Male anabolic androgenic steroid-users: a mixed-methods study. The voice of the AAS-user.

Abstract

Anabolic androgenic steroids (AAS) are increasingly used by the general population, particularly male gym users, for their muscle-building and aesthetic effects. AAS can have a detrimental impact on physical and emotional wellbeing. The motivations for use are wide ranging and include a desire for a muscular physique. There is a shortage of research exploring AAS-users’ experiences, their perceptions of risks of AAS or how the complexity of motivations for use effects support needs. The mixed-methods scoping review in this integrated thesis revealed (a) AAS-users access a range of sources to obtain information on how to inject, side-effects, risk management and types of substance; and (b) a paucity of data on the types of information and support users want. This shaped the questions for the primary research namely to explore the experiences of recreational AAS-users and ascertain their needs and wants on information and support. A two-phase process via quantitative questionnaires and semi-structured interviews was followed. Descriptive statistical analysis was used for quantitative data and thematic analysis for the qualitative data. This study found complex and interlinked motivations for AAS use by participants that could change over time including the use of unprescribed AAS as Testosterone Replacement Therapy. This study suggests that the internalisation of socially constructed ideal perceptions of masculinity could be a reason for using AAS and may impact on users’ health seeking behaviours. Most AAS-users were seeking evidence-based information but did not seek professional support due to stigma and lack of faith in the knowledge of professionals. It is recommended that a person-centred approach should be taken to supporting AAS-users. Professionals should explore with users their history of AAS use and their concerns, so that support can be tailored to individual needs. One-to-one and group support should include discussions around beliefs linked to masculinity and negative self-talk. Services for AAS-users should be separated from those serving other illicit drug users.