{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T14:58:00Z","timestamp":1792853880617,"version":"4.5.0"},"reference-count":32,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2009,5,29]],"date-time":"2009-05-29T00:00:00Z","timestamp":1243555200000},"content-version":"vor","delay-in-days":209,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2008,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Introduction and Aims<\/jats:bold>. Performance\u2010 and image\u2010enhancing drugs have the potential to be a significant public health issue. Detailed data on PIEDs injection are difficult to obtain because of the illicit and unsupervised way in which many PIEDs are used, and the hidden nature of the group. Our study examines the patterns of use, risk behaviours and related harm associated with PIEDs injection. We also report the ways in which PIEDs users currently seek injecting equipment and harm\u2010reduction advice. <jats:bold>Design and Method<\/jats:bold>. Data were obtained via a structured questionnaire administered in face\u2010to\u2010face interviews with 60 men who used PIEDs (primarily anabolic androgenic steroids) for non\u2010medical purposes. <jats:bold>Results<\/jats:bold>. Although the rates of needle sharing were low (5%), the men more frequently reported re\u2010use of needles\/equipment, injecting from a shared container (bladders, vials, etc.), injecting other illicit drugs, injecting insulin and targeting small muscle groups. Self\u2010reports of being hepatitis C antibody positive were associated with lifetime use of heroin and injection of other illicit drugs. All HIV positive participants were gay\/bisexual men. Participants reported a range of other injection\u2010related injuries and diseases such as fevers, scarring and abscesses. \u2018Risky\u2019 injectors (38% of participants) were more likely to initiate PIEDs use at a younger age, use PIEDs in a larger number of cycles per year and report involvement in a violent\/aggressive incident than \u2018low risk\u2019 injectors and report involvement in a violent\/aggressive incident than \u2018low risk\u2019 injectors. Participants mainly reported seeking information about PIEDs from internet sites (62%) and friends (55%). <jats:bold>Conclusions<\/jats:bold>. An over\u2010reliance on personal networks and internet forums limits this groups' access to objective harm reduction advice and primary care services. Targeted, PIEDs\u2010specific interventions are needed.<\/jats:p>","DOI":"10.1080\/09595230802392568","type":"journal-article","created":{"date-parts":[[2008,9,30]],"date-time":"2008-09-30T03:05:22Z","timestamp":1222743922000},"page":"679-686","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":93,"title":["Injecting risk behaviour and related harm among men who use performance\u2010 and image\u2010enhancing 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