Pleasure, shame and harm reduction: A qualitative investigation of poppers and sexualized drug use among men who have sex with men in China.

This qualitative study explores the sociocultural meanings and harm-reduction practices surrounding poppers use among men who have sex with men (MSM) in China. Twenty in-depth interviews conducted in Guangzhou reveal that poppers are experienced as both a routine facilitator of sexual pleasure and intimacy, and a source of moral tension. Participants valued the physiological and psychological effects that enhanced receptive anal sex and emotional connection, yet described these benefits often give way to heightened sexual risk, internalized shame, and subsequent guilt. Stigmatizing public health discourses and a restrictive national drug policy context amplified this ambivalence, framing poppers use as deviant and shameful. Despite these challenges, participants demonstrated agency through self-regulation, peer-based harm reduction, and demands for credible, nonjudgemental information. These findings situate poppers use within a complex interplay of pleasure, stigma, and regulation, underscoring the need for culturally grounded, community-led harm reduction that affirms agency and wellbeing.