Sexually transmitted infections (STIs) are prevalent in the general population. Autistic individuals, both with and without intellectual disability (ID), are potentially at increased risk due to gaps in sexual health education, increased vulnerability to sexual abuse, victimization, and disparities in access to primary and reproductive health care.

This study aims to identify the prevalence of STIs and HIV among a national sample of Medicaid-enrolled autistic individuals and their peers, identifying opportunities for intervention.

Characteristics of autistic Medicaid beneficiaries with and without ID were stratified to compare individuals with and without chlamydia, gonorrhea, syphilis, and HIV. Period prevalence of outcomes among Medicaid enrollees with autism spectrum disorder (ASD) only, ID only, and both (ASD and ID) were compared.

Among autistic individuals, the prevalence of STIs and HIV was highest in the 22–30 age group and among Black enrollees, underscoring the importance of prioritizing their care through screening and preventive health measures.

The results emphasize gaps in addressing the sexual and reproductive health needs of autistic individuals. Policymakers should prioritize funding for clinician training and increased healthcare access to address the sexual health needs of this population, especially those from additionally marginalized communities. It is vital to provide inclusive care that addresses the unique challenges faced by autistic individuals in accessing appropriate sexual health resources.

Autism

Healthcare

Reproductive health

Sexual health

© 2025 The Authors. Published by Elsevier Inc.