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AAS use is also associated with increased aggression and violence , although it has been suggested that this association is confounded by concurrent polysubstance use (i.e., the consecutive or simultaneous use of two or more substances) [6, 8].Traditionally, AAS have mainly been used by professional athletes and bodybuilders.However, AAS use in recreational sports is increasing, and prevalence rates among recreational sportspeople are now believed to have surpassed rates among professional athletes , making this a public health problem.
Prevalence rates are, however, uncertain due to problems with the reliability and validity of measurements .
Long-term use of AAS is associated with physical and mental health problems, including hepatic disease, cardiovascular complications, gynecomastia among men, virilization among women, and mood disorders [4–6].
Anabolic androgenic steroids (AAS) are a class of hormones that can be used to enhance athletic performance and stimulate muscle growth.
AAS are classified as illegal or controlled substances in many countries, yet their use has increased during recent years, particularly among non-competitive recreational athletes [1, 2].
Consequently, it has been proposed that AAS prevention efforts should also focus on the role of polysubstance use .
The use of nutritional supplements is widespread among AAS users [16–19], as such supplements are suggested to improve muscle growth, increase alertness, boost metabolism, and decrease weight or body fat.
The project consists of two studies: Study A will examine the prevalence of AAS use and the effectiveness of 100% PHT (aims 1 and 2), and data for Study A will be collected using questionnaires distributed to gym attendees at two assessment points: baseline (pre-intervention) and follow-up (post-intervention).
Study B will evaluate the implementation of 100% PHT (aim 3), and semi-structured interviews with participating stakeholders will be carried out post-intervention.
Results are also expected to yield information on the prevalence of AAS use as well as associations between the use of AAS and other licit and illicit substances, including nutritional supplements, among recreational sportspeople.
The study was registered retrospectively at (Identifier: ISRCTN11655041; Registration date: 3 November 2016;).