ADHD symptoms and substance use among young sexual minority men: The P18 cohort study

Introduction Attention-deficit/hyperactivity disorder (ADHD) is associated with substance use in adulthood. However, few studies have examined ADHD symptoms among young sexual minority men (YSMM), and even fewer have examined their associations with substance use.Method Using data from a diverse sample of 597 YSMM, we examined the prevalence of current clinically significant ADHD symptoms, as well as their associations with current substance use and age of first use.Results In our sample of YSMM, 21.4% reported inattention, 32.2% reported hyperactivity/impulsivity, and 15.1% reported both using a 3-symptom threshold of clinically significant symptoms. Rates using the 5-symptom threshold in line with the DSM-5 were 8.2%, 9.2%, and 3.7%, respectively. Results of binary logistic, negative binomial, and zero-inflated negative binomial regressions indicated that ADHD symptoms were associated with greater likelihood of current substance use after controlling for sociodemographic characteristics. Results of Cox hazards regressions indicated that ADHD symptoms were associated with earlier age of first use.Conclusion ADHD symptoms are prevalent among YSMM and associated with substance use. Practitioners should consider screening for ADHD and substance use among sexual minority youth. Prevention and intervention efforts should be tailored to meet the needs of YSMM.