Steroids, Stigma, and Health: A Medical Anthropological Analysis of Anabolic Use in a Brazilian Bodybuilding Community

Anabolic-androgenic steroids (AAS) are widely used in bodybuilding communities despite well-documented health risks. While previous studies have addressed AAS prevalence and physiological effects, few have examined how stigma and behavioral bias influence usage and acquisition patterns. This exploratory study applies Ajzen’s Theory of Planned Behavior, Bronfenbrenner’s Ecological Systems Theory, and Goffman’s stigma theory to analyze the sociocultural mechanisms shaping AAS use in a hard-to-reach community. A cross-sectional survey was conducted with 68 high-performance gym-goers at a private training center in Brazil, assessing prevalence, acquisition sources, risk perception, and social profile. Descriptive statistics were used alongside behavioral modeling theories to interpret user responses. Results reveal complex social factors, including physician-sourced supply despite simultaneously expressing distrust toward medical professionals when it comes to disclosure. These findings suggest a need for public health interventions that address stigma-related rationalizations, not only deterrence. The study highlights the importance of integrating anthropological and behavioral science into the epidemiology of AAS abuse. Traditional medical approaches often focus on physiological risks while neglecting the dynamics between macro and micro environments and social influences driving use. This work calls for holistic, evidence-based strategies and anthropologically informed public health initiatives that engage with the lived realities of stigmatized health practices.