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Making 'safer injecting' matter for people who inject image and performance enhancing drugs

Timothy Piatkowski Orcid Logo, Emma Kill, Sonya Weith, Steph Reeve, Luke Cox Orcid Logo, Ross Coomber, Cheneal Puljevic, Thomas O'Connor, Jason Ferris

Health

Swansea University Author: Luke Cox Orcid Logo

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DOI (Published version): 10.1177/13634593251388294

Abstract

Image and performance-enhancing drugs (IPEDs) are primarily injected intramuscularly or subcutaneously, yet traditional harm reduction strategies, focused on blood-borne virus prevention, often overlook the specific health enhancement goals of people who use IPEDs. This study advocates for a collabo...

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Published in: Health
ISSN: 1363-4593 1461-7196
Published: SAGE Publications 2025
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URI: https://cronfa.swan.ac.uk/Record/cronfa70958
Abstract: Image and performance-enhancing drugs (IPEDs) are primarily injected intramuscularly or subcutaneously, yet traditional harm reduction strategies, focused on blood-borne virus prevention, often overlook the specific health enhancement goals of people who use IPEDs. This study advocates for a collaborative approach to safer injecting practices, informed by the lived-living experiences of people injecting IPEDs, to develop targeted messaging that aligns with their unique motivations. Thirty participants who inject IPEDs were recruited through community networks and partnerships. The study used qualitative focus groups and semi-structured interviews to explore injection practices and safety strategies. Data analysis followed an inductive, line-by-line approach, identifying themes related to injection methods and safer techniques, drawing on matters-of-concern. Stigma and misinformation about IPED injection practices were prevalent, contributing to a heightened risk of infection. Participants expressed anxiety about injection site reactions and reported limited knowledge of safe techniques, with poor injecting literacy leading to risky behaviours like needle reuse and inadequate hygiene. Importantly, participants highlighted that IPED injecting knowledge is often shared through peer support networks. This research calls for reframing harm reduction to focus on health enhancement, optimising injecting techniques, and integrating evidence-based resources, empowering peer-led harm reduction to better support the health aspirations of this population.
Keywords: anabolic-androgenic steroids, blood-borne virus, image and performance enhancing drugs, infection, injecting
College: Faculty of Science and Engineering
Funders: This work was partially funded by the Queensland Mental Health Commission.

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