Most of the AAS users in this study were recreational exercisers who practiced polypharmacy. The AAS users were more likely than nonusers to meet criteria for substance dependence disorder, report a diagnosis of an anxiety disorder, report recent cocaine use, and have a history of sexual abuse. The information uncovered in this study may help clinicians and researchers develop appropriate intervention strategies for AAS abuse.

Female AAS users practice polypharmacy. Female AAS users are more likely to have qualified for substance-dependence disorder, have been diagnosed with a psychiatric illness, and have a history of sexual abuse than both male AAS users and female non-AAS users.

AAS misuse is prevalent among older men and is associated with polypharmacy, more aggressive alcohol use, and a higher incidence of substance dependence and anxiety disorders compared to nonusers. This information may help clinicians and researchers identify and develop appropriate intervention strategies for AAS abuse among older men.

Data from the Anabolic 500 survey showed that almost one quarter of AAS users were dependent on these drugs. These AAS-dependent users had a higher rate of heroin use as well as anxiety and major depressive disorders compared with AAS-nondependent users. These findings can help clinicians and researchers better understand and address the potential illicit drug use and psychiatric comorbidities that may be present among AAS-dependent users.

Background and ObjectivesThe majority of anabolic androgenic steroid (AAS) studies have focused on the general male population. Approximately 15% of gay or bisexual men are seropositive for HIV and many AASs are administered via injection. Thus, AAS use among gay and bisexual men likely poses a greater risk of spreading infectious disease. Gay and bisexual men who use AAS were compared with non‐users regarding self‐reported seropositivity for HIV and hepatitis B and C, sexual behaviors and injection practices, illicit drug and alcohol use, and psychiatric disorders.MethodsThe CASTRO (Castro Anabolic Steroid Research Observation) study was a 108‐item cross‐sectional survey of 153 gay and bisexual men who exercise. Data collection occurred outside four gyms in the San Francisco Castro District.ResultsThe lifetime prevalence of AAS use among gay and bisexual men in the study was 21.6%. AAS users and non‐users did not differ in self‐reported seropositivity for HIV or hepatitis B and C, but AAS users reported higher rates of male‐male condomless anal sex in the past year (84.8 vs 60.8%, p < .01) than non‐users. More AAS users used ecstasy and methamphetamines (39.4 vs 16.7%, p < .01 and 18.2 vs 5.0%, p = .01, respectively) than non‐users.Discussion and ConclusionsGay and bisexual men who used AAS were more likely to engage in unsafe sexual behaviors and use illicit drugs relative to non‐users. Multiple factors place AAS users at higher risks for spreading infectious diseases.Scientific SignificantOur study suggests increased infectious disease risk among gay and bisexual men who use AAS. (Am J Addict 2019;XX:1–10)