Skip to main content

Privacy and Confidentially

Privacy and confidentialityd should be guaranteed for all people seeking SRH care to ensure safety and trust. Confidentiality is especially important in the SRH context due to the personal nature of this care and the potential familial, legal, relational, and professional ramifications of breaches of confidentiality. Limitations of confidentiality, including mandated disclosure and reporting requirements, should be discussed with all patients. It is expected that all providers should educate themselves on all relevant federal, state, and local laws and any legal obligations.

Confidentiality matters for all individuals, and special consideration should be given to the needs of adolescents, given that confidentiality can greatly influence their willingness to access and use services.67 The American Academy of Pediatrics (AAP) offers recommendations on education, office policies and procedures, and communications for upholding adolescent confidentiality as well as resources like those giving suggested language.68 Recommendations include talking directly with adolescent patients and their families about the protections and limitations of confidentiality, and reserving time for one-on-one conversation between the provider and the adolescent at each visit, beginning as early as age 11. Telehealth appointments may be a strategy to increase access for adolescents. During telehealth visits, providers can take additional steps to enhance safety and confidentiality by, for example, recommending the use of headphones, using online chat functions, and having a plan in place in case safety concerns arise.

Importantly, maintaining privacy and confidentiality does not mean that family members and other trusted parties cannot be engaged in SRH care. When possible, patients can request that a person of their choosing be present when they are receiving care, particularly education, informed consent, or invasive exams. This practice can enhance patient comfort, empowerment, and shared decision making. Providers can encourage adolescents to discuss their SRH with trusted adults in their life, including but not limited to their parent(s) or legal guardian(s).

Resources for Providers

Tips for Maintaining Patient Privacy and Confidentiality
Source:
Reproductive Health National Training Center
HHS HIPAA Privacy Rule Final Rule to Support Reproductive Health Care Privacy: Fact Sheet
Source:
U.S Department of Health and Human Services
  • 67

    Berlan ED, Bravender T. Confidentiality, consent, and caring for the adolescent patient. Current opinion in pediatrics. 2009;21(4):450-456.

  • 68

    American Academy of Pediatrics. Best Practices for Adolescent Sexual and Reproductive Health Care in Clinical Settings.

  • d

    In April 2024, the HHS Office for Civil Rights (OCR) issued a Final Rule, entitled HIPAA Privacy Rule to Support Reproductive Health Care Privacy (89 Fed. Reg. 32976), which strengthens the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule by prohibiting the disclosure of protected health information related to lawful reproductive health care in certain circumstances. The Final Rule will bolster patient-provider confidentiality and help promote trust and open communication between individuals and their health care providers or health plans, which is essential for high-quality health care. For more information about this Final Rule and other OCR guidance documents related to privacy and reproductive health care, see https://www.hhs.gov/hipaa/for-professionals/special-topics/reproductive-health/index.html.