Contemporary Health Monitoring and Promoting Behaviors Among Consumers of Anabolic-Androgenic Steroids

Aims: The aim of the study was to explore how people who use anabolic-androgenic steroids (AAS) self-monitor their health and navigate barriers related to stigma, legality, and access to care. Design: A qualitative exploratory study using a critical health promotion framework to understand the self-directed health monitoring practices of AAS consumers. Methods: Semi-structured interviews were conducted with 25 current AAS consumers in Australia ( M age = 35.9 years; 20 men, 5 women). Data were analyzed inductively using thematic analysis. Themes were developed through reflexive and collaborative coding between researchers with lived and professional experience in AAS-related harm reduction. Results: Participants described proactive and structured health monitoring practices—regular blood testing, cardiovascular checks, and blood pressure monitoring—as key to “responsible use.” However, stigma from healthcare professionals, financial burden, and fear of legal consequences created substantial barriers to care. Many participants sought alternative, nonjudgmental services or private testing to maintain health surveillance. Despite limited support, participants demonstrated strong health literacy, self-efficacy, and motivation to reduce harm. Conclusion: AAS consumers actively engage in self-directed health monitoring but face systemic exclusion from mainstream healthcare. These findings underscore the need for inclusive, non-judgmental, and collaborative models of care. Nurses in addiction, community, and primary healthcare settings are ideally placed to bridge this gap through harm-reduction-focused, person-centered practice that acknowledges client expertise, and promotes safer engagement with health services.