Be legally wise: When is parental consent required for adolescents’ access to pre-exposure prophylaxis (PrEP)?
Background: South African adolescents (12–17 years) need an array of prevention tools to address their risk of acquiring the life-long, stigmatized condition that is HIV. Prevention tools include pre-exposure prophylaxis (PrEP). However, service providers may not be clear on the instances where self...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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AOSIS
2020-11-01
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| Series: | Southern African Journal of HIV Medicine |
| Subjects: | |
| Online Access: | https://sajhivmed.org.za/index.php/hivmed/article/view/1129 |
| _version_ | 1818545085535485952 |
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| author | Ann Strode Catherine M. Slack Zaynab Essack Jacintha D. Toohey Linda-Gail Bekker |
| author_facet | Ann Strode Catherine M. Slack Zaynab Essack Jacintha D. Toohey Linda-Gail Bekker |
| author_sort | Ann Strode |
| collection | DOAJ |
| description | Background: South African adolescents (12–17 years) need an array of prevention tools to address their risk of acquiring the life-long, stigmatized condition that is HIV. Prevention tools include pre-exposure prophylaxis (PrEP). However, service providers may not be clear on the instances where self-consent is permissible or when parental consent should be secured.
Aim: To consider the legal norms for minor consent to PrEP using the rules of statutory interpretation.
Setting: Legal and policy framework.
Results: We find that PrEP should be interpreted as a form of ‘medical treatment’; understood broadly so that it falls within the ambit of one of consent norms in the Children’s Act. When PrEP is interpreted as ‘medical treatment’, then self-consent to PrEP is permissible for persons over 12 years, if they have the mental capacity and maturity to understand the benefits, risks, social and other implications of the proposed treatment. Currently, PrEP is only licensed for persons over 35 kg. Reaching the age of 12 years is a necessary but not sufficient criteria for self-consent and service-providers must ensure capacity requirements are met before implementing a self-consent approach. Decisional support and adherence support are critical.
Conclusions: We recommend that service-providers should take steps to ensure that those persons who meet an age requirement for self-consent, also meet the capacity requirement, and that best practices in this regard be shared. We also recommend that policy makers should ensure that PrEP guidelines are updated to reflect the adolescent consent approach articulated above. It is envisaged that these efforts will enable at-risk adolescents to access much needed interventions to reduce their HIV risk. |
| first_indexed | 2024-12-11T22:56:55Z |
| format | Article |
| id | doaj.art-281193598ebc43529ef8b37ea5e6e10d |
| institution | Directory Open Access Journal |
| issn | 1608-9693 2078-6751 |
| language | English |
| last_indexed | 2024-12-11T22:56:55Z |
| publishDate | 2020-11-01 |
| publisher | AOSIS |
| record_format | Article |
| series | Southern African Journal of HIV Medicine |
| spelling | doaj.art-281193598ebc43529ef8b37ea5e6e10d2022-12-22T00:47:11ZengAOSISSouthern African Journal of HIV Medicine1608-96932078-67512020-11-0121110.4102/sajhivmed.v21i1.1129712Be legally wise: When is parental consent required for adolescents’ access to pre-exposure prophylaxis (PrEP)?Ann Strode0Catherine M. Slack1Zaynab Essack2Jacintha D. Toohey3Linda-Gail Bekker4School of Law, College and Law and Management Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa; and, HIV/AIDS Vaccines Ethics Group, School of Applied Human Sciences, College of Humanities, University of KwaZulu-Natal, PietermaritzburgHIV/AIDS Vaccines Ethics Group, School of Applied Human Sciences, College of Humanities, University of KwaZulu-Natal, PietermaritzburgSchool of Law, College and Law and Management Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa; and, Center for Community-Based Research, Human and Social Capabilities Division, Human Sciences Research Council, PietermaritzburgSchool of Law, College and Law and Management Sciences, University of KwaZulu-Natal, PietermaritzburgThe Desmond Tutu HIV Centre, University of Cape Town, Cape TownBackground: South African adolescents (12–17 years) need an array of prevention tools to address their risk of acquiring the life-long, stigmatized condition that is HIV. Prevention tools include pre-exposure prophylaxis (PrEP). However, service providers may not be clear on the instances where self-consent is permissible or when parental consent should be secured. Aim: To consider the legal norms for minor consent to PrEP using the rules of statutory interpretation. Setting: Legal and policy framework. Results: We find that PrEP should be interpreted as a form of ‘medical treatment’; understood broadly so that it falls within the ambit of one of consent norms in the Children’s Act. When PrEP is interpreted as ‘medical treatment’, then self-consent to PrEP is permissible for persons over 12 years, if they have the mental capacity and maturity to understand the benefits, risks, social and other implications of the proposed treatment. Currently, PrEP is only licensed for persons over 35 kg. Reaching the age of 12 years is a necessary but not sufficient criteria for self-consent and service-providers must ensure capacity requirements are met before implementing a self-consent approach. Decisional support and adherence support are critical. Conclusions: We recommend that service-providers should take steps to ensure that those persons who meet an age requirement for self-consent, also meet the capacity requirement, and that best practices in this regard be shared. We also recommend that policy makers should ensure that PrEP guidelines are updated to reflect the adolescent consent approach articulated above. It is envisaged that these efforts will enable at-risk adolescents to access much needed interventions to reduce their HIV risk.https://sajhivmed.org.za/index.php/hivmed/article/view/1129parental consentself-consenthivpreventionminors’ capacity |
| spellingShingle | Ann Strode Catherine M. Slack Zaynab Essack Jacintha D. Toohey Linda-Gail Bekker Be legally wise: When is parental consent required for adolescents’ access to pre-exposure prophylaxis (PrEP)? Southern African Journal of HIV Medicine parental consent self-consent hiv prevention minors’ capacity |
| title | Be legally wise: When is parental consent required for adolescents’ access to pre-exposure prophylaxis (PrEP)? |
| title_full | Be legally wise: When is parental consent required for adolescents’ access to pre-exposure prophylaxis (PrEP)? |
| title_fullStr | Be legally wise: When is parental consent required for adolescents’ access to pre-exposure prophylaxis (PrEP)? |
| title_full_unstemmed | Be legally wise: When is parental consent required for adolescents’ access to pre-exposure prophylaxis (PrEP)? |
| title_short | Be legally wise: When is parental consent required for adolescents’ access to pre-exposure prophylaxis (PrEP)? |
| title_sort | be legally wise when is parental consent required for adolescents access to pre exposure prophylaxis prep |
| topic | parental consent self-consent hiv prevention minors’ capacity |
| url | https://sajhivmed.org.za/index.php/hivmed/article/view/1129 |
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