Background: There is growing evidence that shows the possible role of analrnintercourse between the same sex in the epidemiology of HIV/AIDS in Africa. Suchrngeneralization is also applicable in African countries where such sexual behavior hasrnbecome an emergent phenomenon.rnObjective: To asses the possible role of MSM in the epidemiology of HIV/AIDS in AddisrnAbaba.rnMethods: An ethnographic study was conducted in different parts of Addis Ababarnbetween Januaryâ€™06- Marchâ€™06. Snowball sampling method was used to recruit MSM, hotrnline counselors and victims of anal rape. Four Focus group discussions with MSM, keyrninformant interviews with three counselors as well as with three anal rape victims andrnobservation at bars, streets and tearooms were done. Data on the extent, patterns ofrnsexuality and related issues on MSM were collected and analyzed using open codernsoftware and ground theory approach to qualitative data analysis.rnResults: Contextual factors (socio-cultural and politico legal issues) were found to bernthe bases of the development of risk behaviors to HIV/AIDS. This contextual factorrnoperates through mediators such as individual behavioral causes and immediate casualrnfactors. Different strategies were explored for possible cross bridging of infection betweenrnthe subgroup and the other heterosexual community.rnConclusions: The practice of MSM is beyond what one would expect in the city andrndifferent factors are seen to lead people to get engaged in such sexual behavior. As thisrnpractice exposes to HIV/AIDS related risks, it is high time to discuss this issue openly withrnin the context of current efforts to control the HIV pandemic.