Men who inject anabolic steroids and tanning drugs are at higher risk of HIV and viral hepatitis, according to a landmark study from Public Health England (PHE) published in BMJ Open on Friday.

The use of image and performance enhancing drugs has grown substantially over the last twenty years, but the risk of exposure to blood borne viruses among those who inject drugs to change their body appearance or improve their performance has rarely been studied.

Researchers from PHE and Liverpool John Moores University surveyed 395 men using image and performance enhancing drugs and found:

• 1 in 18 injectors have been exposed to hepatitis C

• 1 in 11 have ever been exposed to hepatitis B

• 1 in 65 have HIV

Overall 1 in 10 had been exposed to one or more of HIV, hepatitis B, or hepatitis C, suggesting that the transmission of blood borne viruses is common in this group. These infections can result from unsafe drug injecting practises or unprotected sex.

Lead author Dr Vivian Hope, a PHE expert in infections among people who inject drugs, said: "Our study suggests that levels of HIV and hepatitis infection among men using image and performance enhancing drugs have increased since the 1990s. While we must be cautious in generalising these early findings, they are concerning and show that further research is required.

"Use of psychoactive drugs like cocaine (46% had snorted cocaine, and 12% snorted or swallowed amphetamines) was also high among this population, along with sexual risk behaviours - only 20% of those having sex in the preceding year reported always used a condom."

(CD)