Background Tanzania has the largest land area of any country in East Africa, with a population of 35. million. The HIV prevalence is 9.9 per cent. Tanzania is one of the world’s poorest countries, 59.7 per cent lived below US$2 a day during 1990-2001. Our aim was to investigate the knowledge on HIV/AIDS and sexual risk behavior among men in rural Tanzania. Such knowledge is crucial to improve HIV/AIDS epidemic situation in Tanzania. Similar studies have been conducted on women in Tanzania and on men in rural India. We have compared our findings with these studies. Methods We visited a total of three villages and handed out 250 questionnaires, of these a number of 193 were filled out in a correct way. We also conducted 45 interviews. Results All participants had heard of HIV/AIDS and 60 per cent stated media as one of their first sources to get information on the disease. 88 % knew that sexual intercourse is one of the
ways in which HIV is spread. 77 per cent and 67 per cent knew of sharing sharp instruments and mother-to-child transmission, respectively. Ninety-two per cent of the men knew of at least one way to protect themselves against infection of HIV. The use of condom, being faithful or to abstain from sexual intercourse were the most common answers. Four out of 10 men stated that they had paid money in exchange for sexual favors. When asked if they thought paying for sexual favors was common in their neighborhood, 34 per cent said yes. Conclusions We found the level of HIV knowledge among med in Ilembula, Tanzania to be considerably high, but a small number of men knew almost nothing. Though many men have enough information on the disease; they fail to implement it in terms of changing sexual risk behavior. The HIV problem is closely connected to poverty, and fighting poverty probably would be an effective mean of fighting HIV, e.g. less people would be forced into prostitution. Another effective way of preventing further spread would be to introduce free HIV tests, since many men hesitate to take the existing test due to test fees.