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Measure aims to assure STI treatment, contraception for minors without parental consent

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Measure aims to assure STI treatment, contraception for minors without parental consent

Mar 15, 2023 | 9:00 am ET
By Camalot Todd
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Measure aims to assure STI treatment, contraception for minors without parental consent
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While 31% of Nevada high school students reported having sexual intercourse at least once, 44% did not use a condom, the only birth control method that prevents STIs, according to a Nevada risk behavior survey. (Photo: April Corbin Girnus)

For more than half a century, it has been legal in Nevada for minors to receive treatment for sexually transmitted infections (STIs) without parental consent through a federal family planning program called Title X. 

Amid curtailed Title X funding, several state public health providers lost access to the funding and Title X authorization, and now have to follow state laws that prohibit contraceptives and preventive STI testing for minors unless they have parental consent. 

The state senate’s Judiciary Committee last week took up a measure, Senate Bill 172, that would authorize health centers to treat and prevent STIs, and also provide contraceptives, without parental consent. 

“March 16, 1971, was when we approved the provision that allowed a minor to consent to treatment and examination for sexually transmitted diseases. 1971,” Sen. Dallas Harris (D-Las Vegas), a primary sponsor of the bill, said at a hearing on the measure last week. “We are not taking a fundamental shift in what minors can consent to.”

Under existing Nevada law, minors can access treatment if they have STIs, but they can’t access preventive care. It also limits self-consent for minors to specific health centers like those that are not administered by entities that receive state Department of Health and Human Services grants.

“I introduced Senate Bill 172 to fix the gap,” Harris said in a statement to the Current. “Healthcare providers across Nevada have been affected by the decrease in Title X funding. My amendment to Senate Bill 172 allows clinics to continue providing contraceptive services to minors in the absence of Title X funding.” 

The bill will not cost any money to the state, Harris said. 

Title X serves as the nation’s public family planning program, giving millions of people access to birth control, STI testing and treatment, and preventive care. It was established by the 1970 Public Health Service Act, which aimed to address inequality in America and give people who were low-income, uninsured, young, or otherwise disadvantaged access to and freedom over their reproductive health, according to a policy analysis by the Guttmacher Institute.

In 2022, the Biden Administration began restoring Title X after the Trump Administration enacted a domestic gag rule that severely limited which facilities received funding. Under the Trump administration rule, Nevada was one of several states that drew on emergency funding to allow the services to continue, according to the policy analysis by the Guttmacher Institute.

While 31% of Nevada high school students reported having sexual intercourse at least once, 44% did not use a condom, the only birth control method that prevents STIs, according to the 2019 Nevada High School Youth Risk Behavior Survey (YRBS) Report.

The study also noted that 54.9% of female respondents reported condoms were not used the last time they had sex, and of male and female respondents who reported being sexually active, nine out of ten reported no condom or birth control use during their last sexual intercourse. 

According to the Centers for Disease Control, in 2020, the most current data available, Nevada ranked first in the nation for having the highest rates of primary & secondary (P&S) syphilis and 6th in the U.S. for newly diagnosed HIV cases. 

But without Title X, the services are now lost for the majority of the state. The two organizations which received Title X are located in Carson City and Las Vegas, leaving large areas without coverage, according to a presentation by Jennifer Howell, the Sexual Health Program Coordinator at Washoe County Health District.

Only two centers in Nevada currently fall under Title X: the Nevada Primary Care Association (NVPCA), located in Carson City, and the Southern Nevada Health District, located in Las Vegas. NVPCA doesn’t provide direct services but partners with community based health care centers in the state. The number of Title X sites increased in Washoe County with the NVPCA award from one to six, according to Steven Messinger, the policy director at Nevada Primary Care Association. 

Supporters of the legislation include the Southern Nevada Health District, Nevada Chapter of the American Academy of Pediatrics, Nevada Medical Association, NARAL Pro-Choice Nevada, Silver State Equality, Nevada’s statewide LGBTQ+ civil rights organization, and Nevada Coalition to End Domestic and Sexual Violence, Nevada Faculty Alliance (NCEDSV).

Advocates for SB 172 also said it helps marginalized communities who may not have a trusted adult or feel comfortable talking to an adult about STI treatment, prevention, and contraception. 

Youth living in poverty, LGBTQ+ youth, and Black and Native youth all have higher rates of STI, but that is often due to social and environmental influences called social determinants of health like access to affordable health care and transportation, according to the Centers for Disease Control and Prevention (CDC). 

Opponents of the measure include the Nevada State Republican Party, the Libertarian Party of Nevada, and Nevada Families for Freedom,  the state affiliate of National Eagle Forum, a conservative interest group founded in the 70s to oppose the Equal Rights Amendment, and individual Nevadans. 

Many in opposition to the bill said that it would infringe on parental rights and also claimed, without substantiation, that the bill would effectively protect sexual predators.

Sexual abuse impacts children of all ages including infants, and while many victims of child sexual abuse will not have an STI, it can happen, and the site of infection is consistent with a child’s history of assault,  according to a report by the U.S. Department of Justice. The report further notes that between 75 and 85 percent of children were sexually abused by a man who they know, often a family member like the father, stepfather, mother’s boyfriend, or an uncle or other male relative.

The bill does not change mandatory reporting or the age of consent. If a health care provider sees a child younger than 16 (Nevada’s age of consent) they are still legally obligated to report sexual activity and are still legally obligated to check with the youth that they consented to sexual intercourse, Harris said. 

In addition to Harris, Sen. Melanie Scheible (D-Las Vegas), Sen. Fabian Doñate (D-Las Vegas), Sen. James Ohrenschall (D- Las Vegas) and Sen. Julie Pazina (D- Las Vegas) sponsored the bill. 

The bill also expands the type of providers who can provide these services.

No committee action was taken on the bill during last week’s hearing.

This story was clarified to reflect that NVPCA does not provide direct services and works with community health care centers in the state.