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Piatkowski T, Robertson J, Lamon S, Dunn M. Gendered perspectives on women's anabolic-androgenic steroid (AAS) usage practices. Harm Reduct J 2023; 20:56. [PMID: 37098574 PMCID: PMC10127974 DOI: 10.1186/s12954-023-00786-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 04/19/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND The masculinizing effects from anabolic-androgenic steroid (AAS) appear to be different between men and women, leading to calls for more gender-specific information regarding women and AAS use. This study sought to gather perspectives from both men and women on the unique challenges surrounding women's use of AAS, irrespective of their personal use. Secondly, the study interrogated how women's AAS practices differ from those of men specifically. METHODS The data presented in this paper come from a subsample of participants who participated in a larger study investigating women and performance and image enhancing drug (PIED) use in Australia. Participants were included in the current analysis if they were: (i) males or females who competed with or coached female strength athletes using AAS and (ii) female and male strength athletes who used AAS. The final sample comprised 21 participants of which there was a proportion of males (n = 7) and females (n = 7) using AAS. RESULTS Women's choices in AAS selection were predominantly around oral compounds (e.g. Oxandrolone) as well as other PIEDs (e.g. Clenbuterol). Some women report the use of injectable AAS represents a change in the profile of the typical female user as it reportedly comes alongside drastic physical and psychological changes. CONCLUSIONS The unique challenges facing women who use AAS are largely isolation and stigma, with little evidence-based practice or education being available to them online or through peer-groups. Future work may consider piloting harm reduction strategies that may be co-designed with this group.
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Affiliation(s)
- Tim Piatkowski
- School of Applied Psychology, Griffith University, Gold Coast, Australia
| | - Jonathan Robertson
- Deakin Business School, Deakin University, Melbourne, VIC, Australia
- Centre for Sport Research, Deakin University, Burwood, VIC, Australia
| | - Severine Lamon
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Matthew Dunn
- Centre for Sport Research, Deakin University, Burwood, VIC, Australia.
- School of Health and Social Development/Institute for Health Transformation, Deakin University, Geelong Waterfront Campus, Locked Bag 20000, Geelong, VIC, 3220, Australia.
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Ganson KT, Hallward L, Cunningham ML, Murray SB, Nagata JM. Anabolic-Androgenic Steroid Use: Patterns of Use among a National Sample of Canadian Adolescents and Young Adults. PERFORMANCE ENHANCEMENT & HEALTH 2023; 11:100241. [PMID: 37841070 PMCID: PMC10571510 DOI: 10.1016/j.peh.2022.100241] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Background Androgenic-anabolic steroid (AAS) use is relatively common among international recreational and community samples and is associated with several deleterious side effects and health consequences that have not been studied recently among a large Canadian sample. Therefore, the purpose of this study was to assess and describe characteristics of AAS users compared to non-AAS users among a national sample of Canadian adolescents and young adults. Methods Data from 2,774 adolescents and young adults from the Canadian Study of Adolescent Health Behaviors were analyzed. Participants were recruited via social media advertisements and completed the survey online. Survey items measured sociodemographics, AAS use, AAS side effects, motives for AAS use, AAS administration, body satisfaction, other illicit substance use, mental health, and violence involvement. Results Among the overall sample, 1.6% of participants reported lifetime AAS use, with the majority of users being White, heterosexual males. Most users strived to gain weight, with main motives for AAS use including increased muscularity and strength, and improved appearance. Most AAS users were satisfied with their body compared to non-users. Approximately one in five users had AAS dependence and experienced multiple adverse side effects. Few differences between users and non-users in self-reported mental health were found. Conclusion Findings indicate that AAS use among a community sample of Canadian adolescents and young adults is an important health issue, particularly given the relatively high occurrence of AAS dependence and adverse side effects reported by users. Findings support the need for education and intervention efforts from healthcare professionals. Further investigations among Canadian AAS users may provide more insight regarding the unique supports these individuals require.
