Abstract: After more than two decades of programming and activism aimed at prevention and control of the sexual transmission of HIV, the HIV pandemic continues to grow worldwide. Despite giving sexuality a prominent position in responses to the epidemic, there exist limited context specific understandings of sex health risks of Men who have Sex with Men (MSM) and their female partners of socio-cultural context. This paper discuses socio-cultural determinant of risk behaviors of MSM and their female partners of Targeted Intervention in Vadodara city, India. Such an improved understanding of the sexuality and sexual health risks of MSM is crucial for creating a scientific reference base for designing effective behavior change strategies in targeted interventions (TI).