Attention deficit hyperactivity disorder symptoms and risky sexual behaviours in university students:the i-Share study

Background Risky sexual behaviours (RSB) and attention deficit hyperactivity disorder (ADHD) are both major concerns among university students. However, their association remains insufficiently understood. This study aimed to evaluate the relationship between ADHD symptoms and a broad range of RSB in university students. Methods A total of 13085 French students enrolled in the i-Share (Internet-based Students’ Health Research Enterprise study (mean age: 20.6 years, SD=2.4) completed self-reported questionnaires assessing ADHD symptoms (Adult Self-Report Scale V.1.1), RSB, sociodemographic characteristics and alcohol and cannabis use. Logistic regression models were used to examine the cross-sectional associations between ADHD symptoms and RSB, adjusting for relevant confounders. Results A high level of ADHD symptoms was observed in 5.3% of students. In multivariate models, ADHD symptoms were associated with a wide range of RSB, including early first sexual intercourse (adjusted OR (aOR) 1.26; 95%CI 1.06 to 1.51), inconsistent condom use in the last 12 months (aOR 1.26; 95%CI 1.05 to 1.51), diagnosis of a sexually transmitted infection in the last 12 months (aOR 1.60; 95%CI 1.16 to 2.22) and having had multiple sexual partners in the last 12 months (adjusted incidence rate ratio 1.20; 95%CI 1.14 to 1.27). Among female students, ADHD symptoms were associated with lower current use of any form of contraception (aOR 0.59; 95%CI 0.48 to 0.71), and higher odds of having ever used emergency contraception (aOR 1.22; 95%CI 1.02 to 1.47), and having ever had an abortion (aOR 1.77; 95%CI 1.21 to 2.58). Conclusions University students with a high level of ADHD symptoms are at increased risk of engaging in a wide range of RSB. Targeted preventive strategies may be particularly beneficial for this population.