Background: The non-medical use of Anabolic Androgenic Steroid (AAS) use is increasing worldwide. The internet has been identified as a key catalyst for this by providing an accessible consumer market and virtual support and information networks. The internet as a risk environment for AAS use has yet to be adequately explored and characterized.
Aim: To unobtrusively analyze AAS users’ virtual peer interactions in order to understand and characterize the internet as a risk environment for this form of substance use.
Methods: Thematic and content analysis of 192 threads containing 1906 posts from June 2014 was conducted from two popular UK based AAS internet fora.
Findings: Four themes emerged during analysis: (1) Virtual ethnopharmacology (VEP) (2) Adverse effects (3) Harm reduction strategies (4) High risk behaviour. The first theme explored the characteristics of VEP including Individualised consultations and an extensive formulary. The second theme identified significant anxieties with adverse effects and different meanings these adverse effects had for users and for interactions with health professionals. The third and fourth themes provided insights into information exchanges which both increased and ameliorated harms.
Conclusions: The internet normalizes AAS use on a large scale in excess of that of the non-virtual fitness environment. The findings show the value in unobtrusive investigation of AAS internet fora to identify trends in AAS selection, variations in risk perceptions and hidden risk behaviours not previously identified by conventional research methods. Internet fora allows insight into groups less accessible by alternative means such as oral steroid and prospective users. While the online environment disseminates harm reducing information, it also proliferates high risk practices as users publish their experiences with self-experimentation.