New study: Understanding performance and image-enhancing drug injecting

A team of researchers led by SSAC’s Professor Suzanne Fraser has begun work on a new project investigating performance and image-enhancing drug injecting among Australian men.  Entitled ‘Understanding performance and image enhancing drug (PIED) injecting to improve health and minimise hepatitis C transmission’, the project is funded by the Australian Research Council, and coordinated by research associate Dr Aaron Hart.

Aaron Hart

Dr Aaron Hart: research associate

The project will begin with the formation of an advisory panel of peer advocates, healthcare workers and service providers. Aaron will then begin work developing the materials needed to conduct interviews and, later this year, commence recruitment.

Traditionally the domain of elite athletes and recreational bodybuilders, PIED use is now extending to other groups, including adolescents, gym attendees, working professionals and students, with the vast majority of those who use PIEDs being men. Research on PIED use is extremely limited, but the work that has been done suggests they are used for enhancing physical appearance, optimising athletic performance and improving mental and physical functioning for personal and occupational reasons. Yet PIED use carries a range of health risks and, because it often involves injecting, and the possibility of blood-borne virus (BBV) transmission, especially hepatitis C. Australia’s existing harm reduction framework does not presently deal with this emerging trend, and is significantly underprepared to meet the unique challenges that it poses. This qualitative project aims to:

  1. Explore the meanings given to PIED injecting in Australia, and the individual and social factors shaping the dynamics of use
  2. Explore knowledge and experiences of hepatitis C transmission among people who inject PIEDs;
  3. Investigate the specific practices of PIED injecting among different subgroups;
  4. Investigate the informational needs and preferences of people who inject PIEDs to inform health and safer injecting advice; and
  5. Examine the experiences of relevant practitioners, including their views on appropriate harm reduction responses to new and emergent patterns of PIED injecting in Australia.

The project aims to develop new knowledge about the meanings and practices of PIED injecting. It also aims to develop opportunities for health education and targeted recommendations for PIED-related hepatitis C prevention education and other health information. These insights will build the capacity of the Australian health workforce to respond to PIED use. The project will also construct a publicly accessible research website offering project findings, other relevant research, opportunities to comment on PIED use, and links to policy and treatment services.

As Suzanne explains,

The growing incidence of anabolic-androgenic steroid and other PIED use is associated with an increasing cultural emphasis on the ‘fitness’ and muscularity of male bodies. Because of these associations, PIED use confounds many of the existing concepts underpinning public health responses to the injection practices of illicit drug users. Our job is to learn from people who use PIEDs to understand the meanings of their use, to gather perspectives from health professionals, and to develop proposals for possible harm reduction approaches.

The project team comprises:

Chief investigators

  • Professor Suzanne Fraser (NDRI, Curtin University)
  • Dr Kate Seear (Springvale Monash Legal Service, and Faculty of Law, Monash University)
  • Professor David Moore, (NDRI, Curtin University)

Partner investigators

  • Dr Campbell Aitken, Burnet Institute
  • Kaye Stanton, Darebin Community Health Service

Research associate: Dr Aaron Hart