Mu-Hong Chen1, Ju-Wei Hsu2, Kai-Lin Huang1, Ya-Mei Bai1, Nai-Ying Ko3, Tung-Ping Su4, Cheng-Ta Li1, Wei-Chen Lin1, Shih-Jen Tsai1, Tai-Long Pan5, Wen-Han Chang6, Tzeng-Ji Chen7. 1. Taipei Veterans General Hospital, Taipei, Taiwan and the College of Medicine, National Yang-Ming University, Taipei. 2. Taipei Veterans General Hospital, Taipei, Taiwan and the College of Medicine, National Yang-Ming University, Taipei. Electronic address: jwhsu@vghtpe.gov.tw. 3. College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan. 4. Taipei Veterans General Hospital, Taipei, Taiwan and the College of Medicine, National Yang-Ming University, Taipei; General Cheng Hsin Hospital, Taipei. 5. School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan; the Research Center for Industry of Human Ecology, Chang Gung University of Science and Technology, Taoyuan; and the Liver Research Center, Division of Hepatology, Chang Gung Memorial Hospital, Taoyuan. 6. Taipei Veterans General Hospital. 7. Taipei Veterans General Hospital and the Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei.
Abstract
OBJECTIVE: Previous studies have suggested that attention-deficit/hyperactivity disorder (ADHD) is related to risky sexual behaviors, which have been regarded as a major risk factor of sexually transmitted infection (STI). However, the association between ADHD and subsequent STIs remains unknown. METHOD: Using the Taiwan National Health Insurance Research Database, 17,898 adolescents and young adults who were diagnosed with ADHD by psychiatrists and 71,592 age- and sex-matched comparisons without ADHD were enrolled from 2001 through 2009 and followed to the end of 2011. Participants who developed any STI during the follow-up period were identified. Cox regression analysis was performed to examine the risk of STIs between patients with ADHD and those without ADHD. RESULTS: Patients with ADHD were prone to developing any STI (hazard ratio [HR] 3.36, 95% CI 2.69∼4.21) after adjusting for demographic data, psychiatric comorbidities, and ADHD medications compared with the comparison group. Substance use disorders (HR 1.94, 95% CI 1.27∼2.98) also were associated with STI risk. Short-term use (HR 0.70, 95% CI 0.53∼0.94) and long-term use (HR 0.59, 95% CI 0.37∼0.93) of ADHD medications were related to a lower risk of subsequent STIs. However, an association between substance use disorders and STIs was observed only in women. By contrast, the effect of ADHD medications on the decrease of STI risk was observed only in men. CONCLUSION: Adolescents and young adults with ADHD had an increased risk of developing any STI later in life compared with the non-ADHD comparisons. Patients with ADHD who also had substance use disorders were at the highest risk of subsequent STIs. Treatment with ADHD medications was associated with a lower risk of subsequent STIs.
OBJECTIVE: Previous studies have suggested that attention-deficit/hyperactivity disorder (ADHD) is related to risky sexual behaviors, which have been regarded as a major risk factor of sexually transmitted infection (STI). However, the association between ADHD and subsequent STIs remains unknown. METHOD: Using the Taiwan National Health Insurance Research Database, 17,898 adolescents and young adults who were diagnosed with ADHD by psychiatrists and 71,592 age- and sex-matched comparisons without ADHD were enrolled from 2001 through 2009 and followed to the end of 2011. Participants who developed any STI during the follow-up period were identified. Cox regression analysis was performed to examine the risk of STIs between patients with ADHD and those without ADHD. RESULTS:Patients with ADHD were prone to developing any STI (hazard ratio [HR] 3.36, 95% CI 2.69∼4.21) after adjusting for demographic data, psychiatric comorbidities, and ADHD medications compared with the comparison group. Substance use disorders (HR 1.94, 95% CI 1.27∼2.98) also were associated with STI risk. Short-term use (HR 0.70, 95% CI 0.53∼0.94) and long-term use (HR 0.59, 95% CI 0.37∼0.93) of ADHD medications were related to a lower risk of subsequent STIs. However, an association between substance use disorders and STIs was observed only in women. By contrast, the effect of ADHD medications on the decrease of STI risk was observed only in men. CONCLUSION: Adolescents and young adults with ADHD had an increased risk of developing any STI later in life compared with the non-ADHD comparisons. Patients with ADHD who also had substance use disorders were at the highest risk of subsequent STIs. Treatment with ADHD medications was associated with a lower risk of subsequent STIs.
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