Gender, Peer Networks, and Image and Performance Enhancing Drugs

"Among men who use AAS, research has found that a group identity emerges as a result of the common interests, which centre on training, diet, and the co-occurring substance use [8, 10, 56]. Specifically, there is a level of peer-led education and harm reduction occurring within these peer networks—a ‘safe space’ dynamic [36]. These peer networks extend into online forums [57] and may be partly due to the lack of appropriate harm reduction responses and frameworks available for this group. For example, previous research demonstrates that women searching for advice and the experiences of other women regarding AAS use must navigate male contributions on internet forums [58]. For women who use AAS, our data indicate that a harm reduction dynamic does not exist presently. Females who choose to use these drugs are more secretive, and this likely has links to increased stigma as indicated by some participants. Despite the recognised health complications, these findings are indicative of barriers to meeting women’s needs for accurate information about health risks among women who use AAS, as is evidence by research with women who use and inject substances more broadly [38, 59]. More research is required to understand how these challenges are experienced and navigated by AAS-using women to inform gendered approaches to harm reduction. Future research should attempt to explore how to integrate peer-led approaches and harm reduction frameworks more effectively among women using AAS."