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“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

Luke Cox Orcid Logo, Timothy Piatkowski, Matthew Dunn

Harm Reduction Journal, Volume: 22, Issue: 1

Swansea University Author: Luke Cox Orcid Logo

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DOI (Published version): 10.1186/s12954-025-01198-9

Abstract

BackgroundAnabolic 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.AimThis study aims to e...

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Published in: Harm Reduction Journal
ISSN: 1477-7517
Published: Springer Science and Business Media LLC 2025
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URI: https://cronfa.swan.ac.uk/Record/cronfa70046
first_indexed 2025-07-28T13:54:46Z
last_indexed 2025-08-19T22:13:05Z
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spelling 2025-08-18T13:06:09.7336211 v2 70046 2025-07-28 “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 9811ac84cad867903c385bf7086dfd2d 0000-0001-7625-4603 Luke Cox Luke Cox true false 2025-07-28 EAAS BackgroundAnabolic 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.AimThis study aims to explore the perceptions and preferences underpinning the decision behind ROA.MethodTen semi-structured interviews were conducted with people from the UK who use AAS.FindingsThe 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.RecommendationWith 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. Journal Article Harm Reduction Journal 22 1 Springer Science and Business Media LLC 1477-7517 Image and performance enhancing drugs, Needle and syringe programs, Harm reduction, Stigma, Route of drug administration, Anabolic steroids 25 7 2025 2025-07-25 10.1186/s12954-025-01198-9 COLLEGE NANME Engineering and Applied Sciences School COLLEGE CODE EAAS Swansea University Other 2025-08-18T13:06:09.7336211 2025-07-28T14:51:16.1309910 Faculty of Science and Engineering School of Engineering and Applied Sciences - Sport and Exercise Sciences Luke Cox 0000-0001-7625-4603 1 Timothy Piatkowski 2 Matthew Dunn 3 70046__34853__95cd5414bf8e4052a803108bef97bbb7.pdf 70046.pdf 2025-07-28T14:54:33.1232207 Output 1051144 application/pdf Version of Record true © The Author(s) 2025. This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. true eng http://creativecommons.org/licenses/by-nc-nd/4.0/
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
spellingShingle “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
Luke Cox
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_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_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
author_id_str_mv 9811ac84cad867903c385bf7086dfd2d
author_id_fullname_str_mv 9811ac84cad867903c385bf7086dfd2d_***_Luke Cox
author Luke Cox
author2 Luke Cox
Timothy Piatkowski
Matthew Dunn
format Journal article
container_title Harm Reduction Journal
container_volume 22
container_issue 1
publishDate 2025
institution Swansea University
issn 1477-7517
doi_str_mv 10.1186/s12954-025-01198-9
publisher Springer Science and Business Media LLC
college_str Faculty of Science and Engineering
hierarchytype
hierarchy_top_id facultyofscienceandengineering
hierarchy_top_title Faculty of Science and Engineering
hierarchy_parent_id facultyofscienceandengineering
hierarchy_parent_title Faculty of Science and Engineering
department_str School of Engineering and Applied Sciences - Sport and Exercise Sciences{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Engineering and Applied Sciences - Sport and Exercise Sciences
document_store_str 1
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description BackgroundAnabolic 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.AimThis study aims to explore the perceptions and preferences underpinning the decision behind ROA.MethodTen semi-structured interviews were conducted with people from the UK who use AAS.FindingsThe 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.RecommendationWith 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.
published_date 2025-07-25T05:31:49Z
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