Objective To understand the HIV infection status in men who have sex with men (MSM) and related sociodemographic and behavioral characteristics factors in Sichuan province, and provide evidence for improvement of acquired immunodeficiency syndrome (AIDS) prevention and control strategies for this population.

Methods From April to July during 2016−2023, the information about the demographic and behavioral characteristics of MSM were collected and HIV antibody testing was conducted in sentinel surveillance in Sichuan. Descriptive analysis, χ² test, and logistic regression model were used to analyze their sociodemographic and behavioral characteristics, HIV infection status, and related factors.

Results Between 2016 and 2023, a total of 26643 MSM (person-time) were surveyed. The median age of the MSM was 29 years (IQR:24−38). The MSM with degree of college or higher and homosexuality orientation accounted for 50.83% and 79.15% respectively. The awareness rate of AIDS related knowledge increased from 90.83% to 97.01% (trend χ²=179.717, P<0.05). The rate of using no-condom in the last homosexual anal intercourse decreased from 10.45% to 8.72%(trend χ²=49.244, P<0.05), and the rate of commercial homosex decreased from 4.54% to 3.29%(trend χ²=13.582, P<0.05). The overall infection rate of HIV was 7.13%, and the annual infection rate decreased from 10.23% to 4.96%(trend χ²=129.861, P<0.05). The previously reported positive rate of HIV fluctuated from 4.07% to 3.49%(trend χ²=6.748, P<0.05). The rate of condom use in previously reported positive MSM in homosex was higher than that in HIV negative or newly tested positive MSM, however the rate of inconsistent condom-use remained at 27.64%. The logistic regression analysis showed that aged ≥25 years, Han ethnicity, junior high school education level or below, offline sexual partner seeking, being recruited from MSM gathering sites, inconsistent condom use in homosex and no heterosex in the past six months, history of drug use, sexually transmitted disease(STD) diagnosis within the past year, and HIV counseling and testing, and receving no HIV intervention services within the past year were positively correlated with the detection for HIV infection (P＜0.05).

Conclusion The HIV infection prevalence remained at a relatively high level but showed a downward trend in MSM in Sichuan between 2016 and 2023, whereas the decrease might be overestimated. The awareness rate of AIDS related knowledge was relatively high, however previously reported positive MSM still engaged in risky behaviors. It is necessary to further strengthen the surveillance and interventions in MSM with older age and lower education level, being active in offline MSM gathering sites, having inconsistent condom-use and STD history, as well as previously reported positive MSM.