Author Archive for Krista Lynn Jones

Adolescent Access to Confidential Health Services

confidentiality icon

Few things are more personal than information about our bodies and our health. The information patients share with their health care provider is often sensitive, even embarrassing. Patients expect that it will be kept private. If that privacy is not guaranteed, they may be reluctant to seek care or treatment.

Confidentiality is also important for health care providers. To deliver accurate diagnosis and treatment, the provider must have all relevant information from the patient. If the patient fears that such information will be made public, s/he may not divulge all the necessary facts.

Confidential health services are essential in promoting teens’ health. Adolescents are at a critical stage of development, both physically and emotionally, and are beginning to establish their own identity and autonomy. Teens experiencing depression, rage, suicidal thoughts, sexually transmitted disease (STD), pregnancy, or sexual abuse may pose a grave danger to themselves or those around them. A health care professional can help enormously by encouraging screening and treatment.

The health care provider’s duty of confidentiality becomes complicated when the interests of an adolescent’s parents or guardian must be factored into the provider-patient relationship. The parents’ financial responsibility for, and guiding role in, raising their children and the state’s interest in protecting family autonomy are concerns the health care provider must respect. Health care providers must also balance parents’ and minors’ interests while keeping in mind laws that govern confidentiality and that mandate parental notification.

If you would like to know more about this topic visit:

Bacterial Vaginosis


What is bacterial vaginosis?

Bacterial vaginosis (BV) is an infection caused when too much of certain bacteria change the normal balance of bacteria in the vagina.

How common is bacterial vaginosis?

Bacterial vaginosis is the most common vaginal infection in women ages 15-44.

How is bacterial vaginosis spread?

We do not know about the cause of BV or how some women get it. BV is linked to an imbalance of “good” and “harmful” bacteria that are normally found in a woman’s vagina.

We do know that having a new sex partner or multiple sex partners and douching can upset the balance of bacteria in the vagina and put women at increased risk for getting BV.

However, we do not know how sex contributes to BV. BV is not considered an STD, but having BV can increase your chances of getting an STD. BV may also affect women who have never had sex.

You cannot get BV from toilet seats, bedding, or swimming pools.

How can I avoid getting bacterial vaginosis?

Doctors and scientists do not completely understand how BV is spread, and there are no known best ways to prevent it.

The following basic prevention steps may help lower your risk of developing BV:

  1. Not having sex;
  2. Limiting your number of sex partners; and
  3. Not douching.

 I’m pregnant. How does bacterial vaginosis affect my baby?

Pregnant women can get BV. Pregnant women with BV are more likely to have babies who are born premature (early) or with low birth weight than women who do not have BV while pregnant. Low birth weight means having a baby that weighs less than 5.5 pounds at birth.

Treatment is especially important for pregnant women.

For more information visit:



STD & Pregnancy

Women who are pregnant can become infected with the same sexually transmitted diseases (STDs) as women who are not pregnant. Pregnant women should ask their doctors about getting tested for STDs, since some doctors do not routinely perform these tests.

For more information please visit:

You’ve Tested Positive for Hepatitis C; Now What?

In the past, if someone tested positive for the hepatitis C virus (HCV), a chronic liver infection, the only real treatment was interferon-based medications, which had lower success rates than the latest treatments, especially among people of color, and harsh side effects.

But with treatment progressing over time, a cure for HCV is now a reality.

Thanks to therapies such as Sovaldi (sofosbuvir), Olysio (simeprevir), Harvoni (a combination of ledipasvir and sofosbuvir) and Viekira Pak (also a combination therapy, consisting of ombitasvir-paritaprevir-ritonavir and dasabuvir), HCV has a cure rate of 95-100 percent. Even better: New data have confirmed that treatments have the same success rates among people of different racial and ethnic backgrounds.

But for the 3 million to 5 million people estimated to be living with HCV, the cure seems bittersweet: The treatment alone can cost $1,000 per pill, with a total of $100,000 for the entire 12- to 14-week regimen. Even with health insurance, the cost of treatment and copays can make the drug almost inaccessible.

“It’s actually unconscionable that we have this cure and millions globally can’t afford it,” says Kenyon Farrow, the U.S. and global health policy director for the Treatment Action Group. “And while in other countries the pharmaceutical companies are in negotiations to make the drugs more affordable, here in the U.S. we don’t have a national office that does that, which allows for companies to charge what they want.”

But don’t let this discourage you, because you do have options.

