title: Polypharmacy, Infectious Diseases, Sexual Behavior, and Psychophysical Health Among Anabolic Steroid-Using Homosexual and Heterosexual Gym Patrons in San Francisco's Castro District.
abstract: Limited studies based in England and Australia reported misuse of anabolic-androgenic steroids (AAS) among homosexual men to enhance body image. Anecdotally, AAS are also being misused by homosexual men in the United States. Since many AAS and certain performance enhancing drugs (PEDs) are administered via injection, this poses a potential vector for the spread of infectious disease in an already at-risk population.
  
  
  
  This study compared and contrasted homosexual and heterosexual male gym clients regarding use of AAS and PEDs, use of alcohol and illicit drugs, seroprevalence of infectious disease, engagement in risky injection practices and sexual behaviors, and presence of psychiatric conditions.
  
  
  
  Recruitment and data collection occurred outside four exercise gyms in the San Francisco Castro District area between October 25, 2014 and March 10, 2015. Two hundred and twenty homosexual men and 73 heterosexual men completed the 114-item cross-sectional survey.
  
  
  
  Ten percent of homosexual men reported lifetime AAS use. Homosexual men had almost four times more sexual partners and were over 14 times more likely to knowingly have unprotected intercourse with a known HIV positive person than heterosexual men. In addition, a quarter of homosexual men who injected drugs admitted to sharing used syringes or needles with another person. Conclusions/Importance: The current study is the first to confirm AAS use among homosexual men in the United States. Homosexual men partook in high-risk sexual behaviors and injection practices which may place them at greater risks for contracting and spreading HIV and other infectious diseases.
authors.affiliation: a Department of Clinical Sciences , Touro University California , Vallejo , California , USA.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Ip
authors.affiliation: a Department of Clinical Sciences , Touro University California , Vallejo , California , USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Yadao
authors.affiliation: b Department of Social , Behavioral, and Administrative Sciences, Touro University California , Vallejo , California , USA.
authors.forename: Bijal M
authors.initials: BM
authors.lastname: Shah
authors.affiliation: a Department of Clinical Sciences , Touro University California , Vallejo , California , USA.
authors.forename: Shadi
authors.initials: S
authors.lastname: Doroudgar
authors.affiliation: a Department of Clinical Sciences , Touro University California , Vallejo , California , USA.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Perry
authors.affiliation: a Department of Clinical Sciences , Touro University California , Vallejo , California , USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Tenerowicz
authors.affiliation: a Department of Clinical Sciences , Touro University California , Vallejo , California , USA.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Newsom
authors.affiliation: a Department of Clinical Sciences , Touro University California , Vallejo , California , USA.
authors.forename: Amber A
authors.initials: AA
authors.lastname: Mann
authors.affiliation: a Department of Clinical Sciences , Touro University California , Vallejo , California , USA.
authors.forename: Hermine
authors.initials: H
authors.lastname: Mkrtchyan
authors.affiliation: c Biological Psychiatry Laboratory , McLean Hospital , Belmont , Massachusetts , USA.|d Harvard Medical School , Boston , Massachusetts , USA.
authors.forename: Harrison G
authors.initials: HG
authors.lastname: Pope
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D003141:Communicable Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D020010:Heterosexuality / Q000523:psychology*; D006801:Humans; D008297:Male; D016485:Needle Sharing / Q000706:statistics & numerical data; D058573:Performance-Enhancing Substances / Q000008:administration & dosage*; D019338:Polypharmacy; D012309:Risk-Taking; D012495:San Francisco / Q000453:epidemiology; D012651:Self Medication; D016036:Seroepidemiologic Studies; D012725:Sexual Behavior / Q000523:psychology*; D000072339:Sexual and Gender Minorities / Q000523:psychology*; D019966:Substance-Related Disorders / Q000453:epidemiology; D045165:Testosterone Congeners / Q000008:administration & dosage*; D047568:Unsafe Sex / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D058573:Performance-Enhancing Substances; D045165:Testosterone Congeners
keywords: Anabolic steroids; HIV; infectious disease; injecting risk; sexual behavior