Clarifying Minors’ Ability to Consent to HIV Treatment S.7683 (Hannon) / A.10184 (Gottfried)
Young people aged 13 to 24 accounted for more than 1 in 5 new diagnoses of human immunodeficiency virus (HIV) in 2014.1 Youth with HIV are the least likely of any age group to be linked to care.2 Although New York allows minors to consent to certain types of sensitive health care such as testing and treatment for sexually transmitted infections (STIs) and testing for HIV,3 the law does not clearly allow minors to consent to confidential HIV treatment including preventive care. This means that teens who are unable to involve a parent remain vulnerable and untreated.
This legislation clarifies that qualified health care professionals are legally authorized to provide confidential HIV treatment, including preventive care, to minors who are capable of giving informed consent. The NYCLU strongly urges lawmakers to pass this legislation. Given the significant health consequences of HIV, it is imperative that New York address the structural barriers to accessing preventive care and HIV treatment for young people.
In 2014, Governor Andrew Cuomo’s Ending the Epidemic Task Force detailed a plan to reduce the number of HIV infections and provide for better access to HIV treatment in New York. A core component of this plan recommends amending the New York state public health law to clarify that a competent minor may consent to HIV treatment, including preventive care, without parental consent.
By clarifying the role of health care providers and ensuring patient confidentiality, S.7683 / A.10184 will increase the likelihood that more young people will receive timely HIV preventive care and treatment. While parents are required to be involved in most decisions about their child’s health care, not all teens have healthy, safe family relationships, and some teens are unable or unwilling to involve their parents.4 In fact, studies show that teens will simply not seek sensitive health care services if their confidentiality is compromised or they are required to involve a parent.5 Yet, even without access to sexual health care services, 99 percent of teens reported they would continue to engage in sexual activity and therefore remain at risk.6 Consequently, the law must be amended to ensure that competent minors can consent to their own confidential HIV preventive care and treatment. Public health experts and professional medical associations strongly support this approach, including the Society for Adolescent Medicine, American Medical Association, American Academy of Pediatrics, American Academy of Family Physicians, and American Public Health Association.7
This legislation would clarify New York law and provide necessary safeguards to ensure that young people can access confidential HIV preventive care and treatment that could save their lives. The NYCLU urges swift passage of S.7683 / A.10184.
1 Centers for Disease Control and Prevention, “HIV Among Youth,” May 26, 2016, available at http://www.cdc.gov/hiv/group/age/youth/index.html. (LGBTQ youth, particularly young men of color, are at the greatest risk, with young gay and bisexual males accounting for 8 in 10 HIV diagnoses among youth in 2014).
2 Id., (At the end of 2012, 44% of youth ages 18 to 24 years living with HIV did not know they had HIV).
3 See N.Y. Pub. Health Law § 2305.
4 See Stanley Henshaw and Kathryn Kost, “Parental Involvement in Minors’ Abortion Decisions,” 24 Fam. Plan. Persp. 196, 207 (1992).
5 Jonathan Klein et al., “Access to medical care for adolescents: Results from the 1997 Commonwealth Fund Survey of the Health of Adolescent Girls,” 25 J. of Adolescent Health 120 (1999).
6 Diane M. Reddy et al., “Effect of Mandatory Parental Notification on Adolescent Girls’ Use of Sexual Health Care Services,” 288 JAMA 710, 713 (2002).
7 See, e.g., American Public Health Association, “Confidentiality Standards Folder: Adolescent Access to Comprehensive, Confidential Reproductive Health Care” (1990); American Academy of Family Physicians, “Policies: Adolescent Health Care: Confidentiality” (2006), available at http://www.aafp.org/about/policies/all/adolescent-confidentiality.html; American Medical Association, “Opinion 5.055 - Confidential Care for Minors,” available at http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-... Council on Ethical and Judicial Affairs, American Medical Association, “Council Report: Mandatory Parental Consent to Abortion,” 269 JAMA 82, 83 (1993); Carol Ford et al., Society for Adolescent Medicine, “Confidential Health Care for Adolescents,” 35 J. Adolescent Health 1 (2007), available at https://www.adolescenthealth.org/SAHM_Main/media/Advocacy/Positions/Aug-....