Objective  To examine marital status and its associates among first detected human immunodeficiency virus (HIV) positive men who have sex with men (MSM) and HIV detection in the MSM' spouses in Nanjing city during 2014 – 2018.

  Methods  From National Integrated AIDS Prevention and Control Information System, we extracted the data on ≥ 22 years old HIV positive MSM first registered in Nanjig city during 2014 – 2018. We conducted statistical analyses on the data with SPSS 20.0 software.

  Results  Among 2 197 MSM included in the study, 795 (36.2%) were married and 1 402 (63.8%) were unmarried. Multivariate logistic regression analysis indicated that compared to those aged 20 – 29 years, the MSM at elder age were more likely being married (for the aged 30 – 39: adjusted odds ratio aOR = 10.411, 95% confidence interval 95% CI: 7.700 – 14.077; for the aged 40 – 49: aOR = 41.079, 95% CI: 27.995 – 60.277; and for the aged ≥ 50: aOR = 72.873, 95% CI: 45.405 – 116.958); in comparison with those having the education of college and above, the MSM with lower education were more likely being married, with the aOR of 1.945 (95% CI: 1.426 – 2.653) and 2.756 (95% CI: 1.957 – 3.881) for the MSM having the education of high school or technical secondary school and junior high school and below; in contrast to those with other occupations, the MSM being worker/farmer/fisherman were more likely being married (aOR = 1.585, 95% CI: 1.039 – 2.417); the MSM living in nonlocal regions were more likely being married than those living in local regions (aOR = 1.448, 95% CI: 1.099 – 1.907) and the MSM being followed-up were more likely being married than those being lost to follow-up (aOR = 1.441, 95% CI: 1.094 – 1.899). The HIV positive rate was 12.8% (37/290) for the spouses of the married MSM.

  Conclusion  The proportion of being married increases with the increment of age among the HIV positive MSM in Nanjing city; early HIV detection and HIV positive notification can reduce HIV transmission among spouses of the HIV positive MSM.