The Prevalence of Anabolic-Androgenic Steroid Use Among Same-Sex Attracted Men: A Systematic Literature Review and...

This review aimed to estimate the prevalence of non-medical anabolic-androgenic steroid (AAS) use among same-sex attracted men (SSM).

We conducted a systematic review of peer-reviewed articles in English, focusing on AAS use among SSM. We excluded grey literature and studies that measure AAS use through some form of analysis (e.g., hair or urine). Ten databases were searched. Titles and abstracts for all articles were screened, followed by full-text assessment and data extraction by multiple authors. The pooled overall and subgroup (gym/community-recruited SSM) lifetime and past 12-month prevalence of AAS use among SSM was obtained using a generalised linear random effects model, which was reported when heterogeneity of estimates was not high. Risk of bias was assessed using the Joanna Briggs Institute Prevalence Critical Appraisal Tool.

Nine studies met inclusion criteria. All studies were conducted in high-income countries. Overall, the pooled lifetime and past 12-month prevalences of AAS use were 13.9% (95% CI 9.2%-20.5%, 6 studies) and 8.1% (95% CI 3.9%-16.2%, 3 studies), respectively. Among the gym subgroup, the pooled lifetime and past 12-month prevalences were 15.2% (95% CI 11.6%-19.6%, I² = 72.8%, 3 studies) in the gym subgroup and 13.3% (95% CI 9.9%-17.7%, I² = 73.1%, 2 studies). The difference in lifetime prevalence between gym and community-recruited SSM was not statistically significant (p = 0.676).

The non-medical use of AAS among SSM is higher than general global estimates, with some evidence that use may be higher among gym users.