"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.

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. 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.