Background: Time to meet privately with a health care provider can support optimal adolescent health, but numerous barriers exist to implementing this practice routinely.

Methods: We examined parent reports on their children aged 12 to 17 from a nationally generalizable sample to quantify the presence of time alone with health care providers at the state and national level, as well as socio-contextual correlates using logistic regression analysis.

Results: We estimated that only 1 in 2 adolescents had a confidential discussion at their last medical visit. Certain child, family, and health care factors were associated with lower likelihood for having had confidential discussions. Specifically, adolescents who were Asian; did not have mental, emotional, or behavioral problems; were uninsured; or lived in households with parents who were immigrants, less educated, or did not speak English had significantly lower odds for having had time alone compared with referent groups.

Discussion: Clinical and structural efforts to rectify these gaps may assist a broader share of youth in benefiting from private health care discussions with providers.