Nineteen semistructured interviews with HIV-positive methamphetamine-using gay, bisexual, or other MSM were analyzed qualitatively and using Critical Incident Measure (CIM). Among those who reported successful disclosure, themes regarding disclosure strategies and precontact disclosure emerged. Although few men spontaneously discussed the association between methamphetamine and disclosure, those who did reported less inclination to ascertain partner serostatus while under the influence. Men who reported disclosure to an HIV-seroconcordant partner were more likely to report not exchanging semen in this encounter compared with nondisclosers, whereas condom nonuse emerged as a theme across disclosure groups. Most of those who reported nondisclosure described their most recent encounter under the influence as occurring in the context of a public sex environment and/or with multiple partners. Understanding the interaction between methamphetamine use and serostatus disclosure practices, particularly among HIV-positive men, and how this interaction impacts sexual risk-taking has important implications for HIV prevention work.