To the Editor.

In their article “Anabolic Steroid Use by Male and Female Middle School Students,” Faigenbaum et al indicate that 2.7% of middle school students (grades 5 through 7) report anabolic steroid use. Anabolic-androgenic steroids (AS) can be administered orally or intramuscularly; the latter is the route of administration for 50% of AS users. It has been indicated previously that 25% of students who report AS use share needles for injection. Therefore, this young and relatively uneducated AS user group is potentially at risk for infections related to injection. We conducted a MEDLINE (1966–1998) and AIDSLINE (1980–1998) world literature review to examine references that attributed infections to AS injection.

We found infections attributable to the multi-person use of needles and syringes and improper injection techniques in 11 individuals. None of these cases were among children or younger adolescents. The mean age of these individuals was 25...

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