Steroid Use, Health Risk Behaviors and Adverse Health Indicators among U.S. High School Students

Abstract

Background: Despite recent national attention focusing on steroid use, few studies have assessed the association between steroid use and adverse health indicators among both male and female adolescents. The primary aim is to assess the prevalence of lifetime steroid use and to examine associations between steroid use and health risk behaviors and adverse health indicators among U.S. high school students. Methods: A cross-sectional study examined associations between history of steroid use and aggressive behavior, substance use, mental health status and HIV/STI-associated sexual risk behaviors among a nationally representative sample of 15,425 male and female U.S. high-school students. Results: Overall, 3.5% of adolescents reported a history of steroid use. Males were more likely to report steroid use than females (4.1% vs. 2.9%, p=0.005). Steroid use was associated with team sports participation among males (31.1% non-users vs. 36.2% users, p=0.04) but not among females (49.0% users vs. 47.3% non-users, p=0.71). Males also were more likely than females to report using steroids ≥10 times (49.4% vs. 31.3%, p=0.001). Relative to nonsteroid users, both male and female steroid users were significantly more likely to self-report aggression, victimization, sexual behaviors, other substance use and poor mental health. Among males, marked differences were observed with respect to frequency of steroid use and health risk behaviors and adverse health indicators. Conclusions: Steroid use is a risk behavior that may co-occur with other adverse health behaviors, varies by gender, and may be a marker for identifying a diverse array of health risk behaviors and adverse health indicators among adolescents. Screening and recognition of factors associated with steroid use may be beneficial to help address and curb use among adolescents.