Objective  To investigate the characteristics of sexual behaviors of men aged ≥45 years at key entertainment and public places of urban areas in Suining, Zigong, Yibin, Guangyuan and Mianyang prefectures of Sichuan province, and analyze the related factors. Methods　C ross-sectional study was conducted to investigate the demographic characteristics, high-risk sexual behaviors, condom use, access to HIV/AIDS education services in men aged ≥45 years in the five prefectures. SPSS 19.0 was used for data statistical analysis, including statistical description, univariate and multivariate logistic regression analyses.

  Results  A total of 1884 men aged ≥45 years were investigated at key entertainment and public places of urban areas in the five prefectures, in whom the awareness rate of HIV/AIDS related knowledge was 74.84%, 76.80% had sexuality not seriously affected by age, 42.14% had more than 2 sexual partners in the past year, 45.28% had history of commercial sex, 28.72% had received no free condom supply, 47.08% had received no HIV tests, and in 853 men who have commercial sex, 36.46% had no consistent condom use in the past year. The factors related to the history of commercial sex included marital status, residence status, education level, attitude to commercial sex, AIDS related knowledge awareness, taking sex aid, sexual behavior frequency, number of sexual partners and receiving free condom supply (all P<0.05).

  Conclusion  The proportion of the middle-aged and old men with commercial sex was high in the five prefectures in Sichuan. It is necessary to strengthen health education and behavioral intervention in HIV/AIDS prevention and control, improve emotional care and psychological support, resist commercial sex, reduce extramarital sexual behaviors and promote consistent condom use.