Factors Associated With Anabolic Steroids Use in Bodybuilding Athletes Based on the Theory of Planned Behavior

Background: Athletes’ use of androgenic-anabolic steroids (AASs) is a significant health problem. This study aimed to determine factors associated with AAS in male bodybuilders by applying the theory of planned behavior (TPB). Methods: Using a multistage random sampling procedure, this descriptive-analytical cross-sectional study was performed on 429 athletes participating in gyms in Qom, Iran, in 2019. The data collection tool was a questionnaire, including demographic information and questions related to TPB constructs. Data were analyzed by descriptive statistics, Chi-square test, logistic regression, and linear regression using SPSS software, version 16. Results: The results demonstrated that 188 (48.2%) athletes had a history of AAS use. The attitude (β = 0.39), subjective norm (β = 0.26), and perceived behavioral control (β = -0.36) predicted 38% of the variance of intention to AAS use. Further, behavioral intention was the statistically significant predictor of AAS use among the studied athletes (OR = 0.83, 95% CI: 0.78-0.87). Variables such as having friends (OR = 2.06, 95% CI: 1.28-3.30) or a sports coach using AAS (OR = 3.1, 95% CI: 1.58-6.42) and having a history of supplementation use (OR = 5.8, 95% CI: 2.65-12.8), along with age (OR = 4.3, 95% CI: 0.35-53.6) had a significantly predictive role in using AAS. Conclusion: The findings revealed that nearly half of the studied athletes had a history of using AAS and supplements. TPB is applicable to identify the determinants of beliefs, intention, and behavior to use AAS among athletes. These findings can be useful in designing appropriate programs to prevent AAS use.