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Making ‘safer injecting’ matter for people who inject image and performance enhancing drugs

Timothy Piatkowski Orcid Logo, Emma Kill, Sonya Weith, Steph Reeve, Luke Cox Orcid Logo, Ross Coomber, Cheneal Puljevic, Thomas O’Connor, Jason Ferris

Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine

Swansea University Author: Luke Cox Orcid Logo

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DOI (Published version): 10.1177/13634593251388294

Abstract

Image and performance-enhancing drugs (IPEDs) are primarily injected intramuscularly or subcutaneously, yet traditional harm reduction strategies, focused on blood-borne virus prevention, often overlook the specific health enhancement goals of people who use IPEDs. This study advocates for a collabo...

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Published in: Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine
ISSN: 1363-4593 1461-7196
Published: SAGE Publications 2025
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URI: https://cronfa.swan.ac.uk/Record/cronfa71532
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last_indexed 2026-04-24T04:16:13Z
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This study advocates for a collaborative approach to safer injecting practices, informed by the lived-living experiences of people injecting IPEDs, to develop targeted messaging that aligns with their unique motivations. Thirty participants who inject IPEDs were recruited through community networks and partnerships. The study used qualitative focus groups and semi-structured interviews to explore injection practices and safety strategies. Data analysis followed an inductive, line-by-line approach, identifying themes related to injection methods and safer techniques, drawing on matters-of-concern. Stigma and misinformation about IPED injection practices were prevalent, contributing to a heightened risk of infection. Participants expressed anxiety about injection site reactions and reported limited knowledge of safe techniques, with poor injecting literacy leading to risky behaviours like needle reuse and inadequate hygiene. Importantly, participants highlighted that IPED injecting knowledge is often shared through peer support networks. 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spelling 2026-04-22T16:43:20.1148402 v2 71532 2026-03-04 Making ‘safer injecting’ matter for people who inject image and performance enhancing drugs 9811ac84cad867903c385bf7086dfd2d 0000-0001-7625-4603 Luke Cox Luke Cox true false 2026-03-04 EAAS Image and performance-enhancing drugs (IPEDs) are primarily injected intramuscularly or subcutaneously, yet traditional harm reduction strategies, focused on blood-borne virus prevention, often overlook the specific health enhancement goals of people who use IPEDs. This study advocates for a collaborative approach to safer injecting practices, informed by the lived-living experiences of people injecting IPEDs, to develop targeted messaging that aligns with their unique motivations. Thirty participants who inject IPEDs were recruited through community networks and partnerships. The study used qualitative focus groups and semi-structured interviews to explore injection practices and safety strategies. Data analysis followed an inductive, line-by-line approach, identifying themes related to injection methods and safer techniques, drawing on matters-of-concern. Stigma and misinformation about IPED injection practices were prevalent, contributing to a heightened risk of infection. Participants expressed anxiety about injection site reactions and reported limited knowledge of safe techniques, with poor injecting literacy leading to risky behaviours like needle reuse and inadequate hygiene. Importantly, participants highlighted that IPED injecting knowledge is often shared through peer support networks. This research calls for reframing harm reduction to focus on health enhancement, optimising injecting techniques, and integrating evidence-based resources, empowering peer-led harm reduction to better support the health aspirations of this population. Journal Article Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine 0 SAGE Publications 1363-4593 1461-7196 anabolic-androgenic steroids; blood-borne virus; image and performance enhancing drugs; infection; injecting 8 11 2025 2025-11-08 10.1177/13634593251388294 COLLEGE NANME Engineering and Applied Sciences School COLLEGE CODE EAAS Swansea University Another institution paid the OA fee This work was partially funded by the Queensland Mental Health Commission. 2026-04-22T16:43:20.1148402 2026-03-04T12:20:58.3167212 Faculty of Science and Engineering School of Engineering and Applied Sciences - Sport and Exercise Sciences Timothy Piatkowski 0000-0002-6177-0266 1 Emma Kill 2 Sonya Weith 3 Steph Reeve 4 Luke Cox 0000-0001-7625-4603 5 Ross Coomber 6 Cheneal Puljevic 7 Thomas O’Connor 8 Jason Ferris 9 71532__36560__5b44e3c872b64f1fb2b30aa3aebe8792.pdf 71532.VoR.pdf 2026-04-22T16:40:33.9286655 Output 200195 application/pdf Version of Record true © The Author(s) 2025. This article is distributed under the terms of the Creative Commons Attribution 4.0 License. true eng https://creativecommons.org/licenses/by/4.0/
title Making ‘safer injecting’ matter for people who inject image and performance enhancing drugs
spellingShingle Making ‘safer injecting’ matter for people who inject image and performance enhancing drugs
Luke Cox
title_short Making ‘safer injecting’ matter for people who inject image and performance enhancing drugs
title_full Making ‘safer injecting’ matter for people who inject image and performance enhancing drugs
title_fullStr Making ‘safer injecting’ matter for people who inject image and performance enhancing drugs
title_full_unstemmed Making ‘safer injecting’ matter for people who inject image and performance enhancing drugs
title_sort Making ‘safer injecting’ matter for people who inject image and performance enhancing drugs
author_id_str_mv 9811ac84cad867903c385bf7086dfd2d
author_id_fullname_str_mv 9811ac84cad867903c385bf7086dfd2d_***_Luke Cox
author Luke Cox
author2 Timothy Piatkowski
Emma Kill
Sonya Weith
Steph Reeve
Luke Cox
Ross Coomber
Cheneal Puljevic
Thomas O’Connor
Jason Ferris
format Journal article
container_title Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine
container_volume 0
publishDate 2025
institution Swansea University
issn 1363-4593
1461-7196
doi_str_mv 10.1177/13634593251388294
publisher SAGE Publications
college_str Faculty of Science and Engineering
hierarchytype
hierarchy_top_id facultyofscienceandengineering
hierarchy_top_title Faculty of Science and Engineering
hierarchy_parent_id facultyofscienceandengineering
hierarchy_parent_title Faculty of Science and Engineering
department_str School of Engineering and Applied Sciences - Sport and Exercise Sciences{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Engineering and Applied Sciences - Sport and Exercise Sciences
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active_str 0
description Image and performance-enhancing drugs (IPEDs) are primarily injected intramuscularly or subcutaneously, yet traditional harm reduction strategies, focused on blood-borne virus prevention, often overlook the specific health enhancement goals of people who use IPEDs. This study advocates for a collaborative approach to safer injecting practices, informed by the lived-living experiences of people injecting IPEDs, to develop targeted messaging that aligns with their unique motivations. Thirty participants who inject IPEDs were recruited through community networks and partnerships. The study used qualitative focus groups and semi-structured interviews to explore injection practices and safety strategies. Data analysis followed an inductive, line-by-line approach, identifying themes related to injection methods and safer techniques, drawing on matters-of-concern. Stigma and misinformation about IPED injection practices were prevalent, contributing to a heightened risk of infection. Participants expressed anxiety about injection site reactions and reported limited knowledge of safe techniques, with poor injecting literacy leading to risky behaviours like needle reuse and inadequate hygiene. Importantly, participants highlighted that IPED injecting knowledge is often shared through peer support networks. This research calls for reframing harm reduction to focus on health enhancement, optimising injecting techniques, and integrating evidence-based resources, empowering peer-led harm reduction to better support the health aspirations of this population.
published_date 2025-11-08T07:56:16Z
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score 11.10461

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