Living hi: GBMSM narratives of pleasure, risk, and everyday hi-fun (chemsex) navigation in Thailand
8 affiliations
- 1Institute for Global Health, University College London, London, United Kingdom
- 2Mahidol Center for Health, Behavior and Society, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- 3Asia Pacific Network of People Living with HIV/AIDS, Bangkok, Thailand
- 4International Drug Policy Consortium, Bangkok, Thailand
- 5Institute of HIV Research and Innovation, Bangkok, Thailand
- 6Service Workers in Group Foundation (SWING), Bangkok, Thailand
- 7Ozone Foundation, Bangkok, Thailand
- 8Australian Research Centre in Sex, Health and Society, La Trobe University Melbourne, Victoria, Australia
Abstract
Hi-fun among gay, bisexual and other men who have sex with men (GBMSM) is practiced across Southeast Asia. Yet research remains focused on epidemiological trends and health risks, with limited qualitative work capturing lived experiences, motivations and support needs. These gaps are pronounced in Thailand, where social, legal and cultural structures emphasise control and enforced abstinence over harm reduction and holistic support. This study aims to explore the experiences and perspectives of GBMSM who engage in hi-fun and other types of sexualised drug use, including their strengths and challenges. It seeks to identify the types of support they desire to contribute to the development of harm reduction strategies grounded in the everyday contexts of GBMSM communities in Thailand. This qualitative study drew on five focus group discussions (FGDs) and six in-depth interviews (IDIs) with 30 Thai and non-Thai GBMSM in Bangkok, Khon Kaen and Pattaya. Discussions explored the contexts, experiences, strengths, challenges and support needs related to hi-fun. Thematic analysis was conducted, and findings were reviewed with a community advisory board and partner NGOs. Participants described hi-fun as a distinct world enabling self-expression, pleasure, intimacy and a sense of being valued and accepted beyond what everyday life affords. This world was shaped through equipment preparation, participant screening and unwritten rules promoting trust and safety. Hi-fun offered emotional and social benefits, including connection and belonging. However, participants also reported risks, including mental health challenges, dependence, sexual performance difficulties, violence, non-consensual recording, financial strain and legal consequences. Hi-fun became problematic when individuals lost control, encountered police, were forced into mandatory rehabilitation, experienced health decline or struggled with daily functioning. Participants emphasised the need for sterile equipment, post-use care, accurate information, stigma-free environments and legal reforms aligned with lived realities. Supporting GBMSM engaged in hi-fun in Thailand requires moving beyond abstinence-focused approaches toward flexible harm reduction and structural reforms that uphold dignity, safety and equity.
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BibTeX
@article{waratworawan2026living,
title = {{Living hi: GBMSM narratives of pleasure, risk, and everyday hi-fun (chemsex) navigation in Thailand}},
author = {Worawalan Waratworawan and Nattharat Samoh and Alison J. Rodger and Harry Prabowo and Gloria Lai and Nittaya Phanuphak and Siripong Srichau and Verapun Ngamee and Adam Bourne and Thomas E. Guadamuz and T. Charles Witzel},
journal = {PLOS Global Public Health},
year = {2026},
month = nov,
doi = {10.1371/journal.pgph.0007177},
url = {https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0007177},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Living hi: GBMSM narratives of pleasure, risk, and everyday hi-fun (chemsex) navigation in Thailand
AU - Worawalan Waratworawan
AU - Nattharat Samoh
AU - Alison J. Rodger
AU - Harry Prabowo
AU - Gloria Lai
AU - Nittaya Phanuphak
AU - Siripong Srichau
AU - Verapun Ngamee
AU - Adam Bourne
AU - Thomas E. Guadamuz
AU - T. Charles Witzel
PY - 2026
DA - 2026/11/03
JO - PLOS Global Public Health
DO - 10.1371/journal.pgph.0007177
UR - https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0007177
AB - Hi-fun among gay, bisexual and other men who have sex with men (GBMSM) is practiced across Southeast Asia. Yet research remains focused on epidemiological trends and health risks, with limited qualitative work capturing lived experiences, motivations and support needs. These gaps are pronounced in Thailand, where social, legal and cultural structures emphasise control and enforced abstinence over harm reduction and holistic support. This study aims to explore the experiences and perspectives of GBMSM who engage in hi-fun and other types of sexualised drug use, including their strengths and challenges. It seeks to identify the types of support they desire to contribute to the development of harm reduction strategies grounded in the everyday contexts of GBMSM communities in Thailand. This qualitative study drew on five focus group discussions (FGDs) and six in-depth interviews (IDIs) with 30 Thai and non-Thai GBMSM in Bangkok, Khon Kaen and Pattaya. Discussions explored the contexts, experiences, strengths, challenges and support needs related to hi-fun. Thematic analysis was conducted, and findings were reviewed with a community advisory board and partner NGOs. Participants described hi-fun as a distinct world enabling self-expression, pleasure, intimacy and a sense of being valued and accepted beyond what everyday life affords. This world was shaped through equipment preparation, participant screening and unwritten rules promoting trust and safety. Hi-fun offered emotional and social benefits, including connection and belonging. However, participants also reported risks, including mental health challenges, dependence, sexual performance difficulties, violence, non-consensual recording, financial strain and legal consequences. Hi-fun became problematic when individuals lost control, encountered police, were forced into mandatory rehabilitation, experienced health decline or struggled with daily functioning. Participants emphasised the need for sterile equipment, post-use care, accurate information, stigma-free environments and legal reforms aligned with lived realities. Supporting GBMSM engaged in hi-fun in Thailand requires moving beyond abstinence-focused approaches toward flexible harm reduction and structural reforms that uphold dignity, safety and equity.
SN - 2767-3375
ER -