Investigating the dynamics of HIV and STI disclosure in Chemsex/Party and Play communities

ABSTRACTIndividuals frequently use substances to enhance sexual experiences, known as chemsex, which reduces inhibitions and increases risk-taking behaviors. This can lead to HIV/STI transmission, followed by stigma and isolation, discouraging HIV/STI status disclosure to partners. Participants were recruited through a larger study during January-March 2025. Eligibility criteria included age ≥18 years, participation in chemsex and having been diagnosed with HIV/STI. Semi-structured interviews (n = 11) were performed to examine the phenomenon of disclosing HIV/STI status during chemsex and reasons for not disclosing. In-vivo coding was used for data analysis of qualitative interviews. Participants were 60% Black or African American, 80% cisgender male, 56% gay, 82% had some college education and 36% were from 40-49 years of age. Initial themes included Individual Responsibility, Reasons for Not Disclosing Status and Harm Reduction Behaviors. Participants avoided disclosure of status to maintain the mood, adhered to norms of condomless sex, relied on visible symptoms to assess status and relied on online platforms to determine status of chemsex partners. These findings highlight the need for education and interventions to reduce stigma and promote safer behaviors in chemsex contexts.