{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:00:40Z","timestamp":1790308840326,"version":"4.1.0"},"reference-count":46,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Women who use performance and image\u2010enhancing drugs (PIED) face distinct health risks, yet little is known about how they engage with healthcare or seek support. This study explored how women who use PIEDs navigate healthcare, with a focus on engagement, disclosure and stigma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>An interpretative phenomenological analysis was undertaken, involving semi\u2010structured interviews with nine women with current\/historical experience of PIED use, and engagement in regular weight training. Interviews explored health monitoring, support\u2010seeking, and experiences with healthcare services and providers in the context of their PIED use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants described healthcare experiences ranging from respectful, supportive care to dismissal, judgement and clinical uncertainty. Three interrelated themes were identified: (i) participants' proactive engagement in health monitoring and healthcare to manage risks associated with PIED use; (ii) systemic barriers and knowledge gaps within healthcare, which made appropriate care difficult to access and navigate and, at times, shifted the burden of expertise onto participants within clinical encounters; and (iii) the importance of non\u2010judgemental care, with stigma and fear of judgement shaping disclosure, trust and help\u2010seeking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Conclusions<\/jats:title>\n                    <jats:p>This study provides an in\u2010depth qualitative account of how women who use PIEDs engage with and navigate healthcare. Despite strong health motivation and proactive risk management, participants often encountered structural and interpersonal barriers to care. Respectful, non\u2010judgemental interactions were central to positive healthcare engagement and sometimes more influential than clinical expertise alone. Findings highlight the need for improved professional education and gender\u2010sensitive, harm\u2010reduction\u2010oriented resources to support women who use PIEDs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dar.70227","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:51:15Z","timestamp":1786582275000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Experiences of Healthcare Support and Access Among Women Who Use Performance and Image\u2010Enhancing Drugs"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7353-1027","authenticated-orcid":false,"given":"Hannah C.","family":"Schuurs","sequence":"first","affiliation":[{"name":"School of Psychology The University of Queensland  Brisbane Australia"},{"name":"National Centre for Youth Substance Use Research The University of Queensland  Brisbane 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