Men who inject anabolic steroids and tanning drugs are at higher risk of HIV and viral hepatitis, according to a landmark study from Public Health England (PHE) published in BMJ

The use of image and performance enhancing drugs has grown substantially over the last twenty years, but the risk of exposure to blood borne viruses among those who inject drugs to change their body appearance or improve their performance has rarely been studied.

Researchers from PHE and Liverpool John Moores University surveyed 395 men using image and performance enhancing drugs and found:

One in 18 injectors have been exposed to hepatitis C;
One in 11 have ever been exposed to hepatitis B;
One in 65 have HIV.

Overall one in 10 had been exposed to one or more of HIV, hepatitis B, or hepatitis C, suggesting that the transmission of blood borne viruses is common in this group. These infections can result from unsafe drug injecting practises or unprotected sex.

Lead author Dr Vivian Hope, a PHE expert in infections among people who inject drugs, said: “Our study suggests that levels of HIV and hepatitis infection among men using image and performance enhancing drugs have increased since the 1990s. While we must be cautious in generalising these early findings, they are concerning and show that further research is required.”

Use of psychoactive drugs like cocaine (46 per cent had snorted cocaine, and 12 per cent snorted or swallowed amphetamines) was also high among this population, along with sexual risk behaviours – only 20 per cent of those having sex in the preceding year reported always used a condom.

Dr. Fortune Ncube, Consultant Epidemiologist and lead for PHE on Injecting Drug Use, concludes: “These findings suggest serious health implications for users of image and performance enhancing drugs, but also for their sexual partners and ultimately the wider community.

“These findings suggest we must maintain and strengthen public health interventions focused on reducing injection-related risk behaviours to prevent HIV and hepatitis infections in this group. This includes ensuring those providing voluntary confidential testing services and care related to HIV and hepatitis are alert to the risks associated with image and performance enhancing drug use.”

Jim McVeigh from the Centre for Public Health at Liverpool John Moores University and co-author of the paper said:

“Injectors of anabolic steroids and associated drugs are now the biggest client group at many needle and syringe programmes in the UK. This research shows that anyone who injects drugs is at risk of HIV and other blood borne viruses, regardless of their substance of choice.

“It is essential that all health services, together with the drug users themselves, are made aware of this and appropriate prevention interventions


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