This study aimed to investigate how Anabolic–Androgenic Steroid (AAS) users and healthcare professionals perceive the criminalisation of AAS on users’ ability to seek help and, ultimately, what effect this has on the health outcomes for these consumers. This study triangulated the views ( N = 24) of male ( n = 8) and female ( n = 7) AAS users ( M _age = 35.4, SD = 9.1), as well as healthcare providers ( n = 9), regarding how the criminalisation of AAS had an impact on consumers’ health behaviours and help-seeking. Data were analysed thematically. An overarching narrative was developed regarding the “politicogenic drug effects” which emerge from the illegality of AAS with three overarching themes. First, participants expressed challenges in seeking help and support due to the stigma and fear associated with the illegal nature of AAS use. This fear stemmed from the criminalisation of AAS and the potential legal consequences. Participants also highlighted the social challenges and the need for secrecy surrounding AAS use, which further hindered open discussions and engagement with healthcare providers. The cohort emphasised the close-knit social networks among AAS users, offering support and shared experiences but also entangled in the criminality associated with AAS use. Moreover, participants acknowledged the difficulties in promoting harm reduction initiatives due to the need for secrecy and the potential social and economic disadvantages. The escalation of AAS criminalisation that has impacted both consumers and healthcare professionals has exacerbated the challenges associated with their interaction, further impeding a relationship already fraught with obstacles. Consequently, users remain entrenched within the illicit market, with few options for harm reduction intervention. The study advocates for a rethinking of AAS policies, considering a potential reclassification aligned with the United Kingdom's Class C framework to destigmatise use and promote harm reduction. This shift would require comprehensive research to assess its impact on public health, user behaviour, and harm reduction outcomes.

Background and aim: Evidence suggests there has been an increase in anabolic‐androgenic steroid (AAS) use among women, driven by the evolving landscape of women's participation in sport. However, the extent of use is unknown. This systematic review aimed to estimate the prevalence of women's AAS use.Method: We conducted a systematic review of peer‐reviewed articles in English, focusing on AAS use among women aged 18 and above. We excluded grey literature and studies that measured doping through some form of analysis (e.g. urine or hair). Searched databases were MEDLINE, CINAHL, PsycINFO, SocINDEX, SPORTDiscus, Embase and Cochrane Library. Titles and abstracts for all articles were screened, followed by full‐text assessment and data extraction of included articles by multiple authors for accuracy. The pooled prevalence of lifetime use was determined using a random effects model and the risk of bias was assessed using the Joanna Briggs Institute Prevalence Critical Appraisal Tool.Results: Based on 18 studies, participant numbers averaged 669 per study (median = 189; range = 16 to 7051). The overall pooled AAS use prevalence was 4% (95% confidence interval [CI] = 2–9%) with high heterogeneity overall (I² = 95%). In the subgroup analysis, AAS use prevalence was 16.8% (95% CI = 11.0–24.9%, I² = 44%) in the bodybuilder subgroup, 4.4% (95% CI = 1.2–15.1%, I² = 93%) in athletes/recreational gym user subgroup, and 1.4% (95% CI = 0.4–4.7%, I² = 96%) in the general population/other subgroup. Meta‐regression demonstrated significantly higher AAS use in bodybuilders compared with the other subgroup (P = 0.011).Conclusion: Anabolic‐androgenic steroid use among women appears to be substantially higher among bodybuilders and athletes/recreational gym users than the general female population.

Research supports the feasibility and acceptance of drug checking among nightlife and festival attendees. Interest in expanding drug checking to other groups of people who use drugs, including those who inject drugs, has grown. However, understanding the acceptability and feasibility of drug checking among specific cohorts, like anabolic-androgenic steroids (AAS) consumers, remains a research gap. This study explores AAS consumers' perspectives on drug checking and service preferences, aiding the preparation for drug checking delivery in Queensland, Australia. A purposive sampling technique was used to recruit 15 AAS consumers (9 males, 6 females; Mage = 36.80 years, SD = 6.12) from Australia. One-on-one semi-structured qualitative interviews were conducted with questions exploring participants' views on drug checking/testing and their preferences for AAS analysis. Thematic analysis was conducted with final themes established through iterative consensus. Consumers expressed frustration with the prevailing stereotypes, social stigma, and the perception of criminality associated with the use of AAS. There was a strong dependence on personal connections and trusted suppliers, with coaches exerting significant influence. Participants expressed concerns about the widespread availability of counterfeit products and underground operations. The act of using unknown AAS was likened to a game of Russian roulette, underscoring the importance of obtaining accurate information and access to reliable drug checking services. Consumers expressed a preference for a web-based platform that enables individuals to access their own test results while contributing to a comprehensive database of brand-specific testing outcomes. AAS consumers recognise the significance of monitoring their AAS use and seek a service that can not only assist them in making informed decisions regarding AAS usage but also potentially contribute to the knowledge of the wider AAS-consuming community. These findings underscore the importance of tailored education, drug checking services, and harm reduction measures to address the diverse needs of AAS consumers.

Background and Aims: The clandestine production and distribution of anabolic‐androgenic steroids (AAS) poses health risks due to the uncertainty of their contents. This study aimed to test the chemical content of AAS samples and provide aggregate results back to the community, exploring how these results influenced usage decisions and risk management.Design: A mixed‐methods approach was used, combining chemical analysis of AAS samples with qualitative interviews. Participants submitted samples for testing, and the results were later shared with them. Semi‐structured interviews explored participants' perceptions of AAS risks and the impact of testing results on their behaviour.Setting: The study was conducted at CheQpoint drug checking service in Brisbane, Australia.Participants: Thirty‐two samples were submitted for testing between 19 April and 7 June 2024, with 23 samples analysed. A total of 25 active AAS users participated in interviews.Measurements: Chemical analyses identified substances present and assessed active ingredient concentrations. Qualitative interviews gathered participants' perceptions, and these data were analysed through iterative categorisation, guided by the Health Belief Model.Findings: Chemical analysis identified that 13% of samples contained substances different from what was expected. Concentrations of active ingredients were close to expected levels [e.g. testosterone propionate at 96.2 mg/mL (range = 91.39–101.01 mg/mL)]. Interviews identified four key theme categories. Participants sought testing primarily for substance verification, expressing concerns about contamination and dosage. Barriers to testing included limited access and fear of disclosure. While testing was seen as a valuable harm reduction tool, gaps in health guidance and follow‐up support were identified as areas for improvement.Conclusions: Thirteen percent of 23 anabolic‐androgenic steroid (AAS) samples analysed contained substances different from what was expected. Interviews with active AAS users highlighted the need for reliable information, accessible testing services and tailored health approaches for AAS use.