Knowledge, attitude and practice towards anabolic-androgenic steroids utilisation among gymnasium attendees in Al-Qassim Province, Saudi Arabia.

Despite the serious side effects associated with anabolic-androgenic steroids (AAS) being well-documented, their widespread misuse for bodybuilding and endurance enhancement continues to be a concern worldwide. A substantial number of studies have been conducted, both internationally and in Saudi Arabia, to investigate knowledge, attitudes, and practices with respect to AAS use among gym users. These studies have been conducted in various cities throughout Saudi Arabia and have focused primarily on male gym users; however, no local studies have been conducted in Al-Qassim province. Therefore, this study aimed to investigate the knowledge, attitudes, and practices around AAS use of both male and female gym users in Al-Qassim Province. This community-based, cross-sectional, questionnaire-based study was conducted from January 2022 to March 2022 and recruited 415 gym users from 24 gyms in Al-Qassim. In the results, 62.9% of the participants were men, and 37.1% were women. The participants demonstrated diverse levels of knowledge about AAS: 74% had heard about AAS, and 72.8% and 71.6% were aware of AAS's effects on muscle and body weight, respectively. However, only 13.3% knew that AAS could cause breast enlargement. Regarding participants' attitudes towards AAS, the majority of the participants (83.6%) believed that using AAS harms health, and 52% and 52.8% of participants believed that there should be punishments for people who use or sell AAS, respectively, while 62.4% of participants felt sorry for AAS users. Our findings on participants' practices showed that 37.3% of participants knew someone who uses AAS, and most importantly, that 19.5% of the gym users (19.2% and 20.1% of male and female users, respectively) admitted that they have used AAS. 51.1% of the participants believed that these AAS are easy to obtain. The study also found a significant relationship between AAS use and sociodemographic variables, including marital status (p = 0.031), time spent in the gym (p = 0.016), chronic diseases (p = 0.028), and smoking (p = 0.031). In conclusion, despite the participants' relatively good knowledge, attitudes, and practices concerning AAS use, they lack knowledge on certain side effects. This could direct policymakers in managing and acting to increase awareness for bodybuilders and the public. In addition, the high prevalence of AAS users could alert the ministries of health and other related ministries to the need for strict rules, especially those stopping or at least minimising accessibility to these substances.