Should the results of a urine sexually transmitted disease (STD) test for a 15-year-old be disclosed to the parent or guardian, or directly to the minor?

Disclosure of STD Test Results for a 15-Year-Old

STD test results for a 15-year-old should be disclosed directly to the minor, not to the parent, as adolescents can legally consent to confidential STD services in all 50 states without parental knowledge or consent.

Legal and Ethical Framework

• Adolescents in the United States can consent to the confidential diagnosis and treatment of STDs without parental consent or knowledge 1
• All 50 states plus the District of Columbia allow minors to consent independently to STI and HIV testing and treatment 2
• Confidentiality is critically important to adolescents seeking sexual health services, and breaching this confidentiality can deter them from seeking necessary care 3

Impact of Confidentiality Concerns

• 12.7% of sexually experienced youth would not seek sexual and reproductive health care because of concerns that their parents might find out 3
• This concern is particularly high (22.6%) among adolescents aged 15-17 years 3
• Females with confidentiality concerns reported significantly lower rates of chlamydia screening (17.1%) compared to those without such concerns (38.7%) 3

Best Practices for Providers

• Providers should appreciate how important confidentiality is to adolescents and should follow policies that comply with state laws to ensure confidentiality of STD-related services 1
• Spending time alone with adolescent patients (without parents present) during healthcare visits is associated with higher delivery of sexual health services 3
• The style and content of counseling should be adapted for adolescents, with discussions appropriate to the patient's developmental level 1

Important Caveats and Exceptions

• While minors can consent to STD testing and treatment in all states, confidentiality protections for these services are less common in state laws 2
• Some state laws have prerequisites requiring clinician judgments before providing confidential services 2
• If there is suspicion of sexual abuse (particularly for younger adolescents), different reporting requirements apply - healthcare providers are mandated to report suspected child abuse in all states 1
• The identification of an STI in a child may prompt an investigation of possible abuse, particularly for certain infections that are highly associated with sexual contact 4

Practical Approach

• Inform the 15-year-old directly of their STD test results in a private setting
• Discuss treatment options and prevention strategies directly with the minor
• Encourage but do not require the adolescent to involve their parent(s) in their healthcare decisions
• Document in the medical record that results were provided directly to the patient in accordance with confidentiality laws for adolescent STD services
• If there are signs of abuse or the minor is at risk of harm, follow mandatory reporting requirements for your state 1