Prevalence and risk factors for anabolic-androgenic steroid abuse in Australian high school students

Abuse of anabolic-androgenic steroids (AAS) is reportedly increasing in prevalence and spreading from sportsmen to cosmetic and recreational use, though there are few accurate estimates of the extent of AAS use outside North America. In order to identify the prevalence of, and risk factors for, 'ever' (lifetime) or 'recent' (within last month) use of AAS among Australian high school students, 13,355 students (51.3% male, median age 13.8 years) in 203 schools constituting a stratified random sample of all high schools in New South Wales and Victoria completed a self-report questionnaire about drug use. Lifetime ('ever') use of AAS was reported by 213 boys (3.2%; 95% CI, 2.7-3.6%) and 74 girls (1.2%; 95% CI, 0.9-1.5%). Factors associated with 'ever' use were truancy [odds ratio (OR) 17.7 (95% CI, 9.4-31.6) for 7 or more truant days compared with no trauncy over the last fortnight], unsupervised recreation [OR 8.4 (5.9-11.9) for 6 or more compared with 2 or fewer nights per week], speaking only a non-English language at home [OR 7.75 (4.4-13.1)], Aboriginality [OR 3.4 (2.0-5.5)], male gender [OR 2.8 (2.1-3.7)], higher student income [OR 2.3 (1.7-3.0)], overseas born [OR 2.2 (1.6-3.0)] and low level of social support [OR 2.5 (1.7-3.5)]. Use of AAS within the last month ('recent') was reported by 113 boys (1.7%; 95% CI, 1.4-2.0%) and 28 girls (0.4%; 95% CI, 0.3-0.6%) and virtually identical risk factor patterns except ORs were uniformly higher. We conclude that AAS abuse is relatively uncommon among Australian high school students but has distinctive and strong socio-economic and cultural predictors. Further studies of the behavioural epidemiology of AAS abuse are required to clarify the origins and significance of our findings and to identify potentially effective interventions.