TEXAS MINORS’ USE OF TITLE X SERVICES FOLLOWING A LOSS OF CONFIDENTIALITY PROTECTIONS

IF 2.3 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Contraception Pub Date : 2025-10-13 DOI:10.1016/j.contraception.2025.111055

L Ralph, G Sierra, K White

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引用次数: 0

Abstract

Objectives

A December 2022 ruling in Deanda v. Becerra removed confidentiality protections for minors accessing Title-X supported services in Texas, thereby requiring parental consent for contraceptive care. We examine changes in patient volume and characteristics among minors (vs. older adolescents) following this policy change.

Methods

We obtained data on all Title X-supported clinical encounters with patients aged ≤19 from both Texas Title-X grantees (n=66,046 encounters; 39,118 individuals) between January 2022 and December 2023, representing one-year pre-(2022) and post-(2023) Deanda. We used Poisson regression to examine the percent change in the absolute number of encounters by age (minors vs. patients aged 18-19), as well as changes in the sociodemographic profile (age; sex; English-language proficiency) of patients accessing care pre- and post-Deanda.

Results

The overall number of encounters among minors decreased by 14.2% (95% CI, -16.2,-12.3%) from 2022 (n=15,796) to 2023 (n=13,549). This decrease was larger than that observed among 18- to 19-year-olds (-6.3% (95% CI, -8.4, -4.4%), p<0.001). The number of encounters decreased among both female (-12.0%, 95% CI, -14.2, -9.7%) and male (-27.2%, 95% CI, -31.3, -23.1%) minors. Declines were larger among minors with limited English proficiency (-22.2%, 95% CI, -26.5, -17.9%) than among those with English proficiency (-7.7%, 95% CI, -10.6, -4.9%), and among those aged < 15 (-16.6, 95% CI, -20.0, -13.3%) compared with 16/17-year-olds (-6.8%, 95% CI, -10.2, -3.5%).

Conclusions

Statewide Title-X utilization data in Texas suggests reduced reproductive healthcare seeking among minors following the loss of confidentiality protections, especially if they were male, younger, and had limited English-proficiency.

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德克萨斯州未成年人在失去保密保护后使用标题x服务的情况

2022年12月，Deanda v. Becerra一案的裁决取消了对德克萨斯州未成年人使用第十章支持服务的保密保护，从而要求父母同意避孕护理。我们研究了政策改变后未成年人（相对于年龄较大的青少年）患者数量和特征的变化。方法：我们获得了2022年1月至2023年12月期间所有获得标题x支持的年龄≤19岁的患者临床接触数据（n=66,046次接触；39,118人），代表了（2022年）前和（2023年）后的一年。我们使用泊松回归来检验按年龄（未成年人vs. 18-19岁的患者）就诊绝对次数的百分比变化，以及在迪安达前后就诊的患者的社会人口统计学特征（年龄、性别、英语水平）的变化。结果从2022年（n=15,796）到2023年（n=13,549），未成年人接触的总人数减少了14.2% （95% CI, -16.2,-12.3%）。这一降幅大于18- 19岁人群（-6.3% (95% CI, -8.4, -4.4%), p<0.001）。女性未成年人（-12.0%,95% CI, -14.2, -9.7%）和男性未成年人（-27.2%,95% CI, -31.3, -23.1%）的接触次数都有所减少。英语熟练程度有限的未成年人（-22.2%,95% CI, -26.5, -17.9%）比英语熟练的未成年人（-7.7%,95% CI, -10.6, -4.9%）下降更大，15岁的未成年人（-16.6,95% CI, -20.0, -13.3%）比16/17岁的未成年人（-6.8%,95% CI, -10.2, -3.5%）下降更大。结论：德克萨斯州全州范围内的第十项法案使用数据表明，在失去保密保护后，未成年人寻求生殖保健的人数减少，尤其是男性、年轻、英语水平有限的未成年人。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Contraception 医学-妇产科学

CiteScore

4.70

自引率

17.20%

发文量

211

审稿时长

69 days

期刊介绍： Contraception has an open access mirror journal Contraception: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal Contraception wishes to advance reproductive health through the rapid publication of the best and most interesting new scholarship regarding contraception and related fields such as abortion. The journal welcomes manuscripts from investigators working in the laboratory, clinical and social sciences, as well as public health and health professions education.