Hi-fun, homepas and incidental sex with drugs: a qualitative study developing a locally grounded definition of hi-fun (chemsex) compared to other sexualised drug use types practiced by gay, bisexual and other men who have sex with men in Thailand
Abstract
<title>Abstract</title> <p> <bold>Background</bold> Gay, bisexual and other men-who-have-sex-with-men’s (GBMSM) sexualised drug use (SDU), defined as taking psychoactive drugs before or during sex, is the focus of public health concern globally. ‘ <italic>Hi-fun’</italic> in Thailand (similar to the practice of ‘chemsex’ in Western settings) is a subset of SDU. Much harm reduction programming relies on Western chemsex definitions, obscuring critical variation related to local cultures, drug markets and legislative contexts. We <bold>aimed</bold> to develop, informed by transnational queer sociology, a locally grounded definition of <italic>hi-fun</italic> compared to other SDU types among GBMSM in Thailand. <bold>Methods</bold> To delineate SDU types and explore structural and social influences on how <italic>hi-fun</italic> is practiced and organised, focus groups and in-depth interviews (April-Sept 2024) were conducted with GBMSM (with SDU experience within 12-months) recruited from community organisations in Bangkok, Khon Kaen and Pattaya. Data were transcribed, translated and analysed with a thematic framework. <bold>Results</bold> Participants (n=30) were aged 25-47 years, 25 gay, ten with HIV, seven born outside Thailand. Most (n=23) used crystal methamphetamine ( <italic>ice</italic> ) before/during sex in preceding 12-months, with fewer taking other drugs (ecstasy/MDMA=14, ketamine=12, cocaine=10, GHB/GBL=5). Participants’ accounts coalesced around three main SDU types: <italic>hi-fun</italic> , sex at <italic>homepas</italic> and incidental sex with drugs. <italic>Hi-fun</italic> was delineated from other SDU types based on participant motivations to increase wellbeing through pleasure and intimacy, in contrast to <italic>homepas</italic> and incidental sex with drugs which were linked more to socialising. Crystal methamphetamine ( <italic>ice</italic> ) was considered foundational to <italic>hi-fun</italic> , whereas other drugs (e.g. cocaine, ecstasy/MDMA, ketamine and GHB/GBL) were more common in <italic>homepas</italic> and incidental sex with drugs. Technology, especially geolocation social/sexual networking apps, were central to <italic>hi-fun</italic> organisation, but potentially less important for other SDU types. Both <italic>hi-fun</italic> and <italic>homepas</italic> primarily took place in private settings, whereas incidental sex with drugs happened in a wider range of venues. <bold>Conclusions</bold> <italic>Hi-fun</italic> in Thailand can be defined as the intentional combination of sex and crystal methamphetamine ( <italic>ice</italic> ) to enhance intimacy and pleasure with one or more other man/men, facilitated by technology and usually in a private setting. This definition will be useful for those supporting GBMSM in Thailand through policy, research and service provision. </p>
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