Knowing "Luan" but Craving: An Interpretative Phenomenological Analysis on the Perceptions About Methamphetamine Use, Chemsex, and HIV Risk Among Chinese Men Who Have Sex With Men.

Objective: To understand the perceptions of Chinese MSM regarding methamphetamine use, chemsex, and HIV risk, and interpret the meaning of such experiences and their impact on their health and social well-being.

Methods: Data collection consisted of semi-structured interviews with 24 Chinese MSM who were current or former methamphetamine users, and interpretative phenomenology analysis was applied to analyze the transcripts of the interviews.

Results: Two superordinate and six subordinate themes emerged: 1. Ambivalence about methamphetamine use: (1) Perceived "hi" () but "luan" (), (2) Perceived under control but out of control in reality, and (3) Perceived popularity but being stigmatized. 2. Inevitability of HIV infection: (1) Unwritten rule of using methamphetamine, (2) Fears of getting infection, and (3) "Techniques" to reduce HIV risk.

Conclusion: The current or former methamphetamine users of Chinese MSM experienced significant societal stigma and self-devaluation due to their perceived immoral and illegal behaviors. They felt compelled to engage in chemsex within the subculture of methamphetamine users and believed that contracting HIV was inevitable despite their fear of it. Future interventions for drug use and HIV prevention among MSM should address their ambivalent circumstances and implement tailored and comprehensive strategies.