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Affiliation(s)
- Kyle T. Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Laura Hallward
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- School of Kinesiology, Western University, London, Ontario, Canada
| | | | - Stuart B. Murray
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
| | - Jason M. Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
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Cui Y, Zhang H, Wang S, Lu J, He J, Liu L, Liu W. Stimulated Parotid Saliva Is a Better Method for Depression Prediction. Biomedicines 2022; 10:biomedicines10092220. [PMID: 36140321 PMCID: PMC9496557 DOI: 10.3390/biomedicines10092220] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 02/08/2023] Open
Abstract
Background: Saliva cortisol is considered to be a biomarker of depression prediction. However, saliva collection methods can affect the saliva cortisol level. Objective: This study aims to determine the ideal saliva collection method and explore the application value of saliva cortisol in depression prediction. Methods: 30 depressed patients and 30 healthy controls were instructed to collect saliva samples in the morning with six collection methods. Simultaneous venous blood was collected. Enzyme-linked immunosorbent assay was used to determine the cortisol level. The 24-observerrated Hamilton depression rating scale (HAMD-24) was used to assess the severity of depression. Results: The significant differences in saliva cortisol levels depend on the saliva collection methods. The level of unstimulated whole saliva cortisol was most correlated with blood (r = 0.91). The stimulated parotid saliva cortisol can better predict depression. The area under the curve was 0.89. In addition, the saliva cortisol level of the depression patients was significantly higher than the healthy controls. The correlation between the cortisol level and the HAMD-24 score was highly significant. The higher the saliva cortisol level, the higher the HAMD-24 score. Conclusions: All the above findings point to an exciting opportunity for non-invasive monitoring of cortisol through saliva.
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Affiliation(s)
- Yangyang Cui
- Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
- Department of Mechanical Engineering, Tsinghua University, Beijing 100084, China
- Biomechanics and Biotechnology Lab, Research Institute of Tsinghua University in Shenzhen, Shenzhen 518057, China
| | - Hankun Zhang
- Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
- Department of Mechanical Engineering, Tsinghua University, Beijing 100084, China
- Biomechanics and Biotechnology Lab, Research Institute of Tsinghua University in Shenzhen, Shenzhen 518057, China
| | - Song Wang
- Biomechanics and Biotechnology Lab, Research Institute of Tsinghua University in Shenzhen, Shenzhen 518057, China
- Correspondence: (S.W.); (W.L.); Tel.: +86-0755-26558633 (S.W.); +86-0755-26551376 (W.L.)
| | - Junzhe Lu
- Biomechanics and Biotechnology Lab, Research Institute of Tsinghua University in Shenzhen, Shenzhen 518057, China
| | - Jinmei He
- Biomechanics and Biotechnology Lab, Research Institute of Tsinghua University in Shenzhen, Shenzhen 518057, China
| | - Lanlan Liu
- Biomechanics and Biotechnology Lab, Research Institute of Tsinghua University in Shenzhen, Shenzhen 518057, China
| | - Weiqiang Liu
- Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
- Department of Mechanical Engineering, Tsinghua University, Beijing 100084, China
- Biomechanics and Biotechnology Lab, Research Institute of Tsinghua University in Shenzhen, Shenzhen 518057, China
- Correspondence: (S.W.); (W.L.); Tel.: +86-0755-26558633 (S.W.); +86-0755-26551376 (W.L.)
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Bates G, Ralphs R, Bond VW, Boardley I, Hope V, Van Hout MC, McVeigh J. Systems mapping to understand complexity in the association between image and performance enhancing drugs (IPEDs) and harm. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 107:103801. [PMID: 35858502 DOI: 10.1016/j.drugpo.2022.103801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 07/03/2022] [Accepted: 07/08/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Effective harm reduction work is needed to prevent and respond to the harms associated with image and performance enhancing drug (IPED) use and the diverse needs of IPED communities. Methods based around understanding and mapping complex systems have previously been applied to advance thinking on a range of complex health issues. We applied a systems perspective to explore factors that contribute to IPED-related harms in the UK and to identify harm reduction priorities. METHODS An illustrative systems map was developed based on methods for mapping complex systems with expert stakeholders. Participants in two online workshops debated the important factors contributing to harm amongst people who use IPEDs and helped to refine and clarify the map. Discussions using the map reflected on where in the system intervention is needed and the policy implications. RESULTS Stakeholders (n=18) identified 51 distinct factors as being important determinants of IPEDs-related harms, and the connections between them. These were grouped under nine domains that formed this system: identity, cognitive processes, beliefs about risk and harm, health and wellbeing, social environment, beliefs about healthcare, healthcare providers, interventions, and IPED markets. Four harm reduction priorities identified through reflexive discussion included providing a wider range of interventions, improving engagement between the IPED communities and healthcare professionals, new approaches to disseminating information in the community, and early intervention. CONCLUSION Systems mapping methods are a useful approach to engage stakeholders to discuss drug use issues. A comprehensive policy response is required to this complex issue that recognises diversity in IPEDs communities, their decision-making, and their intervention and service needs, as current approaches are failing to adequately address important areas of harm. Engaging with a wide range of stakeholders is critical to generate new insights that can help respond effectively to reduce the risk of health harms.
