A qualitative exploration of family physicians and people who use anabolic steroids: Barriers to accessing evidence-based care

Abstract

Background

Non-medical anabolic-androgenic steroid (AAS) use poses numerous short and long-term health concerns. Literature has explored the interaction between AAS users and family physicians (FPs); however, there remains a paucity of studies exploring this in the context of the Canadian healthcare system. Further, discussions regarding anabolic steroids online have evolved in recent years with the rise of new social media platforms and information sources, warranting further investigation.

Methods

Participants were recruited through both purposive (professional networks, social media) and snowball sampling (in-person at the gym). Thirteen semi-structured interviews (seven AAS users and six FPs) were digitally conducted and inductively analyzed using thematic analysis.

Results

Four key themes emerged from the anabolic steroid user interviews: 1) AAS Culture Influences Community Connections, Self-Perceptions, and Welcomes New Members 2) Social Media's Evolving Influence on AAS Use Patterns, Culture, and Misinformation 3) Alternative Sources of AAS Information are Typically Consulted Instead of FPs, and 4) The Stigma of AAS Use Disclosure with FPs. Additionally, a fear of legal consequences served as a barrier to users accessing primary care.

Conclusion

A lack of dedicated resources and specialized medical training on anabolic steroid use currently exists. Both AAS users and FPs agreed that social media has become increasingly influential in the culture surrounding anabolic steroid use. Misinformation was observed regarding anabolic steroid use and this has become a considerable barrier exacerbated by mistrust of healthcare professionals. AAS users continue to feel stigmatized by the healthcare system, perpetuating the siloed nature of this community. Future physician training should focus on trust building and education through a harm-reduction lens.