4171.0 - Adolescent perspectives on the role of confidentiality in their HIV testing practices: A qualitative study

Session: Emerging Issues in HIV/AIDS Poster Session IV

Program: HIV/AIDS

Time: 12:30 - 1:30 PM

Presenters:

Christina Aivadyan

Trace Kershaw, PhD

Abstract

Background: Despite population-level progress in reducing the number of new HIV infections in the United States, adolescents continue to face inequities in HIV prevention access. Laws concerning consent and confidentiality in sexual health services vary widely across states, and adolescents – particularly minors under age 18 – experience unequal access to confidential HIV testing. Although confidentiality concerns are a well-established barrier to sexual health care for adolescents, there is a dearth of research investigating their perspectives on the role of confidentiality in their HIV testing practices. This study addresses this gap by comparing adolescent perspectives on the role of confidentiality in their HIV testing practices across two states with varying confidentiality-relevant laws.

Methods: Between November 2022 and March 2023, we conducted semi-structured interviews with a purposive sample of sexually active adolescents aged 16-17 in Connecticut (n=30) and New Jersey (n=30), which vary in terms of confidentiality-relevant laws. Guided by Andersen’s behavioral model of health services use, we used NVivo software to identify key themes and explore areas of thematic convergence and divergence across states.

Results: Despite stressing the importance of confidentiality, participants lacked awareness of state-level confidentiality relevant laws. Participants who received confidentiality assurances from their health care providers reported increased comfort with sharing sensitive information about sexual behavior, discussing HIV prevention, and testing for HIV. No thematic differences were observed across states.

Conclusions: To address inequities in HIV prevention access, age-related legal barriers to confidential HIV testing should be eliminated and health care providers should make concerted efforts to improve their provision of confidential care with adolescent patients.