Background:
Over the past seven years in Massachusetts, STD rates have continued to increase among MSM, despite the existence of accessible STD clinics and culturally-specific community-based-programs.

Objective:
To assess the current level of knowledge that MSM have about STD/HIV symptoms, testing, and transmission; to better understand how MSM respond to STD/HIV prevention and testing messages.

Method:
Fifty MSM completed a one-on-one semi-structured interview. A modified respondent driven sampling method was used to enroll MSM from social networks that might not consider participation otherwise, and to enroll a maximally diverse sample. NVIVO software was used to organize transcripts and to identify emerging themes.

Result:
Respondents ranged in age from 20 to 56 years. Forty percent were White, 30% African American/Black, 12% Latino/Hispanic; sixty-six percent were HIV-infected. Most participants had some understanding of STD/HIV symptoms, transmission, and testing, but there were also consistent gaps in knowledge, such as thinking of chlamydia only as a woman's disease, and lack of awareness that gonorrhea could present rectally. Respondents had a wide-range of understanding of behavioral risk-factors for acquisition and transmission of STDs/HIV. Primary care providers, particularly those who treat HIV-infected patients, were often seen as trusted sources of STD/HIV prevention information.

Conclusion:
These results suggest that MSM differ in their understanding of behavioral risk factors for STD/HIV transmission and acquisition. Health messages that both raise awareness around disease prevalence and include straight-forward and accurate information around prevention are indicated.

Implications:
STD/HIV prevention messages that both raise awareness and include clear and accurate information are needed. Providers should be proactive in disseminating information about STD/HIV prevention and offering STD screening for their at risk MSM patients. For this to be effective, however, more training needs to be available to help providers better communicate with their MSM patients about sexual health.