Prevalence of, and risk factors for, HIV, hepatitis B and C infections among men who inject image and performance enhancing drugs

Prevalence of, and risk factors for, HIV, hepatitis B and C infections among men who inject image and performance enhancing drugs: a cross-sectional study / Vivian D. Hope, Jim McVeigh, Andrea Marongiu, Michael Evans-Brown, Josie Smith, Andreas Kimergård, Sara Croxford, Caryl M. Beynon, John V. Parry, Mark A. Bellis, Fortune Ncube. - (BMJ Open 3 (2013) 9 (12 September); p. 1-11)

  • PMID: 24030866
  • PMCID: PMC3773656
  • DOI: 10.1136/bmjopen-2013-003207


Objective: To describe drug use, sexual risks and the prevalence of blood-borne viral infections among men who inject image and performance enhancing drugs (IPEDs).

Design: A voluntary unlinked-anonymous cross-sectional biobehavioural survey.

Setting: 19 needle and syringe programmes across England and Wales.

Participants: 395 men who had injected IPEDs.

Results: Of the participants (median age 28 years), 36% had used IPEDs for <5 years. Anabolic steroids (86%), growth hormone (32%) and human chorionic gonadotropin (16%) were most frequently injected, with 88% injecting intramuscularly and 39% subcutaneously. Two-thirds also used IPEDs orally. Recent psychoactive drug use was common (46% cocaine, 12% amphetamine), 5% had ever injected a psychoactive drug and 9% had shared injecting equipment. 'Viagra/Cialis' was used by 7%, with 89% reporting anal/vaginal sex in the preceding year (20% had 5+ female-partners, 3% male-partners) and 13% always using condoms. Overall, 1.5% had HIV, 9% had antibodies to the hepatitis B core antigen (anti-HBc) and 5% to hepatitis C (anti-HCV). In multivariate analysis, having HIV was associated with: seeking advice from a sexual health clinic; having had an injection site abscess/wound; and having male partners. After excluding those reporting male partners or injecting psychoactive drugs, 0.8% had HIV, 8% anti-HBc and 5% anti-HCV. Only 23% reported uptake of the hepatitis B vaccine, and diagnostic testing uptake was poor (31% for HIV, 22% for hepatitis C).

Conclusions: Previous prevalence studies had not found HIV among IPED injectors. HIV prevalence in this, the largest study of blood-borne viruses among IPED injectors, was similar to that among injectors of psychoactive drugs. Findings indicate a need for targeted interventions.

Original document


Research / Study
12 September 2013
Bellis, Mark A.
Beynon, Caryl M.
Croxford, Sara
Evans-Brown, Michael
Hope, Vivian D.
Kimergård, Andreas
Marongiu, Andrea
McVeigh, Jim
Ncube, Fortune
Parry, John V.
Smith, Josie
United Kingdom
Other organisations
Aarhus Universitet (AU) - Aarhus University
European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)
Liverpool John Moores University (LJMU)
London School of Hygiene & Tropical Medicine (LSHTM)
Public Health England
Public Health Wales
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Health effects
Substance use research
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Scientific article
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Pdf file
Date generated
21 October 2020
Date of last modification
2 December 2021
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