Multiple risks are associated with early use of anabolic androgenic steroids, yet public understanding is limited and teen use not uncommon. The present study surveyed 4,231 high school students to understand prevalence of use, association with athletics and other substance use and expectations of drug effects. While overall rates of steroid use were low (1.4 percent), use was higher in males and those participating in at least one school sport. Half (49 percent) of the high school students believed that steroids improved athletic performance and 38 percent reported that use improves appearance. Recreational drug use and frequency of drug use increased risk for steroid use. (Published Abstract)