For starters, depending on the progression of your disease, you may want to talk to your doctor about delaying treatment, in hopes that more-affordable treatment will come down the pipeline in the next year or so, as some expect. But that could be a gamble with your health if you need treatment and lower-cost meds don’t materialize. You can also try negotiating directly with your health insurance company to see what it covers and how much it will cover.

In addition, you can utilize the following:

Financial-assistance programs: These can help offset the high costs of HCV treatment for those living with the disease. Depending on your income and/or insurance status, these programs may pay a portion of your prescription and other-related fees, such as your copay, or pay the entire cost, making the treatment free—but only for those who apply and qualify for assistance. These programs may be funded by foundations or pharmaceutical companies such as Gilead.

“They can definitely help those who need it, but it still requires extra steps such as doing online research and filling out what can be confusing forms. Steps that aren’t as easy as just getting a prescription from your doctor and going straight to the pharmacy,” says Farrow.

These links provide comprehensive sources of programs that can help you:

* Hepatitis C New Drug Research and Liver Health

* The American Liver Foundation

* The Patient Access Network Foundation, also accessible by phone at 866-316-7263866-316-7263 FREE

Medicaid and Medicare: These government-issued health-care programs for low-income and elderly Americans will also provide access. According to The Washington Post, in 2014 Medicare spent a whopping $4.5 billion on this treatment for those enrolled in its program, 15 times more than it did in 2013 for older, less-expensive treatment. Because of the high cost, both programs are in ration mode, which doesn’t always sit well with activists.

“These programs have rules like, if you are a drug addict or an alcoholic, you won’t get treatment. They are also prioritizing those with more advanced disease above others to see who gets treatment first,” says Farrow.

Talking with Teens

Middle School

Actual questions middle schoolers are asking, and the answers that you might use to keep the conversation going.

Q: My periods are irregular. Am I normal?

A: Most of the time irregular periods are part of the normal changes that can happen when you’re a teen. At some point as you get older, your cycle probably will settle into a recognizable pattern. Most women have periods every 26–30 days. Why don’t you mark on a calendar when your periods start and when they end? Then if you still are worried about irregular periods, we can schedule an appointment with your doctor and you will have a record to help you answer the doctor’s questions. Also, it’s important that you know that irregular periods make it harder to know when you might get pregnant.

To learn more about the menstrual cycle, check out the Menstruation and Menstrual Cycle Fact Sheet from the Office on Women’s Health.

Q: How can I say “no” to sex and still be in a relationship with my girlfriend?

A: What a great question and I’m glad you came to me with it. Being intimately involved and having sex with someone is a big step in a relationship. Your mom and I hope you will (wait until you are older/until you are married/until you are in a committed, long-term relationship/your personal value), but it is your decision. If you are getting pressure and it’s not what you want, then say, “No, I really like you and want to be friends, but I’m not ready for sex right now.” You’ve got a lot of other things to focus on right now and sex would really complicate a relationship. What else might you say to her?

For other examples of ways to avoid pressure to have sex, check out the’s Dealing with Pressure to Have Sex fact sheet.

Q: When is it OK to have a baby?

A:  Your dad and I want you to be able to have a baby when you are an adult, have finished your education, and have the ability to financially support a child and your family. Until then, it is really important that when you start having sex, you use contraception to prevent pregnancy. Having a baby is a big responsibility, both emotionally and financially. Most people are adults and are married when they have children. What do you think?

Q: What do you do with a condom?

A: When people decide to have sex, a condom is placed over the penis to prevent pregnancy and sexually transmitted diseases. What else would you like to know about condoms?

To learn more about condoms, including how to correctly put on a condom, check out the CDC’s Condom Fact Sheet.

Q: I want to use tampons. Will I still be a virgin?

A: A virgin to me is someone who has not had sexual intercourse. Using a tampon won’t change that. Can you tell me a bit more about why you asked that question?

Q: Can you get pregnant if you have sex during your period?

A: Yes, it is possible depending on a girl’s cycle, especially if she has long periods and short cycles. It’s best to use protection at all times if you don’t want to get pregnant.

Q: Is it normal to get an erection for no reason at all?

A: It is very normal, especially when you are going through puberty. It can be embarrassing because you can’t predict them. Sometimes thinking of a totally different subject can make it go away. Sometimes it can even happen when you are sleeping. What else would you like to know?

For more information on what boys can expect during puberty, visit MedlinePlus’ resource on Puberty in Boys.

For more advice on how to talk with teens, check out OAH’s e-learning module: Talking with Your Teens About Reproductive Health.

Check out questions that high schoolers are asking and model responses.