Nearly 6,000 adolescents across the United States were asked a seemingly simple question: Do you know if you can get tested for HIV and sexually transmitted infections without telling your parents? The answer to that question, it turns out, may matter more than the legal right itself.
A landmark study led by Dr. Kimberly Nelson at Boston University School of Public Health has revealed something that should reshape how we talk to young people about sexual health. While all 50 US states and Washington, DC have laws permitting minors to independently consent to STI and HIV testing and treatment, more than 60% of adolescents surveyed had no idea these protections existed. That gap between law and awareness may be exactly why teen STI and HIV testing rates remain stubbornly below federal targets.
The study, published in the journal Pediatrics and conducted between December 2022 and April 2024, surveyed young people ages 13 to 17 in every state. Adolescents who were aware of their state's minor consent laws were significantly more likely to have sought and received STI or HIV testing in the past year. But the most striking finding was this: among teenagers who accurately knew they could consent to testing without parental permission, testing rates climbed even higher. Those with vague or guessed knowledge—and remarkably, nearly half of those surveyed admitted to guessing about their legal rights—were far less likely to actually get tested.
The distinction matters because confidentiality concerns have long been a primary barrier keeping teens away from sexual health care. Young people worry about parents finding out. They fear judgment. They hesitate to involve guardians. These laws were designed precisely to address those barriers, yet they sit largely unknown on the books. "These findings indicate that having these laws on the books is not enough—teens need to know about them for the laws to be helpful," Dr. Nelson explained in the study's accompanying materials.
The research also identified which sources of information actually moved the needle. Adolescents who learned about minor consent laws from reputable channels—health care providers or school-based education—were notably more likely to have been tested compared to those who heard about them through family, friends, or online sources. That points to a clear path forward: the source and quality of information shape behavior.
This is especially urgent because US youth ages 13 to 24 experience disproportionately higher rates of STIs and HIV compared to older adults. Current testing rates among adolescents fall short of the targets set by Healthy People 2030, the federal government's 10-year public health roadmap. The gap is not a legal one—the laws are there. It is an information gap.
Dr. Nelson's team created a comprehensive dataset now available at LawAtlas.org capturing more than 170 years of minor consent laws across states, and their research suggests a straightforward intervention: schools and health care providers need to actively inform teens about what the law already permits them to do. This is not about creating new rights. It is about ensuring young people know the rights that already protect them. In sexual health, knowledge and access are two sides of the same coin, and right now, many adolescents are holding only one.