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Affiliation(s)
- Geoff Bates
- Institute for Policy Research, University of Bath, 10 West, Claverton Down, Bath, BA2 7AY, UK.
| | - Rob Ralphs
- Department of Sociology, Manchester Metropolitan University, Geoffrey Manton Building, 4 Rosamond Street West, Manchester, M15 6LL, UK
| | - Vincent Walker Bond
- Department of Sociology, Manchester Metropolitan University, Geoffrey Manton Building, 4 Rosamond Street West, Manchester, M15 6LL, UK
| | - Ian Boardley
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Viv Hope
- Public Health Institute, Liverpool John Moores University, 3rd Floor Exchange Stations, Tithebarn Street, Liverpool, L2 2QP, UK
| | - Marie-Claire Van Hout
- Public Health Institute, Liverpool John Moores University, 3rd Floor Exchange Stations, Tithebarn Street, Liverpool, L2 2QP, UK
| | - Jim McVeigh
- Department of Sociology, Manchester Metropolitan University, Geoffrey Manton Building, 4 Rosamond Street West, Manchester, M15 6LL, UK
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Human enhancement drugs: Emerging issues and responses. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 95:103459. [PMID: 34654540 DOI: 10.1016/j.drugpo.2021.103459] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/07/2021] [Accepted: 09/07/2021] [Indexed: 01/07/2023]
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McVeigh J, Hearne E, Boardley I, Bates G, Hope V, Ralphs R, Van Hout MC. Generating evidence on the use of Image and performance enhancing drugs in the UK: results from a scoping review and expert consultation by the Anabolic Steroid UK network. Harm Reduct J 2021; 18:107. [PMID: 34657627 PMCID: PMC8522223 DOI: 10.1186/s12954-021-00550-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/23/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The use of anabolic androgenic steroids (AAS) and associated image and performance enhancing drugs (IPEDs) is now a global phenomenon. There is a need to develop evidence to support the development of interventions to prevent the commencement of use, to minimise the potential harms or to support those in their cessation of use. While the United Kingdom (UK) is no exception to this issue, its public health and legislative response to the phenomenon differs to other countries and requires the examination of research specific to the UK. Therefore, a scoping review has been conducted to examine the recent relevant literature to help inform the development and evaluation of effective interventions to reduce the harmful use of IPEDs. METHODS A comprehensive search strategy was developed for multiple bibliographic databases, supported by and iterative citation searching process and complimented by expert input from the Anabolic Steroid UK Network. Research conducted by or UK academics or within the UK were eligible, if published in the previous five years. RESULTS In total 87 eligible outputs were identified, including 26 review articles, 25 qualitative papers and 24 quantitative papers. together with small numbers of clinical studies/case reports (6) and commentaries/correspondence (6). The most common topics of research were public health, treatment and harm reduction (41), followed by studies focusing on epidemiology, sub-groups of people using IPEDs and motivations for use (34). The studies illustrated the diverse populations of people who use a range of enhancement drugs including concomitant psychoactive drug use. A number of papers focused on blood borne viruses and associated issues, while others reported on the uptake of needle and syringe programmes. No effectiveness evaluations related to any aspect of treatment, harm reduction or other intervention were published during study period. CONCLUSION There is a need for the development of effectiveness evaluations of current interventions and any future service provision for people using image and performance enhancing drugs. While there have been no studies of this nature to date, this review illustrates the rich data that has been gathered through diverse methodologies, that will assist in the development of future effectiveness evaluations.
