One in 10 men who inject themselves with anabolic steroids or tanning drugs have been exposed to HIV, hepatitis B or hepatitis C, according to a study released today.
Public Health England (PHE) said the research was vital because while the number of those who use image and performance-enhancing drugs has rapidly grown over the past 20 years, their risk of exposure to such viruses has not been thoroughly investigated.
Co-author Jim McVeigh, from the Centre for Public Health at Liverpool John Moores University, said: "Injectors of anabolic steroids and associated drugs are now the biggest client group at many needle and syringe programmes in the UK.
"This research shows that anyone who injects drugs is at risk of HIV and other blood-borne viruses, regardless of their substance of choice."
Lead author of the report Dr Vivian Hope, PHE's 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."
Researchers from PHE and Liverpool John Moores University questioned 395 men who use such drugs for the study, published in BMJ Open today.
They found one in 18 injectors had been exposed to hepatitis C, one in 11 had been exposed to hepatitis B and one in 65 have HIV.
Overall, one in 10 had been exposed to one or more of the blood-borne viruses.
The survey also looked at the lifestyle of those surveyed and found that only 20% said they had always used a condom when having sex in the previous year.
Dr. Fortune Ncube, consultant epidemiologist and the PHE's lead on injecting drug use, said: "These findings suggest serious health implications for users of image and performance-enhancing drugs, but also for their sexual partners and ultimately the wider community.
"These findings suggest we must maintain and strengthen public health interventions focused on reducing injection-related risk behaviours to prevent HIV and hepatitis infections in this group.
"This includes ensuring those providing voluntary confidential testing services and care related to HIV and hepatitis are alert to the risks associated with image and performance-enhancing drug use."
The National Aids Trust (NAT) said those using performance or image-enhancing drugs needed to know the risks that came with injecting them.
Yusef Azad, drector of policy and campaigns at the NAT, said: "People who inject steroids and tanning drugs often don't understand safe injecting practices and aren't being targeted by harm reduction messages in the way traditional drug injectors such as heroin users are - and this poses a serious risk of HIV.
"In fact our research has found only 45% of the general public know HIV can be transmitted through sharing injecting equipment.
"If newer communities are starting to inject drugs, then there is an urgent task to ensure health promotion and harm reduction messages reach them.
"NAT has written to all local authorities in the UK bringing this issue to their attention and calling on them to find innovative ways to inform these groups of the risks of blood-borne viruses. We hope they rise to this challenge."