| Background:Men who have sex with men (MSM) have been disproportionately impacted upon by HIV. The infection causes are not only related with their own risk behaviors, but also are accounted for their sexual partners'HIV related risk behaviors. Few studies targeting the relationship between sexual partners'HIV related risk behaviors and HIV infection and MSM unprotected sexual.Objectives:The main objectives are to investigate prevalence of HIV and syphilis infection among MSM, to understand the unprotected sexual partners'risk behaviors and explore correlates of MSM and their sexual partners risk behavior with HIV/syphilis infection among MSM.Methods:A cross-sectional study was conducted among MSM in four cities. The participants were recruited by respondent-driven sampling (RDS) and stratified snowball sampling. A face-to-face questionnaire was administrated, and HIV testing and counseling were provided.Results:80.8% participants were 20-29 years old,65.9% homosexual orientation, 74.5% unmarried, and 50.0% having 1000-3000 CNY per month,46.0%with college education. Half of the participants seek their sexual partners mostly with internet. MSM seeking sexual partners at bars or nightclubs were younger, having more sexual partners and casual or commercial partners and group sex. MSM seeking sex partners from bath house or park or public toilet were elder, mostly married and with low level education, and having higher rates of unprotected intercourse. The rates of unprotected insertive and unprotected receptive anal sex and unprotected vaginal sex of married MSM were 52.4%, 42.5%,82.8%, which being significant high than the non-married ones'(44.1%,33.7%, 65.6%).The participants totally reported 3787 unprotected sexual partners. Among these 3787 unprotected sexual partners, nearly half of them were commercial or casual partners. The proportion of un-disclosed state of HIV infection of unprotected sexual partners was 80.0%, and 66.1% partners'status of whether being IDU was unknown by participants. And more than 50% unprotected sexual partners'history of STIs infection was not uncovered by participants. One third SPUSC had casual sex partners. Nearly 50.0% SPUSC did not use condom each time.Age status of sexual mixing patterns were randomly with Q being less than 0.05 among bar and baths MSM, while it were more likely assortative among other sub group MSM with Q greater than 0.09. And there were no significant correlate between age status sexual mixing patterns. Responders with sexual partners from bar had significantly higher unprotected anal intercourse then those with sexual partners from other venues. The various sub groups with different types of sexual partners were correlative. And core sub group were those who had commercial sexual partners and who had female regular sexual partners. The rate of unprotected anal sexual was highest among MSM with female regular sexual partners, and then were those with male regular sexual partners, male casual sexual partners, and commercial sexual partners, respectively. HIV prevalence was 6.7% and syphilis infection rate was 12.5%.27.2% HIV infected MSM had a co-infection of syphilis. Independent risk factors for HIV infection were unprotected receptive anal intercourse, having sexual partner older than him for over 10 years, and with junior high school or less education. Unprotected receptive anal intercourse, having much more sexual partners than he could not count, with junior high school or less education and more than 39 years old were independent risk factors associated with syphilis infection.AIDS Knowledge Knowing-rate of all participants was 91.2%. Only 53.7% participants had the correct answers for all five AIDS knowledge questions according to the UNGASS' indicators in evaluating HIV/AIDS knowledge of most-at-risk population.50.0% participants reported that they got AIDS-related information from internet and received AIDS related peer education or condoms or handouts.39.6% participants said they would buy medicine by themselves or go to private clinic to treat STI. Conclusions:Unprotected sex behaviors were common among urban MSM. MSM seeking sexual partners at bars or nightclubs were younger, having more sexual partners and casual or commercial partners or having group sex. MSM seeking sex partner from bath houses were elder, mostly married and with much more sexual partners, having higher rates of unprotected anal intercourse and unprotected vaginal sex. Married MSM had much more unprotected anal sex with MSM as well as unprotected vaginal sex.The value of age status of sexual mixing patterns were different in different sub group and the status more liked random among MSM seeking sex partners at bars. These results highlighted MSM who having sex at bath house were the core high risk sub group for HIV transmission.MSM with commercial sexual partners or with female regular sexual partner were the core sub groups, which bridged the gap for HIV transmission between high risk groups and low risk groups as well as general population.MSM were not familiar with their SPUSC's AIDS related high risk behaviors.The prevalence of HIV/syphilis infection was high among MSM. Unprotected anal sex and unprotected vaginal sex and the random age status of sexual mixing patterns would speed the HIV/STIs transmission among MSM as well as-general pulation.
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