Love Island has a lot to answer for. In the pursuit of bodily "perfection" as seen on shows like ITV2's sex-and-shouting-themed battle royale, it's becoming increasingly common for people aged 25 to 34 to inject steroids, with the UK seeing a four-fold increase in anabolic steroid use over the past year.
Among the normal risks associated with steroid use – hypertension, heart problems, mood and personality changes, among many others – there's another danger that's recently been brought starkly into view. That same age bracket – 25 to 34 – also accounts for the highest rate of new HIV diagnoses among people who inject drugs, and sharing steroid paraphernalia is a contributing factor to these rising levels.
A glimpse into any gym across the country will typically reveal a weights room heaving with thick, veiny, musclebound beasts, and it's in gym circles that this steroid culture thrives, with many users injecting in changing rooms, sharing drugs and needles with friends and training partners.
HIV positive 26-year-old James* – who didn't want to give his real name because of stigma around HIV – works out in what he calls "a generic chain family health club" in Worcester. He was first introduced to anabolic steroids during a training session with his personal trainer.
"Quite a few people still think steroids are only used by extreme bodybuilders, but it's so normal in most gyms now," he says. "Loads of us lads and ladies who train there are using synthetics to enhance the look; it's just easy and quick. Injecting anabolics has always helped me bulk quicker than taking pills or using testosterone, and same goes for the boys l train with. We would usually inject together – so sharing needles just happened."
One of the consequences of this is that the transmission of HIV is becoming a significant issue for the body beautiful. Intravenous (IV) steroid users commonly believe blood-borne disease and bacterias to be a problem only for opioid addicts. In fact, HIV has a prevalence of 1.5 percent in those who inject steroids.
HIV diagnosis is multiplying as a direct result of roiders being oblivious to the dangers of needle sharing. In 2015, 45 percent of the HIV diagnoses acquired through injecting drugs were made at a late stage of HIV infection. Those diagnosed at a later stage of contracting the virus have a ten-fold risk of dying within a year compared with those who are diagnosed earlier.
These positive carriers of HIV have probably been living with an undiagnosed infection for a significant amount of time and may have infected multiple training partners though shared use of injecting equipment, as well as sexual partners. They are considered a "grey area" for needle and syringe services around England, typically aimed at helping mainly heroin and crack addicts.
Professor Mike Kelly, Director of the NICE Centre for Public Health, commented, "Needle and syringe programmes have been a huge success story in the UK; they are credited with helping stem the AIDS epidemic in the 80s and 90s. However, we are now seeing a completely different group of people injecting drugs. They do not see themselves as 'drug addicts'. Quite the contrary, they consider themselves to be fit and healthy people who take pride in their appearance."
Gym-roider James agrees: "The boys are all healthy, they all look good. l still buy my juice off a couple of them. I don't know how l even got sick. As far as l know l'm the only one who has HIV, but then l don't ever talk to anyone about it, so l'm not sure they would neither."
David Rourke, Harm Reduction Lead for the CRI Arundel Street Project – a health charity and needle exchange in Sheffield – said: "We run a weekly clinic for steroid users, but we have people coming through the door on a daily basis, with at least seven new clients a week. We know there are many more people out there who are not using needle and syringe programmes, because this group of users do not see themselves as drug users. Traditionally they are more sexually active than users of heroin or crack, so there is more potential for the spread of infections through sex."
One of the main issues professionals are facing with regards to comprehending and calculating the rising levels of HIV in roiders is how best to capture more accurate statistics. Most data collected in the UK focuses primarily on shooting up heroin.
Yusef Azad, Director of Strategy for National Aids Trust, acknowledges that HIV transmission among steroid users is something they're looking out for. "While the prevalence of HIV in this community is low, it is higher than that in the general population," he said. "Public Health England, in response to this new trend in injecting drug use, have started to capture information on prevalence of blood-borne viruses in this community, and it is something that NAT will continue to keep an eye on."
The fact that steroid use – like any drug use – remains taboo also plays a role in the problem. James comments, "The culture of no one talking about this makes it ten times harder. l feel kind of suspicious of all my mates as well – how l got sick, who watched me share that needle. Getting a missus now feels impossible. How do you explain this?"
Behind changing room doors, so much misinformation about the benign effects of steroid use is in circulation, and dangerous habits are potentially passed on to new users and to members of their respective social circle. Personal trainer Nick Johnson has witnessed firsthand just how blasé users are to the effects and risks associated with roiding. "The social media culture that we now live in is so dominated by aesthetics unachievable for most people through natural methods," he points out. "The ends of the spectrum are now expanding – there are more idiots just jabbing D-bol [dianabol] with no prior knowledge or research of how to deal with the side effects when they withdraw or how to cycle the drug."
"I don't share needles now," says James. "But it's awkward trying to make excuses why l'm not sharing with them. I worry someone will suspect something's up. It's embarrassing. l can see how people might be too embarrassed to not share needles. It looks suspect. I nearly bottled it one time and just shared, rather than avoided. It's long, it's fucked."