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Background: Global policies emphasise the need for tailored interventions to reduce the harms of sexualised drug use (SDU) among men who have sex with men (MSM), including taking account of local risk environments and the influence of social norms, drug and sexual minority stigma, and cultural and political conditions. To help guide the production of local SDU harm reduction interventions, this study aimed to explore the social and structural conditions that shape the practice of, and response to, SDU by MSM in Jakarta, Indonesia., Methods: Informed by an interactionism theoretical perspective and socioecological frameworks, a reflexive thematic approach was used to analyse in-depth qualitative interview data from 20 MSM who practised SDU in Jakarta. To recruit the participants, the study was promoted through local organisations providing HIV services for MSM, as well as snowball recruitment., Results: To protect their SDU practice, MSM in Jakarta developed a set of social risk management strategies designed to reduce the generative tension between enabling and disabling forces caused by local social and structural environments. Enabling forces emerged primarily from within MSM networks, were extended through the interpersonal dynamics of sexual partner relationships to peer influence and reinforced by product branding and marketing on both offline and online platforms. The disabling forces, which were introduced primarily from outside the network, manifested in stigmatising social norms, politics and religious beliefs towards homosexuality and drug use, and forced MSM who practised SDU to relocate to virtual environments., Conclusion: Programmatic responses seeking to mitigate the risks associated with SDU practice among sexual minority men should incorporate established mechanisms of peer networks and virtual spaces into their design to maximise reach and intervention acceptability and effectiveness., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

HIV prevention programs typically focus on changing individuals' risk behaviors, often without considering the socioecological factors that can moderate this risk. We characterized HIV risk among men who have sex with men (MSM) in Indonesia (n = 1314) using latent class analysis and used multinomial logistic regression to identify latent class relationships with demographics, social/sexual networks, and community-level socioecological indicators of HIV risk. Three HIV risk latent classes were identified-"Sexually Moderate" (n = 333), "Sexual Explorative" (n = 575), and "Navigating Complexities" (n = 406). Using "Sexually Moderate" (lowest risk) as the reference group, MSM in the "Sexual Explorative" class had additional social/sexual network-level risks (meeting partner(s) using both online and offline methods [RR = 3.8; 95%CI 1.7-8.6] or general social media and gay-specific online platforms [RR = 2.6; 95%CI 1.9-3.6] to meet partners, group sex [RR = 10.9; 95%CI 4.5-25.4], transactional sex [RR = 1.6; 95%CI 1.2-2.2]), and community-level risks (experiencing homosexual-related assaults [RR = 1.4; 95%CI 1.1-1.9]). MSM in the "Navigating Complexities" class had additional social/sexual network-level risks (low social support [RR = 1.6; 95%CI 1.1-2.5], less disclosure of their sexuality [RR = 1.4; 95%CI 1.0-1.9]) and community-level risks (higher internalized homonegativity scores [RR = 1.2; 95%CI 1.1-1.4], ever experiencing homosexual-related assaults [RR = 1.4:95%CI 1.1-1.9], less exposure to HIV/STI health promotion [RR = 0.7; 95%CI 0.5-0.9], attending STI-related services in the past 6 months [RR = 0.6; 95%CI 0.4-0.8]). Co-occurring individual and socioecological risk recommend holistic HIV prevention strategies tailored to consider the social and structural conditions of MSM in Indonesia are needed., (© 2024. The Author(s).)