Abstract: ObjectiveTo understand the need hierarchy of men who have sex with men (MSM), analyze the related factors, and guide the formulation of AIDS prevention and control measures.MethodsSnowball sampling method was used to recruit the MSM in Mianyang City, Sichuan Province, for questionnaire survey and serological test. The survey content included demographic characteristics, knowledge about HIV/AIDS, hierarchy of needs, social networks, and sexuality. Chi-squared test and logistic regression were used for univariate and multivariate analyses.ResultsA total of 1 172 MSM were surveyed. Of the hierarchy of needs, the physiological needs accounted for 20.1% (236/1 172), safety needs for 66.2% (776/1 172), social belonging for 8.4% (98/1 172), esteem for 2.5% (29/1 172), and self-actualization for 2.8% (33/1 172). The positive rates of HIV infection at different levels of needs were 11.4%, 4.5%, 7.1%, 3.4% and 3.0% (P < 0.05). In the multiple logistic regression model of independent statistical correlation variables, for safety needs to compare with physiological needs: education level(OR=0.408), social activity network(OR=0.374), having HIV tested in recent one year(OR=4.025), persons having anal sex with in recent six months (OR=1.639), and protective anal sex in recent six months (OR=9.165); for making friends to compare with physiological needs: the marital status (OR=2.763), mobile MSM (OR=1.919), knowledge about HIV/AIDS (OR=5.207), persons having anal sex with in recent six months (OR=2.809), protective anal sex in recent six months (OR=3.143), and the internet-based sex partners (OR=0.275); for the esteem/self-actualization needs to compare with physiological needs: social activity network (OR=0.268), knowledge about HIV/AIDS (OR=18.420), persons having anal sex with in recent six months (OR=3.517), protective anal sex in recent six months (OR=5.108), and the internet-based sex partner (OR=0.318) (P <0.05 or P <0.01). ConclusionMSM are at a low level of need hierarchy and requires a high level of safety needs. Demographic characteristics, sexual behavior, etc., related to the hierarchy of needs. Physiological needs of MSM dominate the higher risk for HIV infection and spreading, which should be the focus of HIV/AIDS prevention and control.