to consent independently to HIV services was positively associated with past-year HIV testing (aOR = 1.25, 95% CI: 1.02-1.53). Accurate knowledge of legal capacity to consent independently to STI and HIV testing was positively associated with past-year STI and HIV testing, respectively (aOR = 2.81, 95% CI: 2.01-3.36; aOR = 2.19, 95% CI: 1.78-2.92). CONCLUSION: Given the relative magnitude of the associations, adolescents' accurate knowledge of minor consent laws may be more important to their STI/HIV testing than the laws themselves. Ensuring that adolescents know about their ability to consent independently to STI/HIV services may increase adolescent STI/HIV service use.