Hi-fun among men who have sex with men in Bangkok: A scoping study exploring key informants’ perspectives on hi-fun contexts, harms and support strategies
Issued Date
2023-08-01
Resource Type
eISSN
27673375
Scopus ID
2-s2.0-85189175091
Journal Title
PLOS Global Public Health
Volume
3
Issue
8
Rights Holder(s)
SCOPUS
Bibliographic Citation
PLOS Global Public Health Vol.3 No.8 (2023)
Suggested Citation
Witzel T.C., Charoenyang M., Bourne A., Guadamuz T.E. Hi-fun among men who have sex with men in Bangkok: A scoping study exploring key informants’ perspectives on hi-fun contexts, harms and support strategies. PLOS Global Public Health Vol.3 No.8 (2023). doi:10.1371/journal.pgph.0002295 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/98797
Title
Hi-fun among men who have sex with men in Bangkok: A scoping study exploring key informants’ perspectives on hi-fun contexts, harms and support strategies
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Corresponding Author(s)
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Abstract
The use of specific drugs (e.g. methamphetamine, GHB/GBL and other stimulants) to enhance sex among men who have sex with men (MSM), is the focus of global public health concern because of links to social harms, poor mental and sexual health. Often called ‘chemsex’ in Western settings or ‘hi-fun’ in Southeast Asia, this type of sexualised drug use is increasingly visible in Thailand where the unique sociocultural and legislative environments shape sexual cultures and harms. This study aimed to develop an understanding of key informants’ perspectives on hi-fun contexts, harms and current responses in Bangkok. In-depth interviews were conducted with thirteen key informants from clinical, community, policy and development organisations. Four key informants had personal experience of hi-fun. Interviews covered hi-fun contexts, harms and support, were transcribed verbatim, translated to English (where necessary) and analysed using a thematic framework. MSM hi-fun ‘influencers’ shape norms and provide support online, primarily through Twitter. Hi-fun was linked to Westernisation and wealth; complex hierarchies emerged from asymmetries in social/financial capital. Police coercion towards MSM engaged in hi-fun was a concern. Given the nature of their funding, HIV/HCV/STI transmission was the most pressing focus for many organisations, however key informants were concerned especially about drug overdoses and mental health/well-being impacts. The political and economic context means funding for MSM health in Thailand focuses primarily on HIV prevention/treatment; restrictions on development aid constrain holistic hi-fun focused service development. Most hi-fun support was informally developed; successful strategies relied on partnership working and peer developed/delivered services, some of which were adapted from high-income settings. Despite substantial barriers, organisations developed services responding to the needs of MSM engaged in hi-fun. Given that many were informally developed or adapted from high-income settings, establishing a theoretical basis for further interventions that is grounded in this unique context is a priority.