Investigating the Legitimacy of Anabolic-Androgenic Steroids in Australia's Unregulated Market Using Community...

Unregulated anabolic-androgenic steroid (AAS) markets present major health risks due to frequent mislabelling and contamination, especially among oral compounds as compared to injectable compounds. Despite growing harm reduction interest, AAS checking remains rare. This study aimed to (1) describe Australia's unregulated AAS market using community-submitted reports, and (2) compare oral and injectable compounds to identify differences in product legitimacy.

We analysed 2068 AAS testing reports submitted to PEDTest, Australia's only reagent-based AAS checking service, from 2022 to 2024. Participants used community-distributed test kits to assess the presence of AAS in oral or injectable compounds and reported results to the PEDTest database. Each sample was categorised as confirmed, swapped, bunk (no active ingredients), or inconclusive. Chi-square tests examined associations between formulation type (oral vs injectable) and legitimacy outcomes.

Overall, community-submitted results identified that products were predominantly legitimate (68.8%), swapped (12.9%), inconclusive (11.4%), and a smaller proportion were bunk (7.0%). Oral compounds were significantly more likely to be bunk (10.3%) compared to injectable products (5.6%), while injectable products had a higher chance to be confirmed as legitimate (70.2%) than oral compounds (65.3%). These patterns were supported by a significant overall association between formulation type and legitimacy outcome, χ²(3) = 21.29, p < .001.

Oral AAS are reportedly more prone to quality issues than injectable compounds, with elevated rates of results indicating no active compound presence. These findings underscore the importance of responding to unregulated AAS markets with programmes to empower objective data-driven decision-making among people who use AAS.