“Injecting yourself there is stigma around it; taking a few tablets is not too bad, is it?”: understanding perceptions and preferences of anabolic-androgenic steroid route of administration

Abstract Background Anabolic androgenic steroids (AAS) are administered via injectable and oral route of administration (ROA). Each ROA carries a distinct set of challenges and risks; however, scarce qualitative research has focused on why people who use AAS select one ROA over another. Aim This stu...

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Main Authors: Luke Cox, Timothy Piatkowski, Matthew Dunn
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Harm Reduction Journal
Subjects:
Online Access:https://doi.org/10.1186/s12954-025-01198-9
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author Luke Cox
Timothy Piatkowski
Matthew Dunn
author_facet Luke Cox
Timothy Piatkowski
Matthew Dunn
author_sort Luke Cox
collection DOAJ
description Abstract Background Anabolic androgenic steroids (AAS) are administered via injectable and oral route of administration (ROA). Each ROA carries a distinct set of challenges and risks; however, scarce qualitative research has focused on why people who use AAS select one ROA over another. Aim This study aims to explore the perceptions and preferences underpinning the decision behind ROA. Method Ten semi-structured interviews were conducted with people from the UK who use AAS. Findings The findings demonstrate that participants had four primary initiation patterns: exclusive use of orals, exclusive use of injectables, and a transition from orals to include injectables or injectables to orals. Factors underpinning drug ROA included: stigma; risk; fear; convenience; efficacy; knowledge of drugs and their desired effects; health; motivations for use; and experience, including number of cycles completed. Each of these factors contributed to differences within the choice underpinning drug ROA. Recommendation With needle and syringe programs being the primary public health intervention for AAS consumers in the UK, oral-only consumers likely experience a lack of critical support services. We suggest future harm reduction strategies consider ways to engage oral-only AAS consumers, especially considering their comparatively lower prioritization of health concerns.
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spelling doaj-art-4ef475d8f5114bd0aed697c73f0b49302025-08-20T03:42:27ZengBMCHarm Reduction Journal1477-75172025-07-0122111310.1186/s12954-025-01198-9“Injecting yourself there is stigma around it; taking a few tablets is not too bad, is it?”: understanding perceptions and preferences of anabolic-androgenic steroid route of administrationLuke Cox0Timothy Piatkowski1Matthew Dunn2School of Sport and Exercise Science, Swansea UniversitySchool of Applied Psychology and Griffith Centre for Mental Health, Griffith UniversitySchool of Health and Social Development/Institute for Health Transformation, Deakin UniversityAbstract Background Anabolic androgenic steroids (AAS) are administered via injectable and oral route of administration (ROA). Each ROA carries a distinct set of challenges and risks; however, scarce qualitative research has focused on why people who use AAS select one ROA over another. Aim This study aims to explore the perceptions and preferences underpinning the decision behind ROA. Method Ten semi-structured interviews were conducted with people from the UK who use AAS. Findings The findings demonstrate that participants had four primary initiation patterns: exclusive use of orals, exclusive use of injectables, and a transition from orals to include injectables or injectables to orals. Factors underpinning drug ROA included: stigma; risk; fear; convenience; efficacy; knowledge of drugs and their desired effects; health; motivations for use; and experience, including number of cycles completed. Each of these factors contributed to differences within the choice underpinning drug ROA. Recommendation With needle and syringe programs being the primary public health intervention for AAS consumers in the UK, oral-only consumers likely experience a lack of critical support services. We suggest future harm reduction strategies consider ways to engage oral-only AAS consumers, especially considering their comparatively lower prioritization of health concerns.https://doi.org/10.1186/s12954-025-01198-9Image and performance enhancing drugsNeedle and syringe programsHarm reductionStigmaRoute of drug administrationAnabolic steroids
spellingShingle Luke Cox
Timothy Piatkowski
Matthew Dunn
“Injecting yourself there is stigma around it; taking a few tablets is not too bad, is it?”: understanding perceptions and preferences of anabolic-androgenic steroid route of administration
Harm Reduction Journal
Image and performance enhancing drugs
Needle and syringe programs
Harm reduction
Stigma
Route of drug administration
Anabolic steroids
title “Injecting yourself there is stigma around it; taking a few tablets is not too bad, is it?”: understanding perceptions and preferences of anabolic-androgenic steroid route of administration
title_full “Injecting yourself there is stigma around it; taking a few tablets is not too bad, is it?”: understanding perceptions and preferences of anabolic-androgenic steroid route of administration
title_fullStr “Injecting yourself there is stigma around it; taking a few tablets is not too bad, is it?”: understanding perceptions and preferences of anabolic-androgenic steroid route of administration
title_full_unstemmed “Injecting yourself there is stigma around it; taking a few tablets is not too bad, is it?”: understanding perceptions and preferences of anabolic-androgenic steroid route of administration
title_short “Injecting yourself there is stigma around it; taking a few tablets is not too bad, is it?”: understanding perceptions and preferences of anabolic-androgenic steroid route of administration
title_sort injecting yourself there is stigma around it taking a few tablets is not too bad is it understanding perceptions and preferences of anabolic androgenic steroid route of administration
topic Image and performance enhancing drugs
Needle and syringe programs
Harm reduction
Stigma
Route of drug administration
Anabolic steroids
url https://doi.org/10.1186/s12954-025-01198-9
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