“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
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Piatkowski, Tim
Dunn, Matthew
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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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Harm Reduction Journal
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22
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© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
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Public health
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Cox, L; Piatkowski, T; Dunn, M, “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, 2025, 22, pp. 128