Sexual and Reproductive Healthcare Among Youth With Autism and ADHD: A Population-Based Study From Sweden.
Lovisa Hellsten, Jessica Rast, Anna Nielsen and 4 others
PMID 42522081WHAT IT FOUND
ADHD youth used sexual and reproductive health services more than peers.
Autistic youth used them less, especially in person. Digital visits showed smaller differences, but most care was in person.
Key findings
01ADHD youth had higher use of sexual and reproductive health services than control peers across in-person and digital contacts.
02Autistic youth had fewer contacts across all modalities, including in-person and digital visits.
03ADHD females had higher odds of long-acting contraceptive use (adjusted odds ratio 1.91; 95% CI 1.81 to 2.02) and abortion (adjusted odds ratio 2.41; 95% CI 2.21 to 2.62) than control peers.
STILL TO COME
How it was doneWhat they found
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What it does not show
The study is observational, so it cannot show that autism or ADHD caused different sexual and reproductive health service use. Autism and ADHD were identified from registry codes and prescriptions, so some control peers may have undiagnosed conditions, and symptom severity was not measured. The data lacked information on intellectual disability, hormonal and gynecological conditions, and gender identity, so important reasons for different access may be hidden. Parental education or family income was missing for 97,647 individuals, or 21.5% of the population, although sensitivity analyses were consistent. Digital services were still early in this period, and most contacts were in person, so the digital findings may not reflect mature digital care. The age range 12 to 22 may mainly capture youth with more pronounced symptoms and early diagnoses. The setting was Stockholm County, with universal free sexual and reproductive health services and a digitally mature society, so results may not transfer to less resourced settings.
Declared interests
This work was supported by ALF funding through Region Stockholm and Karolinska Institutet. The funders had no role in study design, data collection, analysis, manuscript preparation, or decision to publish. The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that autistic youth need less sexual and reproductive health care. The study found lower service use, not lower need, and autistic females who did visit had intensity similar to control peers.