Introduction: Men who have sex with men (MSM) is counted for almost 17% of new HIV infections where injecting drug users are estimated to account for new HIV infections by 12%. New HIV cases in the city of Bukittinggi in 2019 were 62 people with risk factors for MSM as much as 37.1%. This study aims to determine the risk factors (age at first sexual intercourse, sexual activity, Injection drug use, lifetime number of sexual partnersand migration) of HIV inci- dence in Bukittinggi city. Methods: This is an analytical study on the case control approach involving 456 individuals with 60 people as a research samplewith a ratio of 1: 2, namely 20 cases and 40 control groups. Snowball sampling, questionnaires were mediated as data accumulation and then was analyzed by Chi-suared test. Results: The research results verified that early sexual age (p=0.005) indicated HIV incidence. On the other hand, sexual activity, Injection drug use (IDU), number of sexual lifetime partnert have no significant relation to HIV incidents. People should avoid the high-risk sexual activity such as receptive (recipient) and insertive (giver) without a condom, inconsistency in using condoms and avoid large number of partners. Conclusion: From the above study it can be concluded that there was a relationship between the age at first sexual intercourse with incidence of HIV in MSM and no relationship between sexual activity, IDU, number of lifetime partners and migration with the incidence of HIV among MSM in Bukittinggi city. So, in case of MSM cases, individuals must do an HIV test at least once a year.