The acquired immune deficiency syndrome (AIDS) epidemic data in Qingdao revealed increasing transmission of human immunodeficiency virus (HIV) through male—male sexual behavior from 2008 to 2021. We aimed to provide a scientific basis for targeted HIV prevention and intervention strategies. The study followed the Chinese HIV sentinel surveillance protocol, and included men who have sex with men (MSM) who participated in the Qingdao AIDS sentinel surveillance from 2019 to 2021 and underwent HIV testing in accordance with the requirements of the program. Information on the participants’ demographic characteristics, HIV prevention knowledge, sexual behavior, drug use, and serological examination results were collected. Chi-square tests, multiple logistic regression, and decision tree analysis were employed to assess the factors associated with HIV infection. A total of 1,221 MSM were included, with 39 cases testing positive for HIV antibodies. Multiple logistic regression indicated a positive correlation between HIV infection and factors such as no condom use during the most recent anal intercourse in the past 6 months, use of Rush poppers, and syphilis infection. The decision tree model revealed that MSM with syphilis infection, no condoms use during the most recent anal intercourse in the past 6 months, and used Rush poppers had the highest risk of HIV acquisition (71.4%). Although the overall AIDS epidemic in Qingdao has shown a low prevalence, the infection rate among MSM has been increasing. Targeted measures will help to reduce high-risk behaviors among MSM.
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