OBJECTIVES:

We compared the lifetime prevalence of anabolic-androgenic steroid (AAS) misuse among sexual minority versus heterosexual US adolescent boys, and secondarily, sought to explore possible intermediate variables that may explain prevalence differences.

METHODS:

Participants were 17 250 adolescent boys taken from a pooled data set of the 14 jurisdictions from the 2005 and 2007 Youth Risk Behavior Surveys that assessed sexual orientation. Data were analyzed for overall prevalence of AAS misuse and possible intermediary risk factors.

RESULTS:

Sexual minority adolescent boys were at an increased odds of 5.8 (95% confidence interval 4.1–8.2) to report a lifetime prevalence of AAS (21% vs 4%) compared with their heterosexual counterparts, P < .001. Exploratory analyses suggested that increased depressive symptoms/suicidality, victimization, and substance use contributed to this disparity.

CONCLUSIONS:

This is the first known study to test and find substantial health disparities in the prevalence of AAS misuse as a function of sexual orientation. Prevention and intervention efforts are needed for sexual minority adolescent boys.

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