目的:了解浙江省金华市男男性行为者(men who have sex with men,MSM)艾滋病高危行为特征、感染情况及其影响因素。方法:采用分类滚雪球抽样的方法,在金华市范围内招募MSM进行问卷调查,了解其社会人口学及艾滋病高危行为特征,并采集血样进行人类免疫缺陷病毒(HIV)抗体、梅毒抗体的检测。结果:共调查238名MSM,艾滋病知晓率为83.2%,79.8%最近3个月发生过同性性行为,其中30.5%有2个以上性伴;10.1%最近3个月与同性发生过商业性行为,16.8%与异性发生过性行为;最近3个月与同性固定性伴发生性行为时坚持使用安全套的比例为47.9%,同性固定性伴坚持使用安全套的比例是42.6%,与同性发生商业性行为时坚持使用安全套的比例是54.2%,与异性发生性行为时坚持使用安全套的比例为17.5%。238名调查者均采集血样进行了血清学检测,确证HIV阳性人数15人,阳性率为6.3%(95%CI 3.4%~10.3%);确证梅毒抗体阳性人数18人,阳性率7.6%(95%CI 4.6%~12.2%)。多因素分析结果提示,最近3个月同性性伴数≥2人、与临时性伴发生性行为、既往有性病史、未做过HIV检测是HIV感染的危险因素;在本地居住半年以上、与临时性伴发生性行为时每次都使用安全套是MSM人群感染HIV的保护因素。结论:金华市MSM中艾滋病知晓率不高,无保护性性行为较为普遍,HIV感染影响因素较多,应在该人群中加强包括安全套推广、定期检测促进在内的艾滋病干预措施,控制艾滋病的流行。 Objective: To investigate the characteristics of high risk behaviors, infection and their influencing factors in men who have sex with men (MSM) in Jinhua City, Zhejiang Province. Methods: A classification snowball sampling method was used to survey MSM in Jinhua City to investigate its social demography and HIV / AIDS risk behaviors. Blood samples were collected for the detection of human immunodeficiency virus (HIV) antibody and syphilis antibody. Results: A total of 238 MSMs were surveyed. The awareness rate of AIDS was 83.2% and 79.8% of them had homosexual behaviors in the past 3 months, of which 30.5% had more than 2 partners and 10.1% had the same sex with the same sex in the last 3 months , 16.8% of them had heterosexuality; 47.9% insisted on using condoms in the last 3 months when having sex with same-sex partners, and 42.6% insisting on the use of condoms for same-sex partners, 54.2% insisted on using condoms during behavior, and 17.5% insisted on using condoms when having sex with the opposite sex. Serum samples were collected from 238 investigators and confirmed as HIV-positive. The positive rate was 6.3% (95% CI 3.4% ~ 10.3%). The positive number of confirmed syphilis was 18, the positive rate was 7.6% (95 % CI 4.6% ~ 12.2%). Multivariate analysis showed that the number of same-sex sexual partners ≥ 2 in the last 3 months was associated with sexual intercourse with adolescent with previous history of sexually transmitted diseases and no HIV test was a risk factor for HIV infection. When living in Hong Kong for more than half a year, Use of condoms every time you have sex with a temporary partner is a protective factor against HIV infection in MSM populations. Conclusion: The awareness rate of HIV / AIDS in Jinhua MSM is not high, there is a high prevalence of unprotected sexual behaviors and many factors affecting HIV infection. HIV / AIDS interventions including promotion of condoms, regular testing and promotion should be strengthened in this population, and HIV / AIDS control popular.