| Background:HIV/AIDS is dramatically spreading among MSM community at present. As the increasingly accessable to ARV treatment, HIV positive MSM will accounts for more proportion of people living with the virus. Significantly different from other HIV infected individuals, due to dual stigma and discrimination towards the sero-and sexual status, most of them are lack of the coping capacity in engaging in much safer sexual behaviors, utilizing AIDS/STI related health services, disclosing their sero-status to partners and referring partners to HIV counseling and testing. Few studies targeting HIV positive MSM have been conducted in China and thus the corresponding intervention strategies have not been developed.Objectives:1. To investigate the current utilization of AIDS/STD related health services and the prevalence of unprotected sexual behaviors among HIV positive MSM in Chengdu city and to identify associated factors.2. To explore the changes of sexual behavior by comparing the pre-and post notification of HIV infection.3. To conduct a clinical trial among the study participants to assess efficacy of a comprehensive intervention package which consists of web-based intervention, peer education and one-on-one counseling.Methods:The study participants were recruited by snow ball sampling method for a cross-sectional survey and their historical data stored at local CDC and testing sites were reviewed to collect information regarding sexual behavior specifically. Based on the baseline survey, participants were allocated to 2 arms, one for intervention and the other for study control. An evaluation survey was conducted after 6 month's follow-up.Results:1. The baseline survey showed in the past year about one third of the participants were not covered by any form of intervention measures, specifically the peer education. Syphilis infection rate during baseline survey was 13.9% and 18.9% who reported syphilis infection in the previous year was not treated by government-approved health providers. More than half (58.6%) had ever disclosed their sero-status to others, but 85.8% reported they would not disclose to casual sexual partners.23.1% had referred their sex partners to HIV testing. The ART treatment had covered 29.2% of study participants and among those not receiving ART yet,41.7% were found CD4 counts below 350/mm3.5.9% reported substance abuse and their drug choice were ice, ecstacy and ketamine. The prevalence of unprotected anal intercourse was 31.9% and its associated factors were education experiences, CD4 testing, syphilis infection and the venues where they hunted for sex partners.2. It was drawn from this retrospective cohort study that the rate of consistent condom use was higher after participants were notified HIV positive. However, this change was observed among 58.6% of those who had known their sero status more than 12 months. There was no significant change regarding sex behavior if comparing the pre-notification with the post.3. Results of an intervention trial showed more participants in the intervention arm disclosed their sero-status to others and referred their sexual partners to HIV testing than those in the control group. It seemed the intervention package didn't work well to change their behavior of the unprotected anal intercourse and intention to receive ART treatment at early stage. Conclusion:1. HIV positive MSM was facing a high syphilis infection as some of them were still engaging in unprotected anal intercourse. The current utilization of AIDS/STI related health services, such as qualified STI treatment and ART treatment was low, suggesting that intervention measures should be urgently developed and implemented.2. Being notified the sero-status, HIV positive MSM would change their risk behavior. However, it would take a rather long time to make a positive change.3. The comprehensive intervention package would facilitate the HIV positive MSM to disclose their sero-status and promote them to refer their sexual partners to HIV testing. It would not work in changing their risk behaviors and impelling them to receive early ART treatment.
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