A netnographic study of anabolic-androgenic steroid initiation videos on YouTube.

Introduction: YouTube personalities (YP) have amassed significant followings by distributing health information. There is concern that YP involved in anabolic androgenic steroid (AAS) communities are sharing information on how people should approach initiating AAS use. This research sought to explore how YP are using their platform to distribute information on AAS initiation, what information is being presented and how people are responding.

Methods: This mixed methods research utilised a netnographic approach, a method adapted from traditional ethnographic techniques for the study of online sociocultural phenomena. The research included a selection of YouTube videos (n = 37) and user comments replying to the videos (n = 584).

Results: YP addressed the positives and negatives of AAS initiation (76%; n = 28 and 76%; n = 28 respectively), provided harm reduction strategies (76%; n = 28), and advice on which AAS people should use (97%; n = 36). A qualitative thematic analysis of the comments found two overarching themes: 'Authenticity, capital and the influence of the YP on their audiences' and 'The evolving landscape of enhancement and health'. Viewers engaged with the videos due to the YPs lived experience using AAS, and YP influenced the health behaviours of viewers. Many believed that the videos were useful for health and lifestyle enhancement purposes.

Discussion and conclusions: YP are disseminating diverse information on AAS initiation which is derived from their lived experience using AAS. Harm reduction is a key component of the YPs' message and viewers responded positively to a balanced and honest assessment of AAS initiation which is perceived to respect their personal autonomy.