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Affiliation(s)
- Jim McVeigh
- Substance Use & Associated Behaviours, Department of Sociology, Manchester Metropolitan University, Manchester, UK.
| | - Evelyn Hearne
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Ian Boardley
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Geoff Bates
- Institute for Policy Research, University of Bath, Bath, UK
| | - Vivian Hope
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Rob Ralphs
- Substance Use & Associated Behaviours, Department of Sociology, Manchester Metropolitan University, Manchester, UK
| | - Marie Claire Van Hout
- Faculty of Health, Public Health Institute, Liverpool John Moores University, Liverpool, UK
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Injection of Anabolic Steroids in Men Who Had Sex with Men in Madrid and Barcelona: Prevalence Correlates and Role as a Risk Factor for Transmitted Infections. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168289. [PMID: 34444038 PMCID: PMC8391652 DOI: 10.3390/ijerph18168289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/29/2021] [Accepted: 07/30/2021] [Indexed: 11/17/2022]
Abstract
This study describes the prevalence of anabolic-androgenic steroid (AAS) injection, their main correlates, and the prevalence of specific AAS injection risk behaviours among men who have sex with men (MSM), an area insufficiently addressed in scientific research. Participants were HIV-negative MSM attending four HIV/STI diagnosis services: two clinics and two community programmes in Madrid and Barcelona. Participants answered an online self-administered questionnaire. Crude and adjusted lifetime prevalence and prevalence ratios (PRs) were calculated by different factors and using Poisson regression models with robust variance. Of the 3510 participants, 6.1% (95% CI: 5.3-6.9) had injected AAS before and 3.5% (95% CI: 2.9-4.2) had done so in the last 12 months. In the multivariate analysis, AAS injection was independently associated with being over 40 years old (aPR = 3.6; 95% CI: 2.0-6.5) and being born in Latin America (aPR = 2.5; 95% CI:1.9-3.4), and was less strongly associated (aPRs of around two) with having been recruited into STI clinics, having ever been paid for sex before, injected drugs, used drugs for sex, having been diagnosed with an STI before, and having been diagnosed with HIV at the recruitment consultation. Only three participants, 1.4%, of those who had injected AAS before had shared AAS or equipment for preparation or injecting before. Conclusions: In contrast to drugs, AAS injecting behaviours do not play a relevant, direct role in the transmission of blood-borne infections among MSM. However, AAS injectors have a higher prevalence of sexual risk behaviours. These findings should be confirmed using new studies that employ other sampling procedures.
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De Vincentis S, Tartaro G, Rochira V, Santi D. HIV and Sexual Dysfunction in Men. J Clin Med 2021; 10:jcm10051088. [PMID: 33807833 PMCID: PMC7961513 DOI: 10.3390/jcm10051088] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/22/2021] [Accepted: 03/02/2021] [Indexed: 12/12/2022] Open
Abstract
Sexual issues tend to go unaddressed in human immunodeficiency virus (HIV) management, although overt sexual dysfunctions are more prevalent in people living with HIV than uninfected people. Erectile dysfunction is the most frequent sexual problem, with a prevalence of 30–50% even in men <40 years of age, but other issues such as loss of libido and ejaculatory disorders should not be overlooked. Peculiar factors related to HIV infection (e.g., fear of virus transmission, changes in body image, HIV-related comorbidities, HIV distress and stigma), alongside classical factors non-related to HIV, should be considered when approaching sexual problems in HIV patients. For this reason, the diagnostic and therapeutic workout of sexual dysfunction in the context of HIV requires a multidisciplinary approach, involving specialists in both infectious diseases and sexual medicine. This narrative review presents an overview of current knowledge on sexual dysfunction in HIV men, deepening the factors driving and taking part in these issues, providing advice for the clinical approach, and underlining the importance of caring for sexual health to improve the quality of life of HIV patients.
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Affiliation(s)
- Sara De Vincentis
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giardini 1355, 41126 Modena, Italy; (S.D.V.); (G.T.); (D.S.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
| | - Giulia Tartaro
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giardini 1355, 41126 Modena, Italy; (S.D.V.); (G.T.); (D.S.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
| | - Vincenzo Rochira
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giardini 1355, 41126 Modena, Italy; (S.D.V.); (G.T.); (D.S.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
- Correspondence: ; Tel.: +39-059-396-2453; Fax: +39-059-396-1335
| | - Daniele Santi
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giardini 1355, 41126 Modena, Italy; (S.D.V.); (G.T.); (D.S.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
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