Are State-Level HIV Testing Policies for Minors Associated With HIV Testing Behavior and Awareness of Home-Based HIV Testing in Young Men Who Have Sex With Men?
Evette Cordoba, Carmelle M Kuizon, Robert Garofalo, Lisa M Kuhns, Cynthia Pearson, D Scott Batey, Josh Bruce, Asa Radix, Uri Belkind, Marco A Hidalgo, Sabina Hirshfield, Haomiao Jia, Rebecca Schnall
Author Information
Evette Cordoba: School of Nursing, Columbia University, New York, New York. Electronic address: ec2678@cumc.columbia.edu.
Carmelle M Kuizon: Mailman School of Public Health, Columbia University, New York, New York.
Robert Garofalo: Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Lisa M Kuhns: Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Cynthia Pearson: Indigenous Wellness Research Institute, School of Social Work, University of Washington, Seattle, Washington.
D Scott Batey: Department of Social Work, University of Alabama at Birmingham, Birmingham, Alabama.
Josh Bruce: Birmingham AIDS Outreach, Birmingham, Alabama.
Asa Radix: Mailman School of Public Health, Columbia University, New York, New York; Callen-Lorde Community Health Center, New York, New York.
Uri Belkind: Callen-Lorde Community Health Center, New York, New York.
Marco A Hidalgo: Children's Hospital Los Angeles, The Saban Research Institute, Los Angeles, California; Keck School of Medicine, University of Southern California, Los Angeles, California.
Sabina Hirshfield: STAR Program, SUNY Downstate Health Sciences University, Brooklyn, New York.
Haomiao Jia: School of Nursing, Columbia University, New York, New York; Mailman School of Public Health, Columbia University, New York, New York.
Rebecca Schnall: School of Nursing, Columbia University, New York, New York; Mailman School of Public Health, Columbia University, New York, New York.
PURPOSE: The objective of this study was to determine whether state-level policies that restrict minors' access to confidential HIV testing without parental consent may suppress HIV testing in young men who have sex with men (YMSM) in the United States. METHODS: Secondary data from a national HIV prevention trial among YMSM aged 13-17 years (N= 612) were analyzed to evaluate the association between living in a state with restrictive HIV testing policies for minors and HIV testing behavior, awareness of home-based HIV testing, and confidential interactions with a physician. Multilevel logistic regression models were adjusted for age, parents' education level, race, ethnicity, sexual orientation, being sexually experienced, and health literacy of medical forms and controlled for clustering by state. Age-stratified models by state-level age of consent for HIV testing and a subanalysis (including only sexually experienced participants) were also conducted. RESULTS: Residing in a state with restrictive HIV testing policies was associated with the lack of awareness of home-based HIV testing (adjusted odds ratio [aOR]: 3.06; 95% confidence intervals [CI]: 1.49, 6.28). No significant associations were found for HIV testing behavior (aOR: 1.81; 95% CI: 0.85, 3.84), speaking privately with a physician (aOR: 1.00; 95% CI: 0.56, 1.79), or discussing confidentiality with a physician (aOR: 0.95; 95% CI: 0.52, 1.71) and HIV testing policies for minors. These results were consistent in both the age-stratified models and subanalysis. DISCUSSION: HIV testing proportions among YMSM did not differ by state-level minor consent laws. However, YMSM living in states with restrictive policies on HIV testing for minors were less likely to be aware of home-based HIV testing.
