Understanding performance and image-enhancing drug (PIED) injecting to improve health and minimise hepatitis C transmission – project completed

This ARC-funded national project investigated the social practices associated with men’s use of performance and image-enhancing drugs (PIEDs) in Australia. It was the first of its kind to be undertaken in Australia. The project comprised 60 semi-structured interviews with men who inject PIEDs in Victoria, New South Wales, Queensland and Western Australia, as well as 20 interviews with relevant health professionals. The interviews explored the meanings associated with PIED injecting and the forces shaping contemporary dynamics of consumption, injecting practices, knowledge and experiences of hepatitis C transmission, the informational needs and preferences of men who inject PIEDs, and appropriate harm reduction responses to PIED injecting.

The project aimed to generate new insights into the experiences of men who consume PIEDs in order to inform more appropriate and sensitive harm reduction initiatives, engagement strategies and hepatitis C prevention resources. We also aimed to develop a balanced understanding of men’s experiences and perspectives, placing issues of blood-borne virus transmission in the context of whole lives and diverse priorities.

It also produced a dedicated publicly accessible research portal presenting comprehensively collected relevant research, media reports, health education resources, popular culture representations and consumer perspectives on PIED use. The PIEDs portal also contains the project’s final report detailing findings and recommendations for improving policy and service provision.

The project investigator team comprised:

  • Prof Suzanne Fraser, ARCSHS, La Trobe University
  • Prof David Moore, ARCSHS, La Trobe University
  • A/Prof Kate Seear, Faculty of Law, Monash University
  • Dr Campbell Aitken, Burnet Institute, Monash University
  • Kay Stanton, Your Community Health

Research staff

  • Dr Renae Fomiatti, ARCSHS, La Trobe University
  • Ms Emily Lenton, ARCSHS, La Trobe University
  • Dr J. R. Latham, ADI, Deakin University


Hart, A. (2018). Making a difference? Applying Vitellone’s Social Science of the Syringe to performance and image enhancing drug injectingInternational Journal of Drug Policy, 31, 69-73. https://doi.org/10.1016/j.drugpo.2018.03.029

Moore, D., Hart, A., Fraser, S., & Seear, K. (2019). Masculinities, practices and meanings: A critical review of recent literature on the use of performance and image-enhancing drugs among men. Health, 24(6), https://doi.org/10.1177/1363459319838595

Latham, J., Fraser, S., Fomiatti, R., Moore, D., Seear K., & Aitken, C. (2019). Men’s performance and image-enhancing drug use as self-transformation: Working out in makeover culture. Australian Feminist Studies, 34(100), 149-164.

Fomiatti, R., Fraser, S., Latham, J., Moore, D., Seear K., & Aitken, C. (2019). A ‘messenger of sex? Making testosterone matter in motivations of anabolic-androgenic steroid injecting. Health Sociology Review, 28(3), 323-338.

Fomiatti, R., Moore, D., Latham, J.R., Fraser, S., Lenton, E., Seear, K., Aitken, C. & Stanton, K. (2019). Understanding performance and image-enhancing drug injecting to improve health and minimise hepatitis C transmission: Findings and recommendations from a national qualitative project. Melbourne: The Australian Research Centre in Sex, Health and Society, La Trobe University.

Fomiatti, R., Lenton, E., Latham, J., Fraser, S., Moore, D., Seear, K. & Aitken, C. (2020). Maintaining the healthy body: Blood management and hepatitis C prevention among men who injecting performance and image-enhancing drugs. International Journal of Drug Policy, 75.

Fraser, S., Fomiatti, R., Moore, D., Seear, K., & Aitken, C. 2020). Is another relationship possible? Connoisseurship and the doctor-patient relationship for men who consume performance and image-enhancing drugs. Social Science and Medicine, 246, 112720.

Seear, K., Moore, D., Fraser, S., Fomiatti, R., & Aitken, C. (2020). Consumption in contrast: The politics of comparison in healthcare practitioners’ accounts of men who inject performance and image-enhancing drugsInternational Journal of Drug Policy85, 102883.

The research also drew on the expertise of an advisory board representing a range of sector stakeholders.

  • Geoff Munro, Australian Drug Foundation
  • Anthony Tassone, The Pharmacy Guild of Australia
  • Bill Moore (formerly of Fitness Australia)
  • Nicky Bath (formerly of ACON)
  • Stuart Loveday, Hepatitis NSW
  • Robert Kemp, Queensland Health
  • Samantha White, Hepatitis Queensland
  • Nik Alexander, Queensland Injectors Health Network
  • Elizabeth Birbilis, Department of Health and Human Services Victoria
  • Tim Duck, New South Wales Health
  • Hunter Morgan, Harm Reduction Victoria
  • Melanie Eagle and Isabelle Purcell, Hepatitis Victoria