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

Background 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. ‘ Hi-fun’ 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 aimed to develop, informed by transnational queer sociology, a locally grounded definition of hi-fun compared to other SDU types among GBMSM in Thailand. Methods To delineate SDU types and explore structural and social influences on how hi-fun 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. Results Participants (n=30) were aged 25-47 years, 25 gay, ten with HIV, seven born outside Thailand. Most (n=23) used crystal methamphetamine ( ice ) 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: hi-fun , sex at homepas and incidental sex with drugs. Hi-fun was delineated from other SDU types based on participant motivations to increase wellbeing through pleasure and intimacy, in contrast to homepas and incidental sex with drugs which were linked more to socialising. Crystal methamphetamine ( ice ) was considered foundational to hi-fun , whereas other drugs (e.g. cocaine, ecstasy/MDMA, ketamine and GHB/GBL) were more common in homepas and incidental sex with drugs. Technology, especially geolocation social/sexual networking apps, were central to hi-fun organisation, but potentially less important for other SDU types. Both hi-fun and homepas primarily took place in private settings, whereas incidental sex with drugs happened in a wider range of venues. Conclusions Hi-fun in Thailand can be defined as the intentional combination of sex and crystal methamphetamine ( ice ) 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.