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. 2025 Jul 28;22(1):129.
doi: 10.1186/s12954-025-01269-x.

Managing risks and harms associated with the use of anabolic steroids: a qualitative study

J M X Amaral  1 , A Kimergård  2 , P Deluca  2
Affiliations

Managing risks and harms associated with the use of anabolic steroids: a qualitative study

J M X Amaral et al. Harm Reduct J. .

Abstract

Background: People using anabolic steroids adopt different strategies to manage risks and harms associated with the use of these substances. We investigated how users learn, develop and incorporate risk-management strategies, as well as the events triggering changes in their health-related behaviour.

Methods: Twenty semi-structured interviews were conducted with anabolic steroid users living in the UK to discuss their risk-management strategies (19 males, 1 female; median age = 35.5 years; median time of anabolic steroid use = 9 years). Online interviews were transcribed verbatim and qualitative data was analysed via iterative categorisation.

Results: The use of risk-management strategies was characterised as a continuous cycle of identification, prevention and control of risks and harms. Preventative strategies were more commonly adopted after many years of anabolic steroid use. Changes in life circumstances and adverse health conditions were described as common triggers for changes in behaviour, including the cessation of anabolic steroid use.

Conclusion: Our findings can inform interventions aimed at increasing awareness and promoting healthier behaviours among people who use anabolic steroids. Further research is needed to evaluate the effectiveness and safety of the risk-management strategies employed by this population.

Keywords: Anabolic steroids; Harm-reduction; Human-enhancement drugs.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Ethical approval was obtained from King’s College London Psychiatry, Nursing and Midwifery Research Ethics Subcommittee (Reference HR-20/21-22034). Participants’ consent was warranted prior to the interviews. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Risk-management strategies. 1: People must report history of anabolic steroid use before donating blood. Providing false or misleading health information is a crime in the UK [95]. 2: There is limited evidence regarding the efficacy and safety of different protocols of post-cycle therapy
See this image and copyright information in PMC

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