Changes in public attitudes towards confidential adolescent sexual and reproductive health services in Lithuania after the introduction of new legislation: findings from the cross-sectional surveys conducted in 2005 and 2012.
BACKGROUND
In Lithuania, the right to confidentiality in healthcare for adolescents over the age of 16 was guaranteed in 2010 through the adoption of new legislation. This study sets out to explore changes in Lithuanian residents' attitudes towards confidentiality protection in adolescent sexual and reproductive healthcare (SRH) by comparing data from surveys administered in 2005 and 2012.


METHODS
For both surveys, the participants were random samples of the Lithuanian residents aged 16 to 74. A 23-item questionnaire was used in 2005 and complemented with 2 items in 2012. Linear regression analysis was employed to estimate absolute differences in prevalence of belief in whether or not adolescents would find confidentiality important when consulting a physician on SRH issues. A log-binomial regression model was fitted to estimate the relative changes (prevalence ratio) of the independent variables.


RESULTS
The total number of respondents was 1054 (response rate 83%) in 2005 and 1002 (response rate 80%) in 2012. The proportion of respondents who reported a belief that adolescents would find confidentiality important when seeing a physician for SRH issues increased significantly from 62% in 2005 to 73% in 2012. Regardless of their belief in the importance of confidentiality, in 2012 respondents more often indicated positive outcomes on the relations between the physician and the minor patient, such as increased trust of the adolescent in the physician and more frequent visits to physicians. However, study participants who believed that adolescents would find confidentiality important in 2012 were less optimistic about potential positive outcomes of further legal consolidation of adolescents' right to confidentiality than in 2005. Younger respondents were the most optimistic about potential outcomes if laws were enacted to further protect adolescent confidentiality.


CONCLUSIONS
This study uncovers the dynamics of public attitudes towards the socially and ethically sensitive issue of adolescent SRH. Our study suggests that legislation could be a factor prompting changes in public opinion, but not sufficient in and of itself for its social acceptance.
Department of Family Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania. ljaruseviciene@gmail.com.
Lina
L
Jaruseviciene
Institute of Health Systems Research, Lithuanian University of Health Sciences, Kaunas, Lithuania. Apolinaras.Zaborskis@lsmuni.lt.
Apolinaras
A
Zaborskis
Department of Health Management, Lithuanian University of Health Sciences, Kaunas, Lithuania. smante@centras.lt.
Skirmante
S
Sauliune
Department of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania. gedijaru@yahoo.com.
Gediminas
G
Jarusevicius
Centre for Health and Infectious Disease Research (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. Jeffrey.Lazarus@regionh.dk.
Jeffrey V
JV
Lazarus
D000293:Adolescent; D016497:Adolescent Health Services; D000328:Adult; D000368:Aged; D001290:Attitude; D003219:Confidentiality / Q000331:legislation & jurisprudence*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008097:Lithuania; D008297:Male; D008875:Middle Aged; D010820:Physicians; D011639:Public Opinion; D012098:Reproduction; D034121:Reproductive Health Services; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D055815:Young Adult