Background: Men having sex with men (MSM) are more likely to get HIV infection. 

Objectives: To describe patterns of sexual behaviors and potential determinants of HIV among MSM. 

Results: Alcohol intake was reported by 86.6%, hashish (82.4%) followed by bhang (77.6%).  Drug injection last month was reported by 3.5%. The mean age at first intercourse was 13.93+6.89 years. This first sexual relation was without violence (92.9%) and mostly with a non-family male (67.0%). The mean duration of being sexually active was 7.52+5.57 years. The majority have 1-2 partners (52.8%). Having passive partners last six months was reported by 67.3% with a median of 5 partners. Paid partners represented 17.9%. Use of condom in last anal sexual relation with paid partners was only 17.9%. Always use of condom in last 6 months was reported by only 3.6%. Having anal sex with unpaid partners last 6 months was reported by 82.4% and condom was used by only 9.3%. The majority of studied MSM heard about condom (70.8%) yet only 28.2% reported ever using it. Ever having sex with a female was reported by 58.3% of studied subjects. Use of lubricants during anal sex was reported by 37.2%. Only 24.4% of studied subjects had an idea about sexually transmitted infections (STIs). Study subjects who had an idea about HIV and AIDS were 53.2%. Misconceptions about HIV infection were reported by 40.0%. The stigma against HIV and AIDS was found high among studied participants. Prevalence of HIV infection was 3.2% among studied MSM. 

Conclusion: HIV infection among MSM in the Nile Delta is high compared to general population. They have multiple risk factors for HIV infection which urges for promotion of HIV prevention programs.