Adolescent and young adults with attention-deficit/hyperactivity disorder (ADHD) are at a higher risk for subsequent sexually transmitted infections (STIs), but taking medicine for ADHD can help cut the risk, according to research published in the Journal of the American Academy of Child and Adolescent Psychiatry.
Adolescent and young adults with attention-deficit/hyperactivity disorder (ADHD) are at a higher risk for subsequent sexually transmitted infections (STIs), but taking medicine for ADHD can help cut the risk, according to a study from Taiwan. Based on the findings, the authors made recommendations for clinicians, who may be reluctant to prescribe ADHD medicine for some patients.
The study was published in the January 2018 issue of the Journal of the American Academy of Child and Adolescent Psychiatry. The findings are based on the Taiwan National Health Insurance Research Database, which is a nationally representative database of medical claims and healthcare data.
The study included 17,898 adolescents and young adults diagnosed with ADHD and 71,592 age and sex-matched non-ADHD controls who did not have STIs prior to enrollment. Adolescents aged 12 to 17 years and young adults aged 18 to 29 years were followed from January 1, 2001, through the end of 2009.
The researchers tracked data related to risk of STIs, including HIV, syphilis, genital warts, gonorrhea, chlamydial infection, and trichomoniasis, as well as the presence of other psychiatric conditions. They also measured whether subjects were taking methylphenidate or atomoxetine for ADHD. Short-term use of medicine was defined as taking medicine between 30 and 364 days, and long-term use was defined as more than 365 days.
The researchers wrote that the differences in the risk of STIs between male and female patients with ADHD require additional study.
While previous studies have suggested that ADHD is related to risky sexual behaviors—a major STI risk factor—the link between ADHD and subsequent STIs has been unknown. The authors said there were several possible explanations for the findings, as previous studies have discussed how the main symptoms of ADHD, as well as certain comorbidities, relate to risky sexual behavior.
While the authors noted that some clinicians could have concerns about prescribing ADHD medications, especially psychostimulants, to patients with ADHD who also have a substance use disorder, they pointed to accumulating evidence indicating those concerns may be unfounded. Receiving ADHD medication is unlikely to be associated with a greater risk of substance-related problems in adolescence or adulthood, and the medicine is associated with lower concurrent risk of substance-related events.
The researchers suggested that healthcare providers focus on the increased risk of STIs for patients with ADHD and substance use disorders, and be “exceptionally diligent” in seeking treatment compliance with this high-risk group.
Several limitations were noted with this study.
Chen M, Hsu J, Huang K, et al. Sexually transmitted infection among adolescents and young adults with attention-deficit/hyperactivity disorder: a nationwide longitudinal study. J Am Acad Child Adolesc Psychiatry 2018;57(1):48—53.