Understanding Age-Based Differences in Psychosocial Harms, Physical Harms, and Access Difficulties Among an International Sample of Men Who Use Anabolic-Androgenic Steroids

<b>Background:</b> Anabolic-androgenic steroid (AAS) use is rising globally. However, age-related differences in harms and health care access barriers remain underexplored. As such, this study examined age-based differences in AAS-related harms and access to support services. <b>Methods:</b> The sample (N = 1146) comprised men who reported AAS use within the prior 12 months, stratified into 2 age groups (<40 years and ≥40 years). Chi-square analyses were conducted to examine age-related differences in physical health concerns, psychosocial issues, and barriers to health care access. UpSet plots were used to visualise co-occurrence patterns within each domain. <b>Results:</b> Younger men who use AAS were significantly more likely than older men who use AAS to report psychosocial concerns, including anger and depression (all <i>χ</i> ^<i>2</i> s > 4.0, all <i>p</i>s < .045). They also reported higher rates of physical concerns, including hair loss and fertility issues (all <i>χ</i> ^<i>2</i> s > 6.3, all <i>p</i>s < .012). Access difficulties were also more prevalent among the younger men (<i>χ</i> ^<i>2</i> s > 4.0, <i>p</i>s < .046), particularly with pharmacies and hospitals. <b>Conclusions:</b> Younger men who use AAS appear to face greater burden and complexity than older men who use AAS, underscoring the need for targeted harm reduction strategies and improved service engagement pathways tailored to peoples' age.