Risk behaviours for HIV and hepatitis infection among anabolic-androgenic steroid users

Abstract

This study examined HIV and hepatitis risk behaviours among anabolic-androgenic steroid (AAS) users and controls, providing a detailed assessment of both injection and sexual practices. Fifty AAS-using and 40 non-AAS-using weight trainers completed a semi-structured interview followed by a detailed questionnaire. The 'high risk' behaviour of sharing needles and syringes was not current practice among the AAS-using sample, with only one user reporting sharing injecting equipment in the past. However, for some users it was common practice to share multi-dose vials (19%) and to divide drugs using syringes (17%). Both these practices are potential routes for HIV and hepatitis infection. Significantly more AAS users (36%) reported increases in sex drive over the last three months than did the control subjects (5%). More AAS users than controls were engaging in sex with more than one partner while infrequently using condoms. These findings support the maintenance of needle exchange schemes which are essential to continued safe injecting practices among AAS users. The elevated sexual risk behaviour of AAS users could be due to AAS's effect of increasing sex drive or to a 'risk taking' personality trait among AAS users.

Performance and image enhancing drug injectors’ access to needle syringe programs: Responding to a public policy dilemma

“…This contrasts with the substantially higher rates of RNSS among PWID surveyed in 2013: 14% and 16% reporting RNSS just in the previous month among NSW (Iversen et al, 2014a) and KRC (Iversen, Chow, & Maher, 2014b) participants in the ANSPS, their HCV prevalence being 54% and 73% respectively. This difference in injecting risk behaviour between the PIEDs injector subpopulation and PWID more generally is consistent with other study findings to date (Bolding et al, 1999(Bolding et al, , 2002Crampin et al, 1998;Day et al, 2008;Hope et al, 2013;Iversen et al, 2013;Larance et al, 2008;Midgley et al, 2000). However it contrasts sharply with the findings of the 2014 NNEDC survey wherein 11% of PIEDs injectors reported RNSS the past month, which was quite comparable to 13% RNSS reported for the PWID population surveyed overall, warranting further investigation.…”

“…McVeigh et al noted a six-fold increase in the number of new clients using anabolic steroids in British NSPs from 1991 to 2001 (McVeigh, Beynon, & Bellis, 2003). Previous studies in the UK had found varying prevalence of injecting risk behaviours, use and injection of psychoactive drugs, and sexual behaviours among PIEDs injectors (Bolding, Sherr, & Elford, 2002;Bolding, Sherr, Maguire, & Elford, 1999;Crampin et al, 1998;Midgley et al, 2000). But these were small samples, which did not specifically examine the prevalence of HIV and HCV in this group.…”

Prevalence of, and risk factors for, HIV, hepatitis B and C infections among men who inject image and performance enhancing drugs: a cross-sectional study

“…The prevalence of ever sharing injecting equipment in these studies ranged from 0.3% to 6%,20 28––30 32 but in one study it was 20% 33. The sharing of drug vials was more common (2.4%35; 9.9%34; 23%32). Studies elsewhere have found similar levels of equipment sharing 6 8.…”

“…These studies were mostly small (N<100), and typically recruited through gyms,28–33 with two recruiting gay men 34 35. The prevalence of ever sharing injecting equipment in these studies ranged from 0.3% to 6%,20 28––30 32 but in one study it was 20% 33. The sharing of drug vials was more common (2.4%35; 9.9%34; 23%32).…”

Anabolic steroid abuse and dependence

“…Injection occurs into large muscle groups (buttocks, thigh, or shoulder) or subcutaneously, but not intravenously. Needle sharing is reportedly uncommon, but does occur [13]. Users typically take steroids in "cycles" of 6 to 12 weeks, followed by 6 to 12 weeks off AAS, although longer cycles of use occur.…”