“The Challenge Is That Steroids Are So Effective”: A Qualitative Study of Experts’ Views on Strategies to Prevent Men’s Use of Anabolic Steroids

Abstract

Despite persistent efforts in many countries to prevent the use of anabolic androgenic steroids (AAS) and other image and performance-enhancing drugs (IPEDs), very little is known about effective prevention strategies. This study aimed to explore experts’ views on strategies to prevent AAS use in the context of recreational strength training in gyms. The study builds on in-depth interviews with 46 researchers and practitioners from 15 countries, whose main area of expertise is IPED use, prevention and education in physical activity settings (IPED experts). Participants were asked about their views on AAS use prevention and what intervention strategies may be effective in preventing this behavior. Data were analyzed using thematic content analysis in accordance with recommendations for this technique. The findings showed that the IPED experts generally agree that some, but not all, instances of AAS use can be prevented through targeted prevention in gyms. They pointed to three key priorities for AAS use prevention in gyms: (1) make the case for drug-free training, (2) promote safe and effective ways to enhance muscularity, and (3) attempt to change the physical and social environment in the gym to make the training milieu less conducive to AAS use. Importantly, however, none of the experts were able to pinpoint any specific behavior change strategies that have proven effective.