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ObjectivesTo understand characteristics, perceptions, knowledge and behavior in the Qualitative Phase and to determine HIV/AIDS related knowledge, practices (including risk behaviors), HIV burden and its correlates in the quantitative phase among MSM population of Kolkata, West Bengal, IndiaMethodologyA mixed-method study with a qualitative phase followed by a quantitative cross-sectional component was conducted in Kolkata between August-2015 to June-2016. Focus group discussions and in-depth interview were conducted among 23 MSM. Time location sampling (TLS) with probability proportional to estimated attendance size was used to recruit MSM from 115 venues, corresponding to 3760 VDT complexes from which 584 subjects in randomly selected eligible VDT complexes were interviewed through an android based, tablet-PC assisted, pre-recorded questions-based, audio-integrated, color coded self-interview.ResultsMSM were uniformly treated with contempt in Indian society including by their parents. They were more likely to experience discrimination based on their sexual orientation compared to heterosexual counterpart. Most of them consciously did not disclose their orientation because of fear of rejection from families and society. Lack of support, protection and guidance from families and society influenced the overall well-being of this population. Almost all of them suffered from an impaired self-esteem and some degree of unhappiness because of widespread discrimination. The mechanism of coping varied and some were situational based on their anticipated emotional impact. In quantitative phase, the HIV burden was found to be 10.46%. 71% reported to have multiple male sex partners in their lifetime. 66% had multiple casual male sex partners. The significant predictors of HIV sero-positivity were higher age, acting as both as an anal insertive and receptive, irregular partners and unprotected sex.ConclusionsThe HIV burden among MSM was found to be substantially high in the current analysis. The significant predictors of HIV sero-positivity were higher age, acting as both as an anal insertive and receptive, irregular partners and unprotected sex. Majority of MSM in Kolkata were engaged in high risk activities that elevated their HIV risk. Targeted intervention for high-risk MSM seemed to be the need of the hour.