Confidentiality Issues and Use of Sexually Transmitted Disease Services Among Sexually Experienced Persons Aged 15-25 Years - United States, 2013-2015.

National-level data are limited regarding confidentiality-related issues and the use of sexually transmitted disease (STD) services for adolescents and young adults. Changes in the U.S. health care system have permitted dependent children to remain on a parent's health insurance plan until the child's 26th birthday and required coverage of certain preventive services, including some STD services, without cost sharing for most plans (1,2). Although these provisions likely facilitate access to the health care system, adolescents and young adults might not seek care or might delay seeking care for certain services because of concerns about confidentiality, including fears that their parents might find out (3,4). Therefore, it is important to examine STD services and confidentiality-related issues among persons aged 15-25 years in the United States. CDC analyzed data from the 2013-2015 National Survey of Family Growth and found that 12.7% of sexually experienced youths (adolescents aged 15-17 years and those young adults aged 18-25 years who were on a parent's insurance plan) would not seek sexual and reproductive health care because of concerns that their parents might find out. Particularly concerned were persons aged 15-17 years (22.6%). Females with confidentiality concerns regarding seeking sexual and reproductive health care reported a lower prevalence of receipt of chlamydia screening (17.1%) than did females who did not cite such concerns (38.7%). More adolescents aged 15-17 years who spent time alone with a health care provider (without a parent in the room) reported receipt of a sexual risk assessment (71.1%) and, among females, chlamydia testing (34.0%), than did those who did not spend time alone (36.6% and 14.9%, respectively). The results indicated that confidentiality-related issues were associated with less reported use of some STD services, especially for younger persons and females. Spending time alone with a provider (i.e., without a parent present) during a health care visit has been associated previously with higher reported delivery of sexual health services (5) and has been suggested by the American Academy of Pediatrics and Society for Adolescent Health and Medicine (6). Public health efforts related to confidentiality of STD services might be helpful to increase the use of recommended services among